Brian Jeffrey
Nguyen Xuan Q., a 43-year-old resident from An Thinh commune in Van Yen district, Yen Bai province, was shocked to discover a 70cm long parasite in a swollen, pus-filled area on his leg. It wasn’t until he had removed worms on two occasions that he decided to seek assistance at a central medical facility.
At Dang Van Ngu Hospital, part of the National Institute of Malariology, Parasitology and Entomology, Mr. Q. reported firm, noodle-like growths beneath his skin indicative of a parasitic infection.
“I have extracted worms at home a few times. I went to a local hospital but didn’t trust the treatment, so I came here for a more reliable solution,” he remarked.
Having grown up in a mountainous area, Mr. Q. regularly consumed raw vegetables, uncooked foods, and spring water, never realizing these habits could expose him to parasites.
While working in construction in Hanoi, he first noticed a bothersome patch on his leg. Though it wasn’t painful and didn’t cause a fever, it eventually swelled and became hard. Initially assuming it was just a boil, he chose to wait. When it eventually softened and oozed pus, he squeezed it and was startled to find a lengthy, thread-like creature.
“At one point, I removed a flat worm, thinking it might be a tapeworm. Another time, I pulled out a white worm near my knee that measured roughly 70cm before it broke,” he shared. After hearing about similar issues in nearby villages and conducting some online research, he suspected he had contracted dragon worm disease. Alarmed about not being able to fully extract the parasite, he visited local clinics and was advised to go to a provincial hospital, where another worm was removed.
“Once, I was able to extract the entire worm – even its head was still moving,” he remembered.
Ultrasound imaging at Dang Van Ngu Hospital confirmed the presence of a dragon worm beneath his skin. He received a prescription and specific instructions on managing his condition. “Should you extract any more worms, please contact us immediately so we can collect samples for epidemiological studies,” Dr. Tran Huy Tho recommended.
Dr. Tran Huy Tho, Deputy Director of Dang Van Ngu Hospital, noted that Vietnam currently lacks a specific treatment protocol for dragon worm infections. The approach focuses on worm removal and proper wound care.
The suggested method involves keeping the wound away from communal water. The area should be cleaned and immersed in water using a basin or similar container to encourage the worm to contract and release larvae. The worm is then carefully wound around gauze or a stick to maintain tension, facilitating its extraction. This procedure can take days or even weeks, as the worm may be over a meter in length. It is essential to extract it slowly to prevent breakage.
Medical practitioners typically administer local antibiotics to avert secondary infections, along with anti-inflammatory medications such as aspirin, ibuprofen, or alphachymotrypsin until the entire worm is removed.
According to Dr. Tho, the probable source of infection is untreated spring water containing water fleas that harbor the parasite. Symptoms can be vague but may include dizziness, nausea, diarrhea, local redness, numbness, and joint pain. In certain instances, the worm can calcify and lead to abscess formation.
Vietnam was declared free of dracunculiasis (dragon worm disease) by the WHO in 1998, with no recorded cases of Dracunculus sp. until April 2020, when the first case emerged in Phuc Ninh commune, Yen Binh district. The National Institute of Malariology has reported a total of 25 cases between May 2020 and November 2024.
Dr. Tho confirmed that nearly 30 cases have been documented in Vietnam from 2020 to 2025 across 19 communes in 11 districts within five provinces: Hoa Binh, Lao Cai, Phu Tho, Thanh Hoa, and Yen Bai.
With no vaccine or definitive treatment available for the disease, Dr. Tho calls for medical facilities to improve surveillance efforts to detect human and animal infections (including in pets) within 24 hours of the emergence of the worm. This is crucial to prevent complications like wound infections or sepsis.
Preventative strategies include ensuring the provision of safe drinking water, barring infected individuals and animals from entering water sources, and using larvicides (temephos) to manage water flea populations. There is a need for public health campaigns that promote safe food and water practices while raising awareness about parasitic diseases.
Dr. Tho stressed the importance of consulting appropriate medical specialists for accurate diagnosis and timely treatment. Though the disease is not life-threatening, it can cause significant discomfort and distress for those affected.
