The venom of social Hymenoptera is an important trigger for anaphylactic events. Currently available extracts for testing patients with venom allergy were standardized before recent changes in urbanization and introduction of invasive species. Failure to test for all relevant species may be one reason that these tests are unable to identify the cause of wasp venom allergies in some patients.1 In addition, cross-reactivity between species in the Vespidae (genera Vespa, Vespula, Dolichovespula, Polistes, Mischocyttarus) may cause positive test results in patients for whom the primary sensitization was not one of the species tested.2

Guinea worm (GW) disease, caused by Dracunculus medinensis, is an almost eradicated waterborne zoonotic disease. The World Health Organization currently lists GW as endemic in only 5 African countries. In July 2020 the Vietnamese public health surveillance system detected a hanging worm in a 23-year -old male patient, who did not report any travel to Africa or any country previously endemic for GW. The patient was hospitalized with symptoms of fatigue, anorexia, muscle aches, and abscesses with worms hanging out of the skin in the lower limbs. The worms were retrieved from the lesions and microscopically examined in Vietnam, identifying structures compatible with Dracunculus spp. and L1-type larvae. A section of this parasite was sent to CDC Atlanta for confirmatory diagnosis of GW. The adult worm had cuticle structures compatible with Dracunculus parasites, although the length of L1 larvae was about 339 µm, substantially shorter than D. medinensis. The DNA sequence analysis of the 18S small subunit rRNA gene confirmed that this parasite was not GW, and determined that the sample belonged to a Dracunculus sp not previously reported in GenBank that clustered with the animal-infective D. insignis and D. lutrae, located in a different clade than D. medinensis. This study highlights the importance of effective public health surveillance systems and the collaborative work of local public health authorities from Vietnam with WHO and CDC in the efforts to achieve the eradication of GW.