About a year after infection, a painful blister forms – 90% of the time on the lower leg – and one or more worms emerge accompanied by a burning sensation. To soothe the burning pain, patients often immerse the infected part of the body in water. The worm(s) then releases thousands of larvae (baby worms) into the water. These larvae reach the infective stage after being ingested by tiny crustaceans or copepods, also called water fleas.