Guinea worm – Could it become the second eradicated disease in human history?

Humans are on track to eliminate a second disease from the face of the planet, guinea worm (the first was smallpox in case you forgot your human history). Guinea worm is a parasitic worm that is transmitted only by people drinking water containing parasite-infected water fleas. Guinea worm disease is rarely fatal though it causes long-term debilitating disease when the worm has grown large enough to erupt of of the body (from wherever it wants). Guinea worm mostly affects people living in rural areas who rely on stagnant ponds for their drinking water. Guinea worm propagates through people and there are no other animal reservoirs, making eradication possible.

There’s no known vaccine or medication for guinea worm, we’ve been battling it the same way for thousands of years, by slowing wrapping the erupted worm around a stick to manually extract it. Nice, huh (I won’t show a picture but just Google “guinea worm” and see for yourself). You can imagine how painful that is, and some people try to lessen the pain by putting the affected area in water, thereby allowing the worm to release eggs into the water to start the cycle all over again.

Guinea worm life cycle

There are only 4 countries where guinea worm is still endemic: Chad, Mali, Ethiopia and South Sudan. This is compared to the 20 countries where it was endemic in 1990. The Carter Center has lead the campaign to eradicate guinea worm, reducing cases from 3.5 million in 1986 to 148 in 2013. From January 1,2014 to November 21, 2014 there were only 122 cases of guinea worm disease. Humanity has been able to achieve this near eradication through community-based interventions like filtering water and keeping people with an emerging worm from going into the water. This is a big deal because it shows that diseases like guinea worm that don’t have an animal reservoir and don’t have medication for prevention can be overcome through relatively inexpensive (but sometimes challenging to implement) interventions like behavior changes.

While total eradication may not happen in 2015 (as it takes anywhere from 10-14 months after someone has ingested contaminated water before the worm erupts) I am confident we can eradicate guinea worm in this decade. I wasn’t quite alive yet when smallpox was eradicated but I will be alive for the eradication of guinea worm, and what a public health achievement that will be.

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