SEATTLE — After the recent Ebola outbreaks in West Africa that infected more than 27,000 people and claimed 11,000 lives (NBC News), it should come as a relief to hear that another, historically more prevalent tropical disease now dwindles on the verge of eradication. This easily overlooked but crippling infection is called Dracunculiasis, more commonly known as Guinea-Worm Disease.
Known as the “disease of the empty granary” in afflicted countries like Mali, the parasitic Guinea-worm can incapacitate its hosts for months at a time. Infections often coincide with the times of harvest, leaving many sick and indoors when agrarian labor is most needed (‘Eradicating Guinea Worm Disease’, WHO).
Perhaps the most frightening aspect of this disease is the parasite itself. After entering the body through contaminated drinking water, Guinea Worm larvae incubate for about a year inside the host’s abdomen. At the end of this period, a female worm growing up to a meter long works its way to the surface of the skin. It creates a burning lesion as it slowly surfaces from the body. Many victims attempt to quell the pain by submerging themselves in nearby water sources, which only prompts the emerging worm to spread its larvae. Sadly, in a vain attempt to find relief, sufferers only perpetuate the disease (Carter Foundation).
This unfortunate life-cycle has plagued societies since ancient times when it was well documented throughout India, Greece and the Middle East. In fact, according to a WHO briefing on the disease, “it is believed that the ‘fiery serpent’ that afflicted the Israelites during the Exodus was Dracunculus medinensis” (WHO). Even then the disease, endemic mostly to Egypt and Assyrian Mesopotamia, garnered the attention of Roman and Greek philosophers and physicians like Galan, Agatharchides and Plutarch (WHO).
A couple thousand years later, Guinea Worm still thrived with 3.5 million new cases of Guinea Worm occurring in 1986 (WHO, Global Health Observatory). These infections arose in essentially the same locations as in antiquity. With cases reported in 21 countries throughout Asia and Africa, Guinea Worm extended from India all the way to Senegal on Africa’s western coast (WHO and Carter Center).
Prompted by these figures, the WHO, WHO, UNICEF, the Carter Center and other NGOs began working towards fighting Guinea Worm disease. Unable to find a vaccine or any effective medicine, these groups found ways to stop the insidious life-cycle of the parasite at its source: drinking water.
They sought to raise awareness about the disease and to educate afflicted communities about water sanitation (Carter Center). At the same time, they used larvicide to decontaminate infected water sources.
The results after 30 years are astounding. Compared to the 3.5 million cases reported in 1986, only 126 cases occurred in 2014. Overall, the Carter Center estimates, the combined global health campaign prevented at least 80 million infections of Guinea Worm. It also created the infrastructure to provide rural villages with public health education and personnel that can plan interventions for other diseases (Carter Foundation). Today, the final remnants of Guinea Worm concentrate only in four countries, Chad Ethiopia, Mali and South Sudan, with half of the total infections in Sudan. However, this final stage of eradication seems the most challenging. With cases occurring in isolated areas, it has become increasingly difficult to monitor and treat Guinea Worm.
With only three cases reported this year, though, the eradication of Guinea Worm seems imminent. Once gone, it will serve as a significant milestone in the history of public health; along with Small Pox, Guinea Worm will be the only other disease eliminated by mankind. Moreover, it will also be only disease that humanity has cured without the use of medicine or a vaccine. Now that is an achievement.
– Andrew Logan