The End of Guinea Worm?

Jan 17, 2016 | Colleen Nguyen | Outbreak News

Last week, The Carter Center announced that only 22 cases of Guinea Worm occurred in 2015 [1]. This signals a significant drop from the 146 cases of the disease that occurred in 2014 and indicates another step towards global eradication [1]. For 2015, Guinea Worm cases were reported from four countries – South Sudan, Chad, Ethiopia, and Mali [2].

 

All About Guinea Worm

Guinea Worm, also known as dracunculiasis, is considered a neglected tropical disease and is caused by the parasite Dracunculus medinensis [3]. People contract the disease when consuming stagnant water containing Guinea worm larvae [4]. Once consumed, both male and female worm larvae are able to mature and grow in an individual’s subcutaneous tissues [3,4]. Over the course of about a year, female worms, in particular, can grow to be approximately one meter long. The subcutaneous worm causes painful lesions or oedemas in the skin – occurring when the worm attempts forcibly emerge from the body [4]. To relieve the pain and burning sensation caused by the worm, those infected often immerse their limbs in water sources, resulting in the stimulation of larval release and resetting the cycle of transmission [4]. 

No vaccine exists to prevent Guinea Worm infection, though there are strategies available to prevent the larvae from being consumed [3]. These prevention strategies include the filtration of open bodied waters before drinking, implementation of vector control measures such as chemical larvicides, proper treatment of Guinea Worm, and promotion of health education and behavioral change [3].

While there now exists specific treatment for Guinea Worm, management and treatment of the disease often involves slow teasing and coiling of the worm around a stick, until its full emergence, and then application of topical antibiotic treatment to prevent from potential secondary infections [5].

 

The Road to Eradication

Since 1986, The Carter Center, alongside WHO and UNICEF, have led the charge in eradicating Guinea Worm [3]. In 1986, an estimated 3.5 million people were afflicted with the disease, primarily across Africa and Asia; since then, the incidence of Guinea Worm has been reduced by 99% [3,4]. However, because the incubation period for Guinea Worm spans up to a year, the WHO encourages ongoing surveillance to guarantee that no new cases are missed and to ensure complete eradication [6].

Another challenge facing Guinea Worm eradication includes difficulty accessing remote and rural areas, where the last remaining cases exist, which can also present a significant financial burden [6]. Finally, the discovery and emergence of Guinea Worm infection in dogs may further complicate eradication efforts; research investigating Guinea Worm in dogs is currently underway [6].

 

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Sources

[1] http://www.nytimes.com/2016/01/12/health/progress-in-jimmy-carters-quest-to-end-guinea-worm-disease.html

[2]  http://www.abc.net.au/news/2016-01-09/flesh-burrowing-guinea-worm-almost-eradicated/7077728

[3] http://www.who.int/dracunculiasis/disease/en/

[4] http://www.cartercenter.org/health/guinea_worm/index.html

[5] http://www.cdc.gov/parasites/guineaworm/treatment.html

[6] http://www.who.int/mediacentre/factsheets/fs359/en/

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