Guinea Worm
What Is Guinea Worm? A parasite that enters the human body in contaminated drinking water, grows for almost a year and emerges through a burning blister in the skin.
Symptoms: Symptoms begin just before the worm starts to emerge from the blister. Victims suffer intense pain, often accompanied by bacterial infection and inability to walk.
Can It Be Eradicated? Yes. With no medical cure or vaccine, eradication will be achieved by interrupting the life cycle of the parasite through education, community empowerment, and low-tech interventions like water filtration.
Status: On track for ERADICATION
Only one human disease, smallpox, has ever been eradicated. But soon a second infection will join the list: Guinea worm disease, a painful and debilitating condition caused by the Guinea worm—known to many as the “fiery serpent.” There is no medicine to cure Guinea worm disease and no vaccine to prevent it. Yet it can be stopped.
Guinea worm is not new. Many scholars believe the biblical “fiery serpents” that attacked the children of Israel in the Old Testament were actually Guinea worms. A calcified Guinea worm was even discovered in a 3,000-year-old Egyptian mummy. This engraving from the 1600s shows physicians in Persia (now Iran) removing Guinea worms from their patients’ legs.
A Case Study In South Sudan
The Curse of the Fiery Serpent
Humans have known the searing pain of Guinea worm disease since ancient times, and the common treatment for the disease goes back centuries as well. It involves wrapping the worm around a stick or piece of gauze while gradually—but painfully—extracting it over several weeks. Emerging worms often cause secondary bacterial infection, and depending on where the worm is, there can be long-term paralysis.
On a human level, Guinea worm’s effects are painful and debilitating. On an economic level, they are disastrous. Infected children cannot attend school, and adults cannot farm or tend to their cattle. In Mali, Guinea worm is known as “the disease of the empty granary” because of the starvation it has caused.
The Carter Center/Louise Gubb
The Carter Center/Louise Gubb
Worm-Free Water
Guinea worm disease is spread through water—more specifically, by the copepods that carry Guinea worm larvae. These tiny crustaceans—no more than a couple of millimeters long—thrive in the stagnant ponds and lakes that provide the only source of drinking water in many communities.
Filtering water through a simple mesh fabric, however, removes the copepods, rendering the water 100% Guinea worm free. Since the early 1990s, The Carter Center has worked closely with national health ministries to distribute millions of free filters, teach people how to use them properly and help residents understand the importance of water filtration. Although it hasn’t been easy, this low-tech intervention has prevented millions of cases of Guinea worm disease across sub-Saharan Africa and parts of Asia.
The Carter Center/Louise Gubb
The Carter Center/Louise Gubb
Tracking and Containment
When the goal is eradication, it’s not enough to stop some or even most cases of the disease. Health workers must work tirelessly to track down every single case of Guinea worm disease. When a suspected case is reported, teams set out to find the afflicted person, confirm the diagnosis, identify the infected water source, and break the chain of transmission as quickly as possible. Only when every case is contained can eradication be achieved. Suspected Guinea worm patients are encouraged to come to “case containment centers,” which keep the patients from entering local water sources and spreading the disease. At these centers, worms are also safely extracted and patients have access to bathing facilities, fresh bedding, latrines and healthy food for themselves and their families.
The Carter Center/Louise Gubb
The Carter Center/Louise Gubb
Health Education
While the tools of Guinea worm eradication—a plastic tube or cloth filter—may seem simple, the process of eradication is anything but simple. It’s not enough to hand out filters or establish containment centers. People will only change their behavior if they understand the need for these interventions and are convinced of their value. That’s where education comes in.
Throughout sub-Saharan Africa, thousands of local volunteers have been trained not only to treat infection, but also to raise awareness and teach others about the disease. At the peak of the eradication effort, village volunteers were operating in more than 23,000 African villages. Because many people can’t read, workers get the message out in creative ways—through T-shirts, picture books, performances, radio broadcasts and visits from national leaders.
The Carter Center/Louise Gubb
The Carter Center/Louise Gubb
Challenges
After decades of intense work, Guinea worm eradication is nearly complete. And yet the final push will be especially difficult. The last few cases will likely be found in some of the most remote and war-torn communities. But an eradication effort isn’t successful until it succeeds everywhere.
The remaining endemic areas are mostly insecure or conflict-ridden zones. Fighting in parts of South Sudan and northern Mali make it extremely difficult for health workers to move about freely and to provide necessary services. Refugees from war zones—in addition to the movements of nomadic populations—add to the challenges of tracking and containing new cases.
A more recent challenge is a large number of domesticated dogs in Chad contracting Guinea worm. In Chad’s fishing villages, dogs eat raw fish or fish guts carrying Guinea worm larvae and are infected, even though they are not the parasite’s natural host.
Successes
The global Guinea Worm Eradication Program has already prevented some 80 million cases of Guinea worm disease while educating and empowering people in thousands of communities. And by working closely with local and national health providers, the campaign has helped to strengthen the healthcare infrastructure in 21 African and Asian countries.
Where Guinea worm has been eliminated, adults can work without interruption and children attend school more regularly. Poverty has decreased, and productivity has gone up.
The Carter Center/Peter DiCampo
The Carter Center/Louise Gubb