Guinea Worm: Parasitic Infection Nearing Extinction

Officials at the Atlanta-based Carter Center said this week that the effort to eradicate the Guinea Worm parasite — a scourge that dates back to Biblical times — is now 99 percent complete.

In an elaborate ceremony in Atlanta to honor Niger and Nigeria, the latest in a string of Asian and African countries declared guinea worm-free, Dr. Donald Hopkins, the Center official leading the campaign, cited the last three holdouts.

“Ghana, Mali and Sudan remain to be honored in a fifth and final ceremony,” he said.

We reported on efforts to rid Sudan of the parasite in April:

Former President Jimmy Carter has won widespread praise for spearheading one of the most successful — and at about $300 million — inexpensive public health campaigns in recent times. By comparison, the global effort to wipe out polio, which has seen recent setbacks, has cost $8 billion.

Carter attributes much of the success to a culturally astute and respectful partnership with local rural communities for reducing the incidence from more than 3.5 million cases in 1986 when the campaign began to fewer than 1,800 last year, the vast majority of those in war-torn and hard-to-access southern Sudan. The finish line is well within sight, campaign workers say, “within my lifetime,” says the 86-year-old Carter.

Already, the former president points out that much of the campaign’s dividends have been realized — mostly in restored agricultural productivity that was taken out by the crippling infection. But some public health experts say it’s important to be able to declare a total victory.

Dr. Stephen Blount of the Centers for Disease Control and Prevention says it would provide a much-needed fillip for the cause of global health. To date, small pox remains the only disease ever eradicated. That was in 1979.

More importantly, Blount says the guinea worm campaign mobilized hundreds of thousands of volunteers in 20 countries who can now be pressed into service on the myriad other public health challenges — everything from surveillance to childhood immunizations. This wasn’t done after the small pox campaign, he notes.

For now, even as victory seems in their grasp, the guinea worm campaigners must look over their shoulders. At least two countries previously declared free of the parasite (and similarly feted at the Carter Center) saw fresh outbreaks. They likely were transmitted by migrants from neighboring endemic countries, according to Hopkins.

“We won’t ask Ethiopia and Chad to return their awards, but we won’t have them back when they become disease free again,” he told the gathering, confidently predicting that they would in fact regain that status.

So nervous are the Nigerians about a recurrence of the dreaded parasite that the country’s health ministry is offering a reward of $65 — a hefty sum there — for anyone who spots a case of guinea worm.

People have reported their mothers’ varicose veins, said the country’s health minister at the Atlanta gathering, but for almost two years now, no cases of the dreaded worm known in the scientific literature as Dracunculiasis.

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