Guinea Worm

Jimmy Carter and the Guinea Worm

The Guinea Worm, Dracunculus medinensis, is a nematode which has infected humanity for millennia. It is a subject of interest because of the large size, up to three feet long, and the fact that infection with the worm is extremely painful as the worm makes its way within the body. Secondary infections can be lethal.

Knowledge of the infection dates back to antiquity. Some authors suggest that the closing verses of three stanzas of a poem in the Sanskrit book Rig-Veda, allude to the Guinea worm. The worm was well known to ancient Egyptians and has been found in mummies dating back to 2000 BCE.

The life history of the Guinea worm begins when contaminated water is consumed. The Guinea worm spends part of its life cycle as a larva in an intermediate host, a tiny copepod. When consumed by humans, the copepod dies and releases larvae. They bore through the stomach wall into the peritoneum where they mature. The smaller males mate with the females. Adult females then migrate to the skin, ultimately boring through the skin. When an the infected person then bathes the inflamed tissue in a body of water the female releases larvae, only to be consumed by copepods, renewing the cycle.

Traditional treatment is to extract the worm by slowly winding it onto a stick after it has broken through the skin, a process that can take hours to months long. This may be the source of the biblical allegory of Moses and the serpent. So the story goes, at one point while wandering in the wilderness, the Israelites were again being sinful so God sent serpents to the camp and the people started dying. God told Moses “ Make a snake and put it up on a pole; anyone who is bitten can look at it and live.”

This is also likely to be the origin of an ancient symbol – the Rod of Asclepius, the Greek god of healing. It is the major symbol for professional healthcare associations in the United States, the staff and snake being a proxy for a worm on a stick. It’s a single image instructional manual so to speak.

The disease due to infection is called Dracunculiasis. It has affected millions into the twentieth century, mainly in parts of Asia and sub-Saharan Africa. In 1986 the Carter Center, founded by President Jimmy Carter, estimated that there were 3.5 million people infected. With a small amount of funding and a big educational outreach, that number has dropped to 186, and is likely to be completely eliminated within a year or two. This will be the second disease eliminated from mankind, after Smallpox.

And the solution is so simple. The intermediate host, the copepod, is not a microscopic organism, but rather a little crustacean about the size of a small grain of salt. All that is necessary is to filter drinking water through a gauze-like membrane, even a bandana will do! Because there is no alternate host, once the organism is eliminated from the human population, the worm will be extinct.guinea
The Carter Center set in motion a program to train locals to teach this simple hygiene measure which will soon eliminate a grotesque disease which has afflicted humans for thousands of years. Thank you Jimmy Carter.

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