As cases fall, the condition that once affected millions of people in Africa and Asia could also be the first to be wiped out without medicines
The number of instances of a painful and crippling tropical illness fell to a historic low last year, fueling aspirations that it will soon get to be the second disease to be exterminated in history.
According to the US-based Carter Center, only 13 cases of guinea worm disease were reported worldwide in 2022, a preliminary figure that if confirmed would be the smallest ever documented.
The small number of cases, down from 15 the previous year, is the result of more than four decades of global efforts to eradicate the parasitic disease through community mobilization and improved water quality in transmission hotspots.
If such attempts are effective, guinea worm will become not only the second illness in heritage to be eradicated, after smallpox, but also the first to be eradicated without the use of a vaccine or medicine.
“Our partners, particularly those in affected villages, collaborate with us on a daily basis to eradicate the world of this menace,” Jimmy Carter, the former US president who co-founded the Carter Center in 1982, said.
When the center took over the global elimination program in 1986, there were approximately 3.5 million human cases per year in 21 African and Asian countries. It has been extirpated in countries such as Pakistan, India, and Uganda, among others. Last year, the Democratic Republic of the Congo was added to the list.
Chad, which had six human cases last year; South Sudan, which had five; Ethiopia, which had one; and Angola, Mali, and Sudan, which had none, are the remaining endemic countries. One case has been reported and is being investigated in the Central African Republic, a non-endemic country.
For the disease to be declared eradicated, cases of guinea worm in animals must also be eliminated, and the numbers in this regard are improving. According to the Carter Center, animal infections decreased by more than a fifth last year.
There is no known way to stop the spread of guinea worm, also known as dracunculiasis, once infected. A year after the guinea worm larvae enter the body, usually through contaminated water, the affected person will experience severe pain due to the formation of a blister on their skin and the slow emergence of one or more worms measuring up to a metre in length. The person may be unable to work for several weeks or months.
According to Adam Weiss, director of the Carter Center’s guinea worm eradication program:
