Background
Dracunculiasis is an infection caused by the nematode Dracunculus medinensis, also known as the guinea worm.
D medinensis is in the order Spirurida, an order of parasites that includes the filariae Wuchereria bancrofti, Brugia malayi, and Loa loa.
The term dracunculus is Latin for “little dragon,” a misnomer and reference to the symbol. Thus, when the guinea worm disappears, one of the original inspirations for the discipline of medicine will also disappear. Currently, the infection persists and, although uncommon, can cause significant morbidity.
During ancient times, the presence of dracunculiasis can be inferred by the universally recognized symbol of medicine, the Greek asklepios (ie, Roman aesculapius), which consists of a one-headed snake wrapped around a stick. Dead female worms have also been found in Egyptian mummies older than 3000 years, and writings in ancient Sanskrit, Greek, and Hebrew refer to Dracunculus infection. To this day, the most effective method dracunculiasis treatment involves extraction by wrapping the worm around a stick
, as is seen in the image below.
A method used to extract a guinea worm from the leg vein of a human patient.
During the last 25 years, concerted efforts to eradicate the guinea worm have been undertaken and these have resulted in a reduction of more than 99% of worldwide cases of dracunculiasis. Thanks to a relentless campaign, this is poised to become the first disease since smallpox to be pushed into oblivion. The Carter Center has led the effort to eradicate the disease, along with the CDC, the WHO, UNICEF, and the Bill and Melinda Gates Foundation.
Guinea worm disease remains endemic in 3 countries: Sudan, Mali, and Ethiopia and fewer than 1,800 cases were reported in the world in 2010. The most prominent hot spot for guinea worm disease is South Sudan, which harbors 94% of current cases. Sporadic violence and civil unrest in Sudan and Mali poses the greatest threat to the final eradication of dracunculiasis.