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Meet the Guinea Worm

Screen Shot 2016-03-14 at 10.48.20 PM.pngGuinea worm disease is caused by a parasitic worm found in stagnant waters of Africa. It has been known since early recorded history with possible mentions in the Bible and a definite reference (along with a treatment method for removing the worm that is still used today) in the Ebers Papyrus, an ancient scroll written around 1500B.C.
Presently, only four countries, Chad, Ethiopia, Mali and South Sudan have reported cases of the disease. The worm, Dracunculus medinesis infects its (human) host through the drinking of unfiltered water inhabited by the larval forms that have been eaten by “water fleas.” When a person drinks water containing these water fleas, the larva are released from their insect host while in the stomach and burrow through the digestive tract into the body cavity where they grow into adult worms. After fertilization, male worms die in the host, but female worms can grow up to 2-3 feet long.

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A section of the Ebers Papyrus

The insidious nature of the beast is the way that it manipulates the host (human) when it is ready to release larvae. At this time, the worm will burrow to the surface of the skin (usually on the foot) where it will cause a blister. When the blister erupts, it causes a painful burning sensation that is somewhat alleviated when immersed in water.

Whenever the blistered area is immersed, the worm will eject a milky liquid containing millions of larvae into the water to repeat the life cycle. During this time, the pain can be disabling and the blisters are easily infected with bacteria.
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As the worm emerges, it can be captured and wound around a twig, etc. Pulling the worm will result in a break that worsens the condition, but if attended to, the worm can be removed a bit at a time as it emerges from the blister over the course of days to weeks.
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Since the 1980s eradication of the Guinea Worm has been aggressively pursued by a number of organizations, most notably the Carter Center, founded by President Jimmy Carter. The Carter Center has coordinated the efforts of the Nation Ministries of Health in affected countries, with the World Health Organization, The US Centers for Disease Control and Prevention, and UNICEF. Together, these organizations provide education to at risk populations, water filters, and pumps to obtain uninfected groundwater.
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These efforts have reduced the number of Guinea Worm Disease cases from 3.5 million in 17 countries in1986 to just 22 in four countries in 2015 (provisional total). Importantly, humans are the principal host of Guinea Worms, therefore, if all cases of infection can be eliminated for just one year, this should lead to complete eradication of the organism.

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Posted by on March 14, 2016 in Uncategorized

 

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Polio Does Not Go Gentle into that Good Night

While, as recently as 1988, there were as many as 350,000 cases of Polio per year, there were only 417 cases of polio recognized in 2013. At that time Polio was endemic in just three countries.

Old age … burn[s] and rave[s] at close of day.

So far this year there has been nearly 3 times the global number of cases of Polio as there was last year at this time.

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Though wise men at their end know dark is right

It’s not often that scientists will rally around the idea of intentionally pushing an organism to extinction, but this is exactly what disease eradication is – and it is the ultimate goal of all vaccination programs. The eradication of Smallpox has been hailed as one of the great successes in modern medicine. In fact, the philosophical arguments against making eradication the goal are not meant to subvert eradication, but actually to prevent complacence in monitoring programs and to avoid wasting money on tracking down ‘one last case’ of disease.

This said, a goal of the World Health Organization does have an endgame strategy for polio and plans on having it eradicated by 2018.

Rage, rage against the dying of the light.

Despite our best efforts, The Polio Eradication Initiative, in its May 2014 Special Alert, reports, “WHO Director-General Margaret Chan declared the recent international spread of wild poliovirus a ‘public health emergency of international concern,’ and issued Temporary Recommendations under the International Health Regulations (2005) to prevent further spread of the disease as the high season approaches.” This declaration has the weight of international law for the 194 signee countries.

Curse, bless, me now with your fierce tears, I pray.

Obstacles to final eradication remain largely human and political. Thinkprogress.org’s Hayes Brown reports that, “Pakistan has been the epicenter of attacks on vaccination programs, following the revelation that the CIA in 2010 used a fake vaccination campaign to hide their intelligence gathering efforts to locate Osama bin Laden. Since then, the Pakistani Taliban have now come to see all health workers as suspect and prime for targeting”

War, especially civil war, has led to countries such as Somalia, Pakistan and The Gaza Strip of Israel becoming reservoirs for disease and expanding the number of countries with wild polio.

ImageNevertheless, Even as polio does Rage against our efforts, it is still much reduced and there is no reason to give up hope that a combination of political and medical interventions will be sufficient to add polio to that short list of diseases that are ‘forever gone.’

 
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Posted by on May 6, 2014 in Uncategorized

 

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