Abstract
Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is acquired by drinking water containing copepods (water fleas) infected with its larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, causing pain and disability (1). The worldwide eradication campaign began at CDC in 1980. In 1986, the World Health Assembly called for dracunculiasis elimination, and the global Guinea Worm Eradication Program (GWEP), led by the Carter Center in partnership with the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and others, began assisting ministries of health in countries with dracunculiasis. There is no vaccine or medicine to treat the disease; the GWEP relies on case containment* to prevent water contamination and other interventions to prevent infection, including health education, water filtration, chemical treatment of water, and provision of safe drinking water (1,2). In 1986, an estimated 3.5 million cases† occurred each year in 20§ African and Asian countries (3,4). This report, based on updated health ministry data (3), describes progress during January 2017-June 2018 and updates previous reports (1,4). In 2017, 30 cases were reported from Chad and Ethiopia, and 855 infected animals (mostly dogs) were reported from Chad, Ethiopia, and Mali, compared with 25 cases and 1,049 animal infections reported in 2016. During January-June 2018, the number of cases declined to three cases each in Chad and South Sudan and one in Angola, with 709 infected animals reported, compared with eight cases and 547 animal infections during the same period of 2017. With only five affected countries, the eradication goal is near, but is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic questions.
Highlights
Persons about dracunculiasis during immunization campaigns; 86% of persons living in areas of active surveillance were aware of the cash reward for reporting an infected person
During 2017, South Sudan reported no cases of dracunculiasis in humans for the first time (Table 1); only one infected animal has been reported
The worm occurred in a child who had never traveled outside her home area and was discovered during a nationwide search for dracunculiasis as Angola prepared for WHO certification that it had no endemic disease
Summary
During January–June 2018, the number of cases declined to three cases each in Chad and South Sudan and one in Angola, with 709 infected animals reported, compared with eight cases and 547. Comparisons of the numbers of reported D. medinensis cases between years and countries have been made (Table 1). During January 2017–June 2018, CDC evaluated 120 worm specimens that emerged from humans, including 114 (95%) in countries with endemic dracunculiasis (47 from Chad, 17 from Ethiopia, and 50 from South Sudan), and six (5%) in countries not known to have currently endemic dracunculiasis (one from Angola, one from Cameroon, and four from the Democratic Republic of the Congo). During January–June 2018, 18 specimens from animals were submitted, and 17 (94%) were identified as D. medinensis, from Ethiopia (nine dogs), Mali (five dogs), and Chad (one cat, two dogs)
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