Helminthology I

June 19, 2008 - Harry Eagar
Say, this blogging caper has possibilities. Below is a column I submitted for Off Deadline in September 2001. It was not accepted but I saved it.

Nothing has happened since to change my mind:

Dracunculus medinensis is a human parasite. Otherwise called guinea worm or "fiery serpent," it causes "intolerable pain," according to the World Health Organization. Though it does not itself kill humans, it can encourage fatal bacterial infections. And it debilitates its victims, making them unable to take care of themselves or their families. Few Americans have heard of it, and it does not exist here. Even people who have the worm usually don't know about it for about a year. It is acquired by drinking water that contains infected crustaceans called cyclops, tiny copepods that live just about everywhere. The female guinea worm matures for about a year in her human host. When she is two feet long, she migrates down to a leg or foot and sticks her head through the skin, shedding millions of eggs which will infect a cyclops if they fall in open water. This is the intolerable pain stage, which can last for weeks or months -- longer if a series of worms is slowly emerging. There is no drug that impacts guinea worm, and it is unwise to try to pull an adult out. When its soft body breaks, the part left inside festers. This bland account hardly describes the hideousness of the disease. The best thing I have found that conveys the extent of suffering from guinea worm is a long passage in the novel "Cause Celeb" by the Englishwoman Helen Fielding, better known for "Bridget Jones' Diary." Dracunculiasis, as the disease is formally known, is "extraordinarily easy to combat," according to the WHO. Keep the sufferer away from open water. Nurse him. Slowly wind the emerging worm around a matchstick and throw it in the fire when the worm is entirely out. In recent years, guinea worm has been successfully attacked in many countries. Early in 2001, the Carter Center in Atlanta, which has made guinea worm one of its major projects, predicted that within a few years guinea worm would be extinct. That would make it the second or third human disease, after smallpox and perhaps polio, and the first human parasite to be eradicated. Like all parasites, guinea worm requires a precise set of environmental conditions to survive. Water and cyclops are easy to find, but the worm requires human hosts who are dirty, ignorant and callous. For that reason, in recent decades guinea worm has been restricted to the Koran Belt, from Morocco to India. Nevertheless, western public health technicians, notably from America and Norway, have made great progress against guinea worm even there. I started studying guinea worm in May 2001, with the intention of writing an Off Deadline column drawing attention to the ingenuity, diligence and selflessness of these foreign do-gooders. I have changed my mind. Now I am pulling for the worm.

UPDATE: The same factors that favor the worm -- ignorance and callousness -- also sabotaged eradication of polio since this column was written seven years ago.


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