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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 30; 334(7608): 1345.
PMCID: PMC1906622
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The end of the line for guinea worm

In 1986 an estimated 3.5 million people worldwide were infected with guinea worm. Twenty years later that figure has fallen to about 25 000, thanks to a global eradication campaign pioneered by former US president Jimmy Carter.Carter. Now in its final stages, the campaign has been successful without the help of a vaccine or even an effective treatment, writes one observer. It has relied instead on old fashioned public health measures executed by dedicated community volunteers. The whole campaign has cost a paltry $225m.

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Guinea worm is a waterborne disease spread by copepods harbouring the worm's larvae. People who drink contaminated water become infected, and about a year later the adult worms emerge from under the skin. The disease is painful, incapacitating, and economically costly for countries in the developing world where the disease is endemic, he says. Public education, projects to provide clean wells, and the distribution of fine meshes to filter other water supplies have reduced the number of countries with endemic disease to just nine. In 2006, five of them reported fewer than 30 cases each. All nine countries pledge to eradicate guinea worm by 2009.


  • N Engl J Med 2007;356:2561-4

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