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Tuesday, 17 July 2012

Disease eradication - find out which infection is set to disappear

Smallpox eradication was the pinnacle of public health efforts.  It demonstrated the capacity of the global community to unite for common cause that crossed political, religious and ideological boundaries.   Much was made of the effort and the success. The efforts started in 1958, were augmented in 1967, the last case recorded in 1977 and ultimately declared eradicated in 1980.

With much less pomp and publicity, a second disease is on the verge of eradication Scientific American report .  Yes efforts have targeted polio and measles, and at least for polio, the finish line may be just beyond the horizon – but the disease on the brink of extermination is dracunculiasis – or guinea worm infection.
Key to any disease eradication is that humans must be a required host.   The disease has predominately existed in Africa water consumption where the arthropod cycle of the parasite is hosted.  Eradiction is facilitated by improved sanitary conditions, filtering water supplies by even broad materials such as cloth, and appropriate education and management of cases.  

In 15 years the number of cases has dropped from 3.5 Million to just over a 1000 in 2011 and merely a handful reported so far in 2012.   Most cases are from the new autonomous country of South Sudan, where eradication efforts are slowed by poor water sources and political unrest of the past years.  The complex life cycle is a good example of typical parasitic diseases Wikipedia on Dracunculiasis.  

The interesting side story that seems to have gained some momentum is that the “snake” around the Rod of Aesculapius – the traditional symbol of medicine, was believe by some to have actually been a guinea worm, as the method of removal of the worm is to wrap the worm around a stick and extract sections at regular frequent intervals to extricate the worm which may ultimately be 2-3 meters in length.   This interpretation is not consistent with the use of snakes in ritualistic healing activites that followers of Aesculapian promoted and integrated into the Aesculapian symbol . 

However the analogy is worthy as it is a reasonable stylist depiction of the traditional method for guinea worm extraction. 

Polio remains the disease next on the brink of elimination.    

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