Progress Toward Global Eradication of Dracunculiasis, January 2016–June 2017

Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on a lower limb (1). Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for dracunculiasis elimination,* and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with endemic dracunculiasis. In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (2). Since then, although the goal of eradicating dracunculiasis has not been achieved, considerable progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2016 has declined by >99%, and cases are confined to three countries with endemic disease. This report updates published (3-4) and unpublished surveillance data reported by ministries of health and describes progress toward dracunculiasis eradication during January 2016-June 2017. In 2016, a total of 25 cases were reported from three countries (Chad [16], South Sudan [six], Ethiopia [three]), compared with 22 cases reported from the same three countries and Mali in 2015 (Table 1). The 14% increase in cases from 2015 to 2016 was offset by the 25% reduction in number of countries with indigenous cases. During the first 6 months of 2017, the overall number of cases declined to eight, all in Chad, from 10 cases in three countries (Chad [four], South Sudan [four] and Ethiopia [two]) during the same period of 2016. Continued active surveillance, aggressive detection, and appropriate management of cases are essential eradication program components; however, epidemiologic challenges, civil unrest, and insecurity pose potential barriers to eradication.

[1]  E. Ruiz-Tiben,et al.  Guinea Worm (Dracunculus medinensis) Infection in a Wild-Caught Frog, Chad , 2016, Emerging infectious diseases.

[2]  E. Ruiz-Tiben,et al.  Progress Toward Global Eradication of Dracunculiasis -January 2015-June 2016. , 2016, MMWR. Morbidity and mortality weekly report.

[3]  E. Ruiz-Tiben,et al.  Possible Role of Fish and Frogs as Paratenic Hosts of Dracunculus medinensis, Chad , 2016, Emerging infectious diseases.

[4]  Dracunculiasis eradication Global surveillance summary , 2015 .

[5]  N. Holroyd,et al.  The Peculiar Epidemiology of Dracunculiasis in Chad , 2014, The American journal of tropical medicine and hygiene.

[6]  E. Ruiz-Tiben,et al.  Dracunculiasis eradication: and now, South Sudan. , 2013, The American journal of tropical medicine and hygiene.

[7]  Charbel El Bcheraoui,et al.  Renewed transmission of dracunculiasis--Chad, 2010. , 2011, MMWR. Morbidity and mortality weekly report.

[8]  Meeting of the International Task Force for Disease Eradication, April 2011. , 2011, Releve epidemiologique hebdomadaire.

[9]  E. Ruiz-Tiben,et al.  Dracunculiasis (Guinea worm disease) eradication. , 2006, Advances in parasitology.

[10]  J. Gerberding,et al.  Progress toward global eradication of dracunculiasis. , 1995, MMWR. Morbidity and mortality weekly report.

[11]  S. Watts Dracunculiasis in Africa in 1986: its geographic extent, incidence, and at-risk population. , 1987, The American journal of tropical medicine and hygiene.