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Just 14* human cases of Guinea worm disease occurred worldwide in 2021, drawing nearer to the goal of global eradication, The Carter Center announced Wednesday. It is the lowest annual case total ever recorded, and the cases occurred in just four countries. When The Carter Center assumed leadership of the global Guinea Worm Eradication Program in 1986, about 3.5 million human cases occurred annually in 21 countries in Africa and Asia.

Guinea worm
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The 14 cases mark a 48% decline from the 27 cases reported in 2020. Guinea worm infections in animals fell 45% in 2021, the Center reported.

Former U.S. President Jimmy Carter, who co-founded The Carter Center in 1982 with his wife, former First Lady Rosalynn Carter, was pleased with the news.

“Rosalynn and I are encouraged by the continued commitment and persistence of our partners and the citizens in the villages to eradicate Guinea worm,” he said. “Because of their persistence, this dreadful disease will be eradicated. Today we are closer than ever, and I am excited at the prospect of seeing the job finished.”

Carter Center CEO Paige Alexander said: “Eradication is an approaching reality. The national ministries of health, with our support, have implemented interventions that are working, and the result is a measurable reduction in human suffering and animal infections. That’s what this work is all about. We need to keep pressing to the finish line.”

During 2021, seven* human cases of Guinea worm disease were reported in Chad, a dramatic 42% reduction from 12 the previous year. Four* cases were reported in South Sudan, two* in Mali, and one* in Ethiopia. Angola and Cameroon, which each had one human case in 2020, had none in 2021.

“Chad’s Ministry of Health made significant strides against both human and animal cases in 2021,” said Adam Weiss, director of the Carter Center Guinea Worm Eradication Program. “Everyone in Chad, from the national leadership to the village volunteer, has shown a strong commitment to carrying out the interventions and protecting everyone against this disease.”

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As for Guinea worm infections in animals, Chad reported infections in 790 domestic dogs and 65 domestic cats, Cameroon reported 10 infected dogs along its border with an area endemic in Chad, and Mali reported 16 infected dogs and one cat. Ethiopia reported two infected dogs and one cat. Significantly, Ethiopia found no infections in baboons in 2021, compared to four infected baboons in 2020. The worms that infect animals are the same species (D. medinensis) as those that infect humans; therefore, eradication requires stopping infections in both.

Guinea worm disease is usually contracted when people consume water contaminated with tiny crustaceans (called copepods) that eat Guinea worm (Dracunculus medinensis) larvae. After about a year, a meter-long pregnant female worm emerges slowly through an excruciatingly painful blister in the skin, often of the legs or feet. A sufferer may seek relief by dipping the affected limb in water. However, contact with water stimulates the emerging worm to release its larvae and start the cycle all over again. Guinea worm disease incapacitates people for weeks or months, reducing individuals’ ability to care for themselves, work, grow food for their families, or attend school.

(*All annual figures are considered provisional until officially confirmed, typically in March.)

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