[HN Gopher] Guinea worm disease nears eradication
       ___________________________________________________________________
        
       Guinea worm disease nears eradication
        
       Author : pseudolus
       Score  : 189 points
       Date   : 2022-02-13 11:56 UTC (11 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | FollowingTheDao wrote:
       | Am I the only one who feels sad for dracunculus medinensis?
        
         | rectang wrote:
         | Surely not.
         | 
         | There are those who feel sympathy for any living creature.
         | There are those who espouse a non-human-centric philosophy of
         | existence, some of whom view the elimination of other classes
         | of organisms either neutrally or negatively. There are those
         | who are hostile in varying degrees to the population afflicted
         | by the guinea worm and who, disconnected from their suffering,
         | are ambivalent about the cessation of that suffering.
         | 
         | Any individual in those groups might change their perspective
         | if the guinea worm's menace were made more tangible to them --
         | if they or those close to them were infected, or perhaps if
         | they were to witness the suffering of the afflicted up close.
         | But the range of human emotion and ideology is vast.
        
           | nekcihc wrote:
           | I for one do not wish to have any such worm in my body, but
           | eradication of whole species(in other words - genocide)
           | raises some moral questions and also some other issues that
           | have to be dealth in near future.
           | 
           | Apparently, in this case humans already are giving advantages
           | to baboons and if they multiply too many - humans again will
           | need to intervene to kill them to maintain their "normal"
           | numbers.
           | 
           | The solution to the worm and other parasites is very simple -
           | boil your water before using it. Swim only in pools that have
           | been threated against parasites. Instead the offered solution
           | is to sterilize all water in nature - in jungle environment,
           | that is infested with life, that by nature is hostile to
           | humans and others. I suppose, that the thinking of
           | eradication of these worms comes from how they are dealing
           | with malaria.
        
         | BurningFrog wrote:
         | I have no hate for the worm, but it's literally eating people,
         | and it needs to go.
        
         | ycombinete wrote:
         | Quite possibly!
        
           | FollowingTheDao wrote:
        
         | thriftwy wrote:
         | There were a joke website arguing for its preservation, but as
         | usual, Google can't find it for me.
        
           | lkbm wrote:
           | There's this: http://www.deadlysins.com/guinea-worm
           | 
           | I also remember seeing that website years ago, and I feel
           | like this isn't it (or at least that it's been redesigned). I
           | seem to remember the classic unstyled text of the early web.
        
       | pyuser583 wrote:
       | One absolutely terrifying disease down. 100,000 more to go.
        
       | aaron695 wrote:
        
       | Arubis wrote:
       | Fabulous news. This has been a long time coming.
        
       | amelius wrote:
       | Let's not keep any left over specimens in a lab.
        
         | inglor_cz wrote:
         | In all likelihood, 100 years from now mere knowledge of the
         | entire genetic code will suffice to recreate the animal from
         | scratch. You won't even have to store specimens.
         | 
         | Perhaps much sooner than that, at least with worms. This is a
         | simple organism, it does not need 9 months in a womb like we
         | do.
        
           | pmoriarty wrote:
           | _" In all likelihood, 100 years from now mere knowledge of
           | the entire genetic code will suffice to recreate the animal
           | from scratch."_
           | 
           | For some animals, maybe. I'm not so sure of those that
           | require a womb.
           | 
           | A living organism born from a womb is not just the result of
           | its genetics, but also of its interaction with its parent
           | while in the womb.
           | 
           | If an animal is extinct, then you won't have an animal of its
           | species to gestate in, so you'd be forced to either use a
           | different animal or an "artificial womb" (if that ever
           | becomes possible). In either case the environment it gestates
           | in will be different from gestation in the real animal of its
           | own species.
           | 
           | It's an open question whether the result of that will really
           | be the same as the extinct animal, even if the genes are the
           | same.
        
             | inglor_cz wrote:
             | Yes, that is definitely an important questions. We are
             | probably not that far from fuctional artificial wombs (the
             | research into them seems to be slowed down by ethical
             | concerns rather than by outright impossibility), at least
             | for some animals, but they won't be the same as natural
             | wombs, and the effects down the line are ... unclear to say
             | the least.
        
         | choeger wrote:
         | Oh come one what could possibly go wrong? We'll just store the
         | specimen over there, right next to our synthetic samples of
         | vaccine-evading COVID-19.
        
         | lettergram wrote:
         | It's not a deadly disease it's a parasite. Though I do believe
         | humans are the primary hosts. Filtering water, using deep Wells
         | or anti-parasitic drugs are what's driving down the number of
         | cases.
         | 
         | https://en.m.wikipedia.org/wiki/Dracunculiasis
        
           | strainer wrote:
           | Your link actually states "There is no medication or vaccine
           | against the disease."
        
             | ethbr0 wrote:
             | It's a disease (a set of symptoms) and a parasite (the
             | cause of the symptoms / disease). It is not bacterial or
             | viral. If we're looking for accurate words.
        
               | strainer wrote:
               | Ah, I didn't even notice the contention over the word
               | 'disease'. I just found it notable that there are no
               | anti-parasitic drugs for it, according to the WP article.
        
       | msarrel wrote:
       | We've been "near guinea worm eradication" for 25 years.
        
         | pg_bot wrote:
         | There has been significant progress over that time period.
         | There were approximately 10,000 cases in 2007. There were 14
         | cases in 2021. It may take a few more years to get to zero, but
         | that means no one will ever have to deal with this parasite
         | ever again.
        
       | BeFlatXIII wrote:
       | Is polio still the next most likely disease to be eradicated
       | after Guinea worm?
        
         | Beltalowda wrote:
         | Some types of the poliovirus are already eradicated! The polio
         | case is exceedingly frustrating as it's been hindered by the
         | Taliban, Boko Haram, and the likes with their stupid "this is a
         | tool for massacre Muslims!!11" and similar rhetoric. It's not
         | inconceivable Polio would already have need eradicated if it
         | wasn't for that, and COVID didn't help either due to shifting
         | priorities and such.
         | 
         | The good news is that the Taliban did a u-turn on this after
         | taking over last year, and now vaccination efforts in
         | Afghanistan are underway again. Small silver lining from the
         | Taliban takeover I guess :-/
         | 
         | At any rate, current hopes for polio eradication seem to be for
         | 2026[1], whereas Guinea worm is 2030.
         | 
         | [1]: https://polioeradication.org/gpei-strategy-2022-2026/
        
           | ars wrote:
           | No, that's not the biggest problem. The biggest problem is
           | cVDPV2 (i.e. vaccine derived type 2 Polio). Type 2 Polio is
           | extinct in the wild, but the vaccine derived version refuses
           | to stop.
           | 
           | The trouble is the only way to stop cVDPV2 is to immunize for
           | it - but that same immunization is what creates cVDPV2 in the
           | first place.
           | 
           | Until a better vaccine arrives, it doesn't look like we'll
           | ever eradicate it, Taliban etc aren't changing that. However
           | there might be good news:
           | 
           | "March 2021 saw the first use of the modified nOPV2 vaccine
           | in selected countries. This was engineered to allow
           | vaccination against strain 2 poliovirus without the frequent
           | spawning of cVDPV2 seen with the original OPV2. Full rollout
           | was not expected until 2023."
           | 
           | If that works, then eradication might succeed.
        
             | Beltalowda wrote:
             | I was under the impression that vaccine derived polio would
             | eventually fizzle out after the entire population becomes
             | vaccinated (i.e. "herd immunity")?
        
               | ars wrote:
               | That was the idea - but it failed. Type 2 does not exist
               | in the wild, it's all from vaccine derived. It got so bad
               | they stopping giving type 2 vaccine, but then people have
               | no immunity to the vaccine derived version - but if you
               | give the vaccine, then the vaccine causes more cases (of
               | type 2) than it's stopping.
               | 
               | There's no solution here - either option makes things
               | worse.
               | 
               | So I hope the new version of the vaccine works, because
               | otherwise this will fail.
               | 
               | Type 3 appears basically extinct - both in the wild, and
               | vaccine derived. Only type 1 still exists in the wild,
               | and vaccine derived type 2.
        
               | gus_massa wrote:
               | IIUC the idea is to mix the oral vaccine with attenuated
               | virus with only the types 1 and 3, and the injectable
               | vaccine with inactive virus with the types 1, 2 and 3.
               | https://en.wikipedia.org/wiki/Polio_vaccine#Schedule So
               | you have coverage for the three types.
               | 
               | (It's more complicated. For example country without
               | recent cases and good vaccine coverage only use the
               | injectable vaccine.)
        
           | gus_massa wrote:
           | The fake vaccination campaign by the CIA in Pakistan didn't
           | help either. https://en.wikipedia.org/wiki/Save_the_Children#
           | Expulsion_fr...
        
             | GauntletWizard wrote:
             | The real vaccination campaign with alternate motives.
             | Nobody who got a shot there wasn't vaccinated. That they
             | also carried out surveillance was regrettable, because it
             | did create a negative narrative, but the vaccines weren't
             | fake.
        
             | Beltalowda wrote:
             | Gosh, I didn't know about that. What a short-sighted
             | programme - and all with the very limited purpose to
             | perhaps maybe catch one guy :-/
        
       | sanj wrote:
       | We have been here before:
       | 
       | https://www.nature.com/articles/d41586-019-02921-w
        
         | ethbr0 wrote:
         | The fact sheet has an apt comment: _" Eradication can be
         | certified only when surveillance can be carried out in all
         | areas to show transmission has been interrupted in humans and
         | animals. Parts of some affected countries are inaccessible to
         | the program because of internal armed conflict. Resolution of
         | these conflicts is key to eradication."_
        
       | swayvil wrote:
       | They say the guinea worm inspired HR Geiger when he did his work
       | on Alien (1979).
        
         | alexfoo wrote:
         | It also appears in the novel _ Miss Smilla's Feeling for Snow_
         | by Peter Hoeg.
        
           | swayvil wrote:
           | There is also a worm in Adventure Time. It drinks tea. A
           | clear allusion to filthy river water.
        
       | throwthere wrote:
       | Fact sheet about the program---
       | https://www.cartercenter.org/resources/pdfs/factsheets/CC-GW...
        
         | ahazred8ta wrote:
         | Their newsletter is "The Guinea Worm Wrap-Up"? That's painful
         | in more ways than one. Fortunately the Guinea Worm is on its
         | last legs. (ahem)
        
         | readthenotes1 wrote:
         | IMO, Carter is the 2nd best ex-President of the United States.
         | 
         | (Washington is 1st because he was the first ex-President)
        
           | staticautomatic wrote:
           | He's pretty good as presidents who sponsored genocides go
           | (East Timor, for those who don't know).
        
             | tialaramex wrote:
             | I actually don't know the details for East Timor, but,
             | presumably Carter didn't _personally_ sponsor this, like as
             | a hobby after he was President or something - instead it
             | was US government policy and it remained US government
             | policy to turn a blind eye to what was happening in East
             | Timor and presumably as the US President receives high
             | quality global intelligence briefings Carter will have had
             | a pretty good idea what it was turning a blind eye to.
        
               | drekk wrote:
               | If you don't know the details why are you speaking on it?
               | Jimmy Carter increased US military aid to Indonesia as we
               | knew they were committing genocide and selling donated
               | Red Cross supplies. 90% of the weapons Suharto used in
               | the invasion of East Timor were supplied by the United
               | States. And we were responsible for the coup that put
               | Suharto in power.
               | 
               | You can spin it however you want to try and defend poor
               | Jimmy Carter, but I know Americans would not make the
               | same effort for, say, Xi Xinping.
        
               | tialaramex wrote:
               | I can't speak for Americans, but I'm sure to some extent
               | Xi Jinping (that's who you meant right?) is railroaded by
               | the existing situation of the PRC. That of course doesn't
               | magically make him not responsible for things done by
               | China under his control - for say, Hong Kong's "National
               | Security Law", or the attempted expansion of Chinese
               | control in the South China Sea not to mention the
               | Uighurs, but it's also not as though he seized power one
               | afternoon and China's policies changed overnight to
               | reflect his personal preferences. We are a product of our
               | society.
               | 
               | For example China can't just wake up on a Tuesday morning
               | and become a thriving modern industrialised democracy.
               | Even if Xi Jinping desperately wanted that (and I've no
               | reason to think he does) it can't be done, so there's a
               | huge gap between what you might wish and what these
               | leaders can actually do with their power. Do you think
               | that East Timor would have been stopped if Gerald Ford
               | had won the 1976 election instead of Carter? Would he
               | have picked up the phone and said "Sorry, changed my
               | mind, if you don't pack up and leave East Timor I will
               | bomb you into the stone age"? No?
               | 
               | Lots of countries tacitly supported Indonesia. Australia
               | basically wanted to split the loot, which is in some
               | sense morally worse than selling them arms; the UK sold
               | guns and military aircraft to Indonesia during the
               | fighting; India argued that such invasions are legitimate
               | (and like the US it closed its eyes to the torture, rape
               | and murder) because of its own history of such de-
               | colonial activities. Lots of blame to go around so far as
               | I can see. Carter deserves some share of that blame.
        
               | macintux wrote:
               | It seems an unfortunate truth that moral purity is
               | impossible for the leaders of the largest countries.
               | Every decision is made with complex trade-offs and
               | regrettable consequences even for the "right" choice.
        
               | creato wrote:
               | And this is why it is so destructive when low effort
               | peanut gallery commentary gains traction in society.
        
               | macintux wrote:
               | The era of the soundbite has radically transformed
               | politics, and definitely not for the better.
        
           | DiogenesKynikos wrote:
           | John Quincy Adams.
           | 
           | After retiring from the Presidency, he was elected to the
           | House of Representatives, where he was one of the leading
           | opponents of slavery.
           | 
           | Washington didn't do much after retiring, because he died
           | soon after.
        
           | throwaway6734 wrote:
           | Carter is an incredibly underrated president as well: he
           | appointed Volcker to the Fed Board & he began the military
           | buildup that bloomed under Reagan.
        
             | throwawayboise wrote:
             | I think Carter is a decent human being, served his country,
             | a devout Christian, and has done a lot of good in his post-
             | presidency. But he was a terrible president. My father, a
             | lifetime straight-ticket D voter, could not bring himself
             | to vote for him a second time. The economy of the late 70s
             | was a nightmare. High inflation, double-digit interest
             | rates, low growth. Energy crisis (I remember sitting in
             | school with most of the lights off and wearing winter coats
             | because the heat was set so low). Iranian hostage crisis,
             | and rescue debacle. It was not a good time.
        
               | lordnacho wrote:
               | Why is the president responsible for how the economy
               | goes? To me it seems like one of those things that's easy
               | to mess up but hard to improve. It's also the result of a
               | lot of interactions, so blaming or crediting the
               | president seems unfounded.
        
               | HarryHirsch wrote:
               | The president heads the executive and at the and of the
               | day is responsible for setting industrial policy,
               | economic policy and foreign relations. Of course he is
               | responsible (but we all know that in truth the country is
               | run by appointed civil servants, all of who are under 40
               | years old).
        
               | throwaway6734 wrote:
               | High inflation was solved via Volcker nuking the economy
               | under Reagan. Volcker was appointed by carter
        
               | kwhitefoot wrote:
               | > The economy of the late 70s was a nightmare.
               | 
               | And that was Carter's fault? I think you give him to much
               | blame (or credit depending on your point of view).
               | 
               | the idea that one person can have such rapid effects
               | seems to me to be one of the most pernicious in politics.
               | 
               | The causes of many of those late 70s problems were much
               | earlier than Carter's presidency, And the oil crisis was
               | largely over by then anyway.
        
               | ethbr0 wrote:
               | > _rapid effects_
               | 
               | Absolutely. We often judge Presidents as though the state
               | of the country today was defined by their decisions
               | yesterday. Or even by their predecessors a few months or
               | years ago.
               | 
               | And they shouldn't avoid blame! They are in the most
               | powerful seat in the US government.
               | 
               | But at the same time, economic timescales are lengthy,
               | and often more than 4 or 8 years.
               | 
               | I get _why_ : because the people pushing that framing are
               | doing so as political PR (positive or negative). But we
               | shouldn't confuse the inaccurate framing with the
               | underlying truth.
        
           | [deleted]
        
           | baybal2 wrote:
           | Democratic party transformation from the party of the deep
           | south, to a hipster, liberal one in just around 1 decade is
           | truly remarkable.
           | 
           | Remember, Carter won the vote in 1976! Just few years after
           | the Vietnam war.
        
             | pjc50 wrote:
             | .. I put that at about a five decade period? "Hipster"
             | wasn't really a thing until about the Obama era, and the
             | "party of the deep south" ended round about the Civil
             | Rights Act?
             | 
             | Carter lost due to (a) oil crisis inflation driven by OPEC
             | and (b) the botched military operation in Iran, neither of
             | which outcomes were really within his control.
             | 
             | (The emphasis on Benghazi used against Hilary Clinton was
             | clearly driven by this strategy having worked previously)
        
           | lisper wrote:
           | First is not necessarily best. But Washington deserves credit
           | for setting the precedent of becoming an ex-president
           | _voluntarily_. That was a big deal at the time.
        
             | brnt wrote:
             | And seems to be again...
        
               | lisper wrote:
               | Indeed. :-(
        
             | jml7c5 wrote:
             | It's worth noting that Washington simply didn't want to be
             | president any more. Leaving politics was also relief of his
             | personal burden, rather than solely a noble sacrifice for
             | republican values. He was exhausted after years of public
             | service, his health was growing worse, and he was deeply
             | frustrated by the mismanagement of his farm. In short: he
             | was burnt out and wanted well-earned rest.
             | 
             | That isn't to say he was blind to the dangerous precedent
             | that would be set by remaining president until death. After
             | all, he was president of the Society of the Cincinnati.
             | (Named after Lucius Cincinnatus, a Roman who was given
             | emergency dictatorial powers (two times?), which he
             | relinquished when they were no longer necessary.) But he
             | didn't want to remain president anyway, so the decision was
             | not a fraught one.
             | 
             | Source: half-remembered details from Ron Chernow's
             | "Washington: A Life"
        
           | bigbillheck wrote:
           | Carter didn't own nearly as many people.
        
           | ethbr0 wrote:
           | Carter no doubt has marketing behind the name and stellar
           | executive teams at his various associated programs.
           | 
           | But as far as I can tell, he's the only recent ex-President
           | who's kept up a similar pace of work and results since:
           | everyone else finishes and retires.
           | 
           | His book was a decent read too. In a "some things are just
           | right and good" way. https://www.amazon.com/Hour-Before-
           | Daylight-Memories-Boyhood...
        
           | wnoise wrote:
           | He also signed into law home brewing, which greatly improved
           | beer in the U.S.
        
         | sdoering wrote:
         | Thanks for the fact sheet. Quite an impact since 1986.
        
       | hdevarajan wrote:
       | It is believed that those snakes you see in the logo for medical
       | services (caduceus) are actually Guinea worms as physicians used
       | to advertise their services that way. See for example
       | 
       | https://medium.com/@DrWink/what-does-the-caduceus-represent-...
        
         | kergonath wrote:
         | AFAIK this is not the mainstream understanding (to say the
         | least). A source better than a medium post would be useful.
        
           | hdevarajan wrote:
           | https://en.wikipedia.org/wiki/Caduceus_as_a_symbol_of_medici.
           | ..
           | 
           | ".. older representations from Syria and India of sticks and
           | animals looking like serpents or worms are interpreted by
           | some as a direct representation of traditional treatment of
           | dracunculiasis, the Guinea worm disease."
        
         | crooked-v wrote:
         | You've posted an article that conflates the two symbols, but
         | the caduceus means different things than the Rod of Asclepius
         | and has different origins despite the similar appearance.
        
           | hdevarajan wrote:
           | Actually, no. https://en.wikipedia.org/wiki/Caduceus_as_a_sym
           | bol_of_medici...
        
         | [deleted]
        
       | mhalle wrote:
       | Here's an interview with Don Hopkins, the point person for the
       | Carter Center's Guinea worm eradication efforts (the job he took
       | up after helping lead worldwide smallpox eradication):
       | 
       | https://www.hsph.harvard.edu/news/multimedia-article/were-be...
        
         | MaxBarraclough wrote:
         | For anyone else wondering: no, it looks like it's not the same
         | person as HackerNews regular _DonHopkins_.
        
       | happytiger wrote:
       | Is this true eradication or elimination? A reduction to zero
       | cases is amazing and awesome, but is there ever a chance of the
       | disease being truly eliminated?
        
         | lettergram wrote:
         | Seems humans are the primary hosts, so yes it's possible.
         | 
         | https://en.m.wikipedia.org/wiki/Dracunculiasis
        
           | jessriedel wrote:
           | > Because dogs may also become infected,[4] the eradication
           | program is monitoring and treating dogs as well.
        
             | inglor_cz wrote:
             | Same with baboons. This wasn't expected when the intent to
             | eradicate was declared and the existence of animal
             | reservoirs complicates things.
        
         | morelisp wrote:
         | True eradication was the original goal, but since 2016 there's
         | a zoonotic reservoir in dogs which complicates that. If not for
         | that it would've been eradicated a few years ago and it's
         | currently unknown if that can be brought under control.
        
           | selimthegrim wrote:
           | Discovered in 2016? Was it preexisting?
        
             | morelisp wrote:
             | My understanding (not an expert - just saw the articles in
             | 2016-2017) is that it might have been pre-existing but no
             | one was looking because human-human transmission was
             | overwhelmingly dominant.
             | 
             | But I had he date wrong - apparently it was first observed
             | in 2012, but only became a significant vector in 2016
             | (presumably as humans stopped being such accessible hosts).
        
       | basementcat wrote:
       | The current standard treatment for this disease was described as
       | early as 1550 BCE in the Egyptian medical literature.
       | 
       | https://en.m.wikipedia.org/wiki/Ebers_Papyrus
        
         | ruined wrote:
         | some things are just obvious. it's hard to be more effective
         | than "grab it and pull"
        
           | chasil wrote:
           | ...gently, for about a month.
           | 
           | https://en.wikipedia.org/wiki/Dracunculiasis#Treatment
        
             | nerdponx wrote:
             | Thousands of years is plenty of time for trial and error!
        
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