[HN Gopher] Guinea worm disease nears eradication
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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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