Health Programs

Guinea Worm Eradication Program


Often known as the "fiery serpent," Guinea worm disease (dracunculiasis) has existed since ancient times, but an international coalition led by The Carter Center is now close to eradicating it. With its access to world leaders, the Center is mobilizing government officials and garnering support for the Guinea worm disease eradication effort, while working at the village level to empower and educate communities to take simple measures to prevent the disease from recurring.

How Guinea Worm is Contracted

Guinea worm disease is contracted when a person drinks stagnant water that is contaminated with microscopic water fleas carrying infective larvae. Inside a person's body, the larvae grow for a year, becoming thin thread-like worms, up to 3-feet-long. These worms create agonizingly painful blisters in the skin, through which they slowly exit the body. People with emerging worms must not bathe or step in sources of drinking water, because a worm will release hundreds of thousands of eggs, or larvae, into the water. Water fleas then eat the larvae, and people who drink unfiltered water from the pond become infected -- continuing the life cycle of the parasite. View chart: The Life Cycle of Guinea Worm >>

Prevalence of Guinea Worm

When The Carter Center began leading the campaign to eradicate Guinea worm in 1986, there were an estimated 3.5 million cases of the disease in 20 countries in Africa and Asia. Today, there are fewer than 10,000 cases in five African countries—Sudan, Ghana, Nigeria, Niger, Mali.

Worldwide Cases

Map of Endemic Countries (PDF)

Number of Cases 1989-2007 (PDF)

Activities by Country

2007 Final Report of Guinea Worm Cases

2007 Map of Distribution of Cases (PDF)

2007 Distribution of Cases by Country Bar Graph (PDF)

2008 Provisional Report of Guinea Worm Cases

2008 vs. 2007 % Change in the Number of Indigenous Cases of Dracunculiasis: January-August (PDF) 

2008 Map of Distribution of Reported Cases by Country: January-August (PDF)

Impact on Communities

The presence of Guinea worm disease is an indicator of extreme poverty, including the absence of safe drinking water, in a community. Entire communities suffer, not just the individuals afflicted with Guinea worm disease. Victims are totally incapacitated as a worm emerges from their body. Children cannot attend school. Farmers cannot farm.

Communities suffer food shortages when their residents are unable to work. In southeastern Nigeria, rice farmers in a single county lost $20 million in just one year due to outbreaks of Guinea worm disease. View chart:

Treatment for Guinea Worm Disease 

There is no vaccine or medicine to treat or prevent Guinea worm disease. Infected people won't even realize they have it until a year after drinking contaminated water, when they will develop blisters as the worm begins to emerge. Once that happens, a local health worker or the patient will wrap the live worm around a piece of gauze, extracting it from the body little by little. The long, painful process often takes up to one month. 

Preventive Measures

Health education and low-technology measures to promote behavioral change are used to prevent Guinea worm disease. The most effective way to prevent it is to filter the tiny water fleas out of drinking water. The Carter Center provides families with fine-mesh filter cloths that fit over clay pots used to hold water.  Some people, especially nomadic groups, receive pipe filters, which are small straw-like personal filters that can be worn around the neck.  These simple but revolutionary devices enable people to drink water safely no matter where they are.

Other important interventions include treating ponds with a safe chemical larvicide called ABATE©, donated by BASF, and constructing boreholes or deep wells.

Banishing a Disease Forever

Humans are a Guinea worm's only host, so spread of the disease can be controlled by identifying all cases and modifying human behavior to prevent it from recurring.  Once all human cases are eliminated, the disease will be eradicated. Today, cases of Guinea worm disease are down more than 99% since 1986, making it poised to be the next disease after smallpox to be eradicated.

It will be the first parasitic disease to be eradicated and the first disease to be eradicated without vaccines or medicines. The only other "active" eradication campaign is against polio. The Carter Center's International Task Force for Disease Eradication has identified only six diseases as potentially eradicable.

Read more about the International Task Force for Disease Eradication.