Headed to History’s Dust Bin: Guinea Worm Disease (Dracunculiasis)

“Only 10 human cases of Guinea worm disease (dracunculiasis) were reported worldwide in 2025, the fewest ever recorded, bringing the parasitic disease closer than ever to eradication.”

The Carter Center, January 30, 2026

“I would like to see Guinea worm completely eradicated before I die. I’d like for the last Guinea worm to die before I do.”

Former President Jimmy Carter, speaking at a press conference in 2015

In 1982, former President Jimmy Carter and his wife Rosalynn founded the Carter Center, a non-governmental, not-for-profit organization whose mission is to advance human rights and alleviate human suffering. For 40 years, the Center has led the international campaign to eradicate (meaning “to get rid of completely”) Guinea worm disease (GWD).

In 1986, when the Center assumed leadership of this campaign, there were 3.5 million cases of GWD occurring annually in 20 countries in Asia and Africa. Now there are only 10 cases worldwide. GWD is therefore poised to be only the second human disease in history to be eradicated from planet Earth. (Smallpox is the only human disease that has been eradicated from our planet.) In this Germ Gems’ post, I provide an overview of this nasty parasitic infection.

What is Guinea worm disease? GWD or Dracunculiasis is one of 21 neglected tropical diseases—a group of preventable and treatable diseases that affect more than one billion people around the world. It is a parasitic disease caused by the nematode (round worm) Dracunculus medinensis. It predominately affects rural, underserved, and remote populations that rely on open stagnant water sources for drinking water. Thankfully, GWD is rarely fatal.

D. medinensis is transmitted to humans by drinking water contaminated with small crustacean copepods (tiny “water fleas”) containing the larvae of D. medinensis. (Rawal, P., Jan, R., “Dracunculiasis,” NCBI Bookshelf, August 22, 2023). The larvae mature into adult worms. The male worms die after impregnating the female worms who then migrate through the subcutaneous tissue. Approximately one year after infection, the mature pregnant female worm  seeks an exit site on the body from which to emerge in order to expel her larvae when in contact with water. (“Guinea Worm Disease,” CDC, March 14, 2024). Most worms emerge from the lower extremities, that is the legs or feet, but can come out of any other parts of the body as well. 

The worm can cause blistering and ulceration at the point at which it exits. And systemic symptoms like fever, rash, nausea, vomiting and diarrhea can develop. The key is once the worm emerges it is important to extract the entire worm—a spaghetti-sized worm measuring up to a meter long—from the body. This process can take eight weeks or more.

The process for extracting the worm has not changed much since ancient times; it consists of winding the worm around a small stick and slowly pulling it out by applying gentle traction to avoid breaking the worm.

Topical antibiotics can be used to avoid the development of secondary bacterial infections and anti-inflammatory agents can be used to decrease pain and swelling. There is, however, no medication that is effective against GWD. There is no vaccine against GWD. Instead, prevention and surveillance measures have brought this disease to the brink of eradication.

No cigars, quite yet. Improving access to clean water was the central intervention that drove a greater than 99% reduction in GWD cases culminating in the all-time low this past year of just 10 human cases confined to three countries (Chad, Ethiopia, and South Sudan). But Guinea worm in animals are the same species that affects humans. Therefore, complete eradication requires interrupting the transmission cycle in both humans and other animals.

Animals remain a key barrier to eradication and animal transmission is more persistent and challenging than human transmission. Last year, global animal cases increased slightly to over 600, driven by higher counts in Cameroon (445), Chad (147), and Angola (70) with smaller numbers in Mali, Ethiopia, and South Sudan. (Report from the Carter Center, January 3, 2026).

Nonetheless, the Center is committed to eradicating GDW. As Adam Weiss, director of the Center’s Guinea Worm Eradication Program said, “Guinea worm causes immense suffering—not just for the individual but for their family and community as well. Every case is a real person we know by name. They are enduring a disease we know how to prevent, and we’ve been given this opportunity to wipe it out completely. We are energized by this year’s progress, but zero is the only acceptable number and that’s why our commitment to finishing this job is unwavering.”

If the Center does eradicate GWD, it would be only the second disease to be eradicated in history but the first parasitic disease eradicated and the first disease eradicated without a vaccine or medicine. I wish them and all those at the Carter Center working on this project Godspeed.