GENEVA MEETING TO AGREE ON STANDARDS FOR CERTIFYING ERADICATION OF GUINEA WORM DISEASE
Press Release
H/2901
GENEVA MEETING TO AGREE ON STANDARDS FOR CERTIFYING ERADICATION OF GUINEA WORM DISEASE
19960306 GENEVA, 5 March (WHO) -- As part of the final chapter of a highly successful global campaign, an international body, under the guidance of the World Health Organization (WHO), will meet for the first time today in Geneva to deliberate on the conditions for certifying that individual countries have eradicated dracunculiasis, or guinea worm disease.The International Commission for the Certification of Dracunculiasis Eradication is expected to reach agreement upon the scientific criteria for determining eradication, taking into account the risk of importation from neighbouring countries, as well as the need to maintain cross-border surveillance.
Dracunculiasis is the only parasitic disease that might be completely eradicated in the near future. Global eradication will be certified after all clinical manifestations of the disease are absent worldwide for three years. Until now, smallpox remains the only disease ever to be eradicated by human effort, the results of a WHO-led campaign hailed as perhaps the single greatest achievement in the history of the United Nations.
The campaign against guinea worm began in 1980 within the context of the International Drinking Water Supply and Sanitation Decade. Progress since then has been dramatic, especially considering the fact that most national eradication programmes did not get under way until 1990. Although widely distributed at the beginning of the twentieth century, the disease today exists in only 18 countries, 16 of which are in Africa south of the Sahara. Between 1986 and 1995, the number of endemic villages around the world was reduced from 23,000 to fewer than 8,000, many of which today experience only a handful of cases. The number of cases worldwide fell from 3.5 million in 1986 to just 120,000 cases in 1995, a 97 per cent reduction rate. Half of all cases now occur in a single country, the Sudan.
Some of the major national success stories include:
-- Pakistan, which used an intensive programme of cash incentives for disease reporting and nation-wide system of surveillance, so that no cases of guinea worm disease have been reported since October 1993, and certification is expected in the near future;
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-- Cameroon, which had only 14 cases reported last year, most of them imported, and may become the next country after Pakistan to eliminate the disease;
-- India, the world's first country to implement a national eradication campaign, which was reduced the number of cases from nearly 40,000 in 1984 to just 60 in 1995, all of them occurring in a remote group of villages in Rajasthan;
-- Nigeria, using control measures and a national village-based surveillance campaign has cut prevalence from 653,000 cases in 1988 to 16,374 in 1995; and
-- Ghana, which a campaign similar to Nigeria's, has reduced cases almost as dramatically from 180,000 in 1989 to 8,500 in 1995.
The main focus of concern is now the Sudan, where almost 58,000 cases of guinea worm disease were reported in 1995 and widespread civil strife continues to hamper eradication efforts. A cease-fire was declared last year to facilitate control activities against a number of diseases, including guinea worm, river blindness, polio, measles and others.
Dracunculiasis is caused by the parasite Dracunculus medinensis. It is the largest of the tissue parasites affecting humans, growing to lengths of up to one metre. Following infection, the parasite migrates throughout the body causing severe discomfort. As the worm emerges, patients develop intolerable pain accompanied by fever, nausea and vomiting. Infected persons often remain sick for several months because super-infections are frequent.
Guinea worm disease is contracted by drinking contaminated water and typically reappears every year in endemic countries during the agricultural season. There are no drugs or vaccines for the disease. The world-wide campaign to eradicate dracunculiasis is a joint effort involving the WHO, the United Nations Development Programme (UNDP), the United Nations Children's Fund (UNICEF), Global 2000, bilateral and multilateral funding agencies, non- governmental organizations and national ministries of health.
For more information, please contact Michael Luhan, Health Communications and Public Relations, WHO Geneva, Tel: (4122) 791-3221; or fax: 791-4858; e-mail: luhanm@who.ch; or Dr. Philippe Ranque, Chief, Dracunculiasis Eradication Service, Tel: (4122) 791-3874.
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