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Posted by bookofjoe 2 days ago

Guinea worm on track to be 2nd eradicated human disease; only 10 cases in 2025(arstechnica.com)
315 points | 151 comments
fanatic2pope 2 days ago|
Thanks, Carter!

https://www.cartercenter.org/programs/guinea-worm/

aaronblohowiak 2 days ago||
best _former_ president of all time.
overfeed 2 days ago|||
I won't stand for Carter slander: he was a darn good president too. What he wasn't good at, was politicking, and that was because he also was a good man, to a fault. He gave an honest answer to a question on if he had ever lusted after a woman who was not his wife, and reaped a scandal.
assaddayinh 2 days ago||
He created modern iran by trying to ditch the shah?
jakobnissen 2 days ago||
No way that created the modern Islamic Iran. Carter supporter the shah. To the extend USA decided the outcome, it was by supporting the shah for too long, and for the US role in the 1953 coup. But IMO the USa played third fiddle in that story, this was between Ruholla and the shah
wbl 2 days ago||||
He's helicopter crash away from being remembered as a daring wartime president.
rayiner 1 day ago||||
Pretty good president overall. Too bad he told America what they didn’t want to hear, like they had to make tradeoffs regarding energy use.
dyauspitr 2 days ago|||
I just listened to a the rest is history podcast and he had a few things he was lacking and wasn’t particularly flattering but he was an upstanding citizen at the very least.
dgoodell 2 days ago||
Rickover: Did you do your best? Carter: No, sir. I didn't always do my best. Rickover: Why not?
jswiss0424 2 days ago||
I worked for the Carter Center in South Sudan for a little less than a year in 2011. It was an extraordinarily tough job and required perseverance, humility, creative problem solving, negotiation, and acceptance. Events outside our control, like civil war, made eradication even harder.

The Carter Center teams should be very proud of what they accomplished. It would’ve been nice to get it done before Jimmy passed though

ahazred8ta 2 days ago|
Spread the word: "The guinea worm is on its last legs."
theGeatZhopa 2 days ago||
_"a lie has no legs *_ the guinea worm neither..
AngryData 2 days ago||
This is amazing, those things are an absolutely nasty parasite from out of a sci-fi horror movie. If you drink contaminated water with them it releases its larva into your body which burrow out of your digestive systems into your body consuming your nutrients for a year or more as it grows, then migrates towards your legs and creates debilitatingly painful blisters trying to force its way out over the course of weeks, and when you submerge the wound in water to relieve the burning pain it releases its larva into the water to infect others. Also don't try to pull it out even when its halfway out of your body or it will snap and die and give you a super nasty infection as it decays inside of you.
trhway 2 days ago||
>Also don't try to pull it out even when its halfway out of your body or it will snap and die and give you a super nasty infection as it decays inside of you.

Pardon probably stupid question, yet i'm wondering why (under local or general anesthesia of course) it isn't possible to "drain snake" the remainder of the worm and to clean/disinfect the worm channel that way. After all we insert similar flexible stuff into blood vessels from say thigh all the way up to the heart.

dathanb82 2 days ago|||
As you might expect from the description -- largely passed on via contaminated water -- the guinea worm is mostly present in areas of extreme poverty. Even if such a treatment were feasible, it would be inaccessible to most of the relevant population.
shattl 1 day ago||||
Not a stupid question at all, it's actually quite logical thinking. Here's why it's not that straightforward: The worm is extremely fragile. Guinea worms can be up to a meter long but are very thin and delicate. When you pull too quickly or forcefully, the worm breaks. This is the central problem — it's not like a catheter or guide wire, which are engineered to have tensile strength. The worm's body is essentially a thin biological tube filled with millions of larvae. Breaking it is the real danger. When the worm ruptures, it releases those larvae and bodily fluids into the surrounding tissue, triggering a severe inflammatory reaction, secondary bacterial infection, and sometimes abscess formation or sepsis. This is far worse than the worm itself. So the traditional slow winding onto a stick (a few centimeters per day) works with the worm's own gradual release from the tissue it's embedded in. The path isn't a clean channel. Unlike a blood vessel, which is a defined, smooth lumen, the worm sits winding through subcutaneous connective tissue. It doesn't create a neat tunnel — it's loosely embedded and adhered to surrounding tissue along its length. There's no "pipe" to snake a tool through. A catheter in a blood vessel follows a pre-existing anatomical highway; here there's no such structure. Surgical extraction is sometimes attempted, but it requires carefully dissecting along the entire worm's path without rupturing it — which is technically demanding, time-consuming, and requires facilities and skills that are often unavailable in the rural sub-Saharan communities where the disease occurs. For a worm that may wind through 30–60 cm of tissue, that's a significant operation for a condition that, while painful, is usually self-limiting. The real solution turned out to be prevention. The Carter Center's eradication campaign brought cases from ~3.5 million per year in the 1980s to fewer than 15 per year now, almost entirely through water filtration and education — making the surgical question largely moot. So in short: the worm isn't strong enough to pull, the path isn't clean enough to navigate, breaking it makes everything worse, and the settings where it occurs rarely have the surgical capacity for careful dissection.
trhway 1 day ago||
thank you, i see.

>the worm sits winding through subcutaneous connective tissue. It doesn't create a neat tunnel — it's loosely embedded and adhered to surrounding tissue along its length.

that's bad. In my thinking i in particular missed that it may be winding instead of being more streamlined like say blood vessels/etc. Stuff of nightmares. Now i imagined a one winding in the grooves of the brain ...

sdiupIGPWEfh 2 days ago|||
Anaphylactic shock, and possibly death, is a potential outcome from the worm breaking internally. Far too risky.
noman-land 1 day ago||
This is one of the more horrifying things I've read in recent memory.
MPSimmons 2 days ago||
I was going to say, "finally something that ivermectin can help with!" except https://pubmed.ncbi.nlm.nih.gov/7974686/
gus_massa 2 days ago||
Ivermectin is a very good dewormer! Most 2020 crap studies were easy to make because ivermectin was already distributed to big populations as a dewormer.

I'm the guy that every time someone calls it a good horse dewormer I reply: "And a good human dewormer too!"

duskwuff 2 days ago|||
> Ivermectin is a very good dewormer!

And that may be responsible for some false positives in ivermectin studies for COVID - if a patient has a parasitic infection as well as COVID, treating the parasites will improve their outcome.

storus 2 days ago||
Wasn't the ivermectin hypothesis based on it blocking NS3 helicase preventing double-stranded viral RNA from being unwound after replication? Paxlovid targets a few steps earlier by blocking 3CL protease that chops viral RNA into functional parts of a virus.
duskwuff 2 days ago||
That may have been the theory, but it seems more likely that, inasmuch as it appeared to improve outcomes in some trials, it did so by treating parasitic infections which were concurrently present. (Which makes sense! That's its primary application, after all.)
moralestapia 1 day ago||
What happens if you take Ivermectin but turns out you didn't have a parasitic infection?

Is it dangerous?

GenerocUsername 1 day ago|||
Very low risk. Ld50 is incredibly high. Side effects minimal. Adverse reactions very rare
kirykl 1 day ago|||
Dangerous only to your career and only if you posted about it on social media
jfengel 2 days ago||||
True. But you can't get a prescription for the human version unless you actually have worms. So if you're taking it for some other reason, you're probably getting the version for horses, which you can buy by the bucket.
giardini 2 days ago|||
Ivermectin is also prescribed for scabies and may sometimes be prescribed for bedbugs. It can be taken orally or in a topical version.
groundzeros2015 2 days ago|||
The media knowingly repeated “horse dewormer” because it made people they don’t like look dumb.
not2b 2 days ago||
People were literally buying horse dewormer when their doctors wouldn't prescribe it for them. "Influencers" were selling it. So the media were being accurate. To the extent that this made people look dumb, the intent was mostly to shame them into trying something more effective.
groundzeros2015 2 days ago||
> the intent was mostly to shame them

Yeah I don’t like news that does that, as opposed to giving the best information.

not2b 1 day ago||
You dropped my words "into trying something more effective". Steering people into treatments found to be more effective is, precisely, giving people the best available information. Ivermectin is great if you have a parasitic infection. It doesn't help against viral infections.
groundzeros2015 1 day ago||
Telling them which treatment is more effective is different than shaming, and also different than making up a misleading name like “horse dewormer”.
tzs 2 days ago|||
Well then, it's good you didn't say that then, considering that ivermectin has been on the WHO list of essential medicines since 1987 and its discoverers were awarded the 2015 Nobel Price in Physiology or Medicine for it.

Saying that something might be "finally something" that ivermectin can help with would have been embarrassing.

It would have been especially embarrassing because the link you gave gives two things ivermectin helps with. After concluding that ivermectin did not affect the guinea worms it says:

> No adverse reaction to treatment was seen. It appears that ivermectin can be used safely as mass chemotherapy against onchocerciasis and lymphatic filariasis in areas where guinea-worm is also endemic.

They are saying that if a patient has onchocerciasis or lymphatic filariasis it is safe to use go ahead and use ivermectin (which is the normal treatment for those) to treat those, even if the patient has guinea worms.

So good thing you didn't say it!

tim333 2 days ago||
It also poisons any bed bugs feeding on you.
david-gpu 2 days ago||
Anything that annihilates bed bugs is a net positive to the world. Drinking poison out of spite for those sons of the devil is well within reason. To hell with those infralings.
gus_massa 2 days ago||
Unless you overdose, it's not poison for you. Ask your medical doctor anyway.

From https://www.science.org/content/blog-post/what-s-ivermectin

> It acts most strongly on glutamate-gated chloride channels, which vertebrates don't even have.

They are like little holes in the wall of the cell of worms that can be opened and closed, and ivermectin locks them in the open position. A much better and more technical explanation https://pdb101.rcsb.org/motm/191

JohnMunsch 2 days ago||
Hey, let's not be defeatist. Give RFK Jr. a shot at it and we can bring it roaring back.
Tagbert 2 days ago|
We know that he’s very pro-worm
ThrowawayTestr 2 days ago||
What are you talking about? Dude loves ivermectin.
lysace 2 days ago||
The eradication program works by offering cash rewards for reporting cases in areas where the worm is present. Those reports are then investigated and followed to prevent transmission and identify the source.

Clever. I wonder if the same model can be reused for other diseases.

An example:

https://www.who.int/news/item/11-04-2014-south-sudan-introdu...

Any individual presenting with the disease who meets all the criteria for containment is now rewarded with 500 South Sudanese pounds (SSP). The informer is given 100 SSP.

MagicMoonlight 2 days ago|
I’m not sure it is clever, because you’re bound to get an entrepreneur who infects their local school to farm rewards. It’s inevitable with these kinds of schemes.
gus_massa 2 days ago|||
It has been done for snakes. Nobody minds you have a snake farm and sell them to the government. Neighbors may even sell you captured mices.

On the other hand, infecting the children at the school will make everyone go to your house, probably burn it and hit you until you are rescued by the police. Did I mention the local police chief has nephew in the school?

lysace 2 days ago||||
Somehow it seems to have worked here. There's probably a bit more to the secret sauce.
buellerbueller 2 days ago||||
You then create a bigger bounty to identify the entrepreneurs, and now it's bounties all the way down.
onraglanroad 2 days ago|||
500 SSP is about 4 USD. If you have the ability to come up with the scheme, you can do better with pretty much anything else.
palmotea 2 days ago||
The free market could never accomplish something like this.
tim333 2 days ago||
Maybe not just the free market but the Carter Center funding was 7% governments, 90% foundations, corporations and individuals. (fye 2024)
JumpinJack_Cash 2 days ago|||
Well people who made their fortunes beating other guys in politics or in business now want to graduate to the next hit that is beating nature.

So yes in a sense it is free market.

Especially disease eradication is beating nature in macrobiology and philantropic foundations are the optimal tool to do that.

Jblx2 2 days ago|||
https://ia803407.us.archive.org/0/items/i-pencil-pdf-2019/I%...
palmotea 1 day ago||
Come on. It's 2026: I, Pencil isn't a mic drop. It's a cliche. It's 70 years old, assume everyone's read it.

Also, your drop of it betrays a pretty fundamental lack of understanding. I stand by my statement that free market could never accomplish something like this. Eradicating a disease is nothing like a business making a pencil to sell.

marcosdumay 2 days ago|||
We nobody could ever achieve something like this without a free market taking care of most things.
onraglanroad 2 days ago||
There's no such thing as the "free market". It's a foolish propaganda term to try and assign people's actions to a philosophy they don't care about.
9875325996435 2 days ago||
[flagged]
dbvn 1 day ago|||
71% of their 2022-23 funding was from corporations soooo....
bugeats 2 days ago||
Consider what you might choose to do for the public good with the 30% of your income that is taken from you in the name of the public good.

Philanthropy is a predictable outcome of an individual having met the basic needs of Maslow’s hierarchy. Consider how many more philanthropists would be created by returning this 30% back to individual discernment.

ceejayoz 2 days ago|||
> Consider what you might choose to do…

Emphasis on might.

Evidence suggests "a giant boat and some helicopters" is the more likely result.

antonymoose 2 days ago||
I’d love to pay off my house early instead of giving 200% it’s worth to the banks in interest to hire the guys with the yachts.. Call me selfish.
ceejayoz 2 days ago||
And your house value doesn’t benefit from taxes? No utilities? No road? No regulations protecting you from shitty neighbors? No army keeping you safe?
mmooss 2 days ago||||
Is there evidence that it happens? And that it serves the public good, not the personal interests of the wealthy? Do we need another $100 million given to a health program accessible only to the wealthy, or funding for public health? To a business school or art museum, or to arts programs for public schools?

Philanthropy is anti-democratic; the people don't choose what is important to support, the wealthy few do. You can see that in the relatively poor public goods in the US, which has much lower taxes relative to peers.

janalsncm 2 days ago||||
Well my taxes go to roads, healthcare for people who can’t afford, schools, and the fire department. I would consider those public goods.
throwway120385 2 days ago||
Not to mention the one meal per day that many children would otherwise not eat. And sometimes the free breakfast that keeps their gnawing hunger at bay long enough for them to learn something in school.
harladsinsteden 2 days ago||||
Which 30% are you talking about? Taxes? If so: From what do you build things like infrastructure?
Loughla 2 days ago||
If you've ever worked with a church you know that donation and good will is not a way to ensure anything is structurally sound. Donations always come with asterisks.

Nobody wants to make sure the roof is shingled and doesn't leak but everybody leaves money for new stained glass windows or the organ that nobody knows how to play.

dennis_jeeves2 1 day ago||||
Lol, the reaction that you are getting to your post...

They sure have a pretty dim view of their fellow humans while paradoxically believing in the goodness of the gubberment.

One tiny correction to your post. While it's true that most income tax is in the region of 30%, the cumulative taxes would be of the order of 60% of what of what one could potentially earn. Cumulative taxes = income + payroll+ property taxes etc.

lostlogin 2 days ago||||
The billionaires out there are being revealed as paedophiles quicker than they are solving world health problems.

I’d prefer not to rely on them.

palmotea 2 days ago||||
> Consider how many more philanthropists would be created by returning this 30% back to individual discernment.

Many, many fewer than you assume.

Libertarians like to make lots of good-sounding promises to justify their favored radical policy, but it's bullshit and the promises don't pan out when tested [1]. By that point, the libertarian has gotten what he wanted and moved on.

[1] Or their policy was already tried and already failed, e.g. https://news.ycombinator.com/item?id=46876387, leading to reforms to fix the problems that they're now mad about and want to undo.

hobs 2 days ago|||
A lot less because they'd be dead from easily preventable diseases in their water supply?
I_dream_of_Geni 2 days ago||
Honest question here: how is a worm (parasite) considered a "disease"? I Googled this question two different ways and got two different responses.
cperciva 2 days ago||
The parasite is not the disease; the parasite causes the disease.

Similarly, SARS-COV-2 is a virus which causes Coronavirus Disease 2019 (COVID-19) and the Human Immunodeficiency Virus causes AIDS.

People often conflate parasites or viruses with the diseases they cause, and it's practically impossible to eliminate the diseases without eliminating the causative agent, but they are technically distinct concepts.

metalliqaz 2 days ago|||
We use "disease" for maladies caused by infections (virus, bacteria), and we use "disease" for maladies caused by genetics (cancer), caused by chemicals (lung disease), and so forth. So yeah, a parasite certainly would qualify I think.
I_dream_of_Geni 2 days ago||
And (weirdly, I think) a few years back they called alcoholism and smoking diseases, which, well, really??
nemomarx 2 days ago|||
I guess the same way a virus is a disease, in that a small living thing gets inside you and harms you / causes immune system reactions?

I think technically you get a parasite and then it causes a disease in reaction, but if it's a parasite you can spread it's basically fine to model it / talk about eradicating it in the same way right?

duskwuff 2 days ago||
How would you draw the line? The common cold, tuberculosis, malaria, and hookworm are all caused by foreign bodies which enter the human body, reproduce, and cause illness; the only difference is the size of those agents (virus, bacterium, single-cell parasite, multicellular parasite).
cubefox 2 days ago||
Sounds like there is still some way to go:

> To fully eradicate the disease, cases in animals (infected by the same species of worm) must also be wiped out. In 2025, animal cases were detected in Chad (147 cases), Mali (17), Cameroon (445), Angola (70), Ethiopia (1), and South Sudan (3).

jasongill 2 days ago|
Isn't fewer than 1000 infected animals in an area that covers 6 countries pretty good? Obviously there's still work to do, but I would have expected hundreds of thousands or millions of animal cases if it was an epidemic
jaggederest 2 days ago|||
Few cases is good, but if there are any, the whole machinery of surveillance, treatment, and education has to be in place. As soon as we reach 0 cases for a certain amount of time, all those resources can be redirected to other neglected tropical diseases that haven't been wiped out, like onchocerciasis, loa loa, yaws, lymphatic filariasis, trachoma, and all the others. Yaws in particular is a good candidate for eradication.
noname120 1 day ago|||
Are they just the known infected animals or is it an estimation of the total count of infected animals?
basilikum 2 days ago|
Eradication of the Guinea worm will be one of the huge milestones in the history of humankind. Just reading about them is nightmarish. In 1986 estimated 3,500,000 people had an infestation. Now we're well below 100. However eradication also needs animal cases to go to zero which are still in the hundreds.

Anyway, really great news about humanity beating one of its many terrible enemies just like the Malaria vaccine.

MrDunham 2 days ago|
I mentioned in another comment how hard it is for our brains to really comprehend the orders of magnitude difference between all animal cases (~680) and the former number of human cases (3.5M).

It would take ~5000 years at the current annual rate of animal cases to match the number of human cases just 40 years ago.

That's The Great Pyramid of Giza ago time... PLUS the amount of time since Michelangelo, Leonardo da Vinci, and Raphael roamed the earth.

The cool thing is that at a few hundred, one could theoretically* round up all (known) animal cases left. That's truly incredible work getting to this point if you think about it.

* Yes, geopolitical issues, geography, and plenty of other reasons might make this somewhat impossible... but the fact that we can actively picture a few hundred animals in our brains means that it's a very attainable goal.

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