Humans have had dracunculiasis since at least 1,000 BCE, and accounts consistent with dracunculiasis appear in surviving documents from physicians of antiquity. In the 19th and early 20th centuries, dracunculiasis was widespread across much of Africa and South Asia, affecting as many as 48 million people per year. The effort to eradicate dracunculiasis began in the 1980s following the successful eradication of smallpox. By 1995, every country with endemic dracunculiasis had established a national eradication program. In the ensuing years, dracunculiasis cases have dropped precipitously, and 15 previously endemic countries have been certified to have eradicated dracunculiasis, leaving the disease endemic in just four countries: Chad, Ethiopia, Mali, and South Sudan. A record low 15 cases of dracunculiasis were reported worldwide in 2021. If the eradication program succeeds, dracunculiasis will become the second human disease ever eradicated. Signs and symptoms
The first signs of dracunculiasis occur around a year after infection, as the full-grown female worm prepares to leave the infected persons body. As the worm migrates to its exit site – typically the lower leg, though they can emerge anywhere on the body – some people have allergic reactions, including hives, fever, dizziness, nausea, vomiting, and diarrhea. Upon reaching its destination, the worm forms a fluid-filled blister under the skin. Over 1–3 days, the blister grows larger, begins to cause severe burning pain, and eventually bursts leaving a small open wound.
Plutarchs Symposiacon refers to a (now lost) description of a similar disease by the 2nd century BCE writer Agatharchides concerning a "hitherto unheard of disease" in which "small worms issue from [peoples] arms and legs... insinuating themselves between the muscles [to] give rise to horrible sufferings". Many of antiquitys famous physicians also write of diseases consistent with dracunculiasis, including Galen, Rhazes, and Avicenna; though there was some disagreement as to the nature of the disease, with some attributing it to a worm, while others considered it to be a corrupted part of the body emerging. In his 1674 treatise on dracunculiasis, Georg Hieronymous Velschius first proposed that the Rod of Asclepius, a common symbol of the medical profession, depicts a recently extracted guinea worm.Carl Linnaeus included the guinea worm in his 1758 edition of Systema Naturae, naming it Gordius medinensis. In Johann Friedrich Gmelins 13th edition of Systema Naturae (1788), he renamed the worm Filaria medinensis, leaving Gordius for free-living worms. Henry Bastian authored the first detailed description of the worm itself, published in 1863. The following year, in his book Entozoa, Thomas Spencer Cobbold used the name Dracunculus medinensis, which was enshrined as the official name by the International Commission on Zoological Nomenclature in 1915. Despite longstanding knowledge that the worm was associated with water, the lifecycle of D. medinensis was the topic of protracted debate. Alexei Pavlovich Fedchenko filled a major gap with his 1870 publication describing that D. medinensis larvae can infect and develop inside Cyclops crustaceans.