Then in a third phase, programs intensified surveillance efforts with the goal of identifying each case within 24 hours of the worm emerging and preventing the person from contaminating drinking water supplies. Most national programs offered voluntary in-patient centers, where those affected could stay and receive food and care until their worms were removed.In May 1991, the 44th World Health Assembly called for an international certification system to verify dracunculiasis eradication country-by-country. To this end, in 1995 the WHO established the International Commission for the Certification of Dracunculiasis Eradication (ICCDE). Once a country reports zero cases of dracunculiasis for a calendar year, the ICCDE considers that country to have interrupted guinea worm transmission, and is then in the "precertification phase". If the country repeats this feat with zero cases in each of the next three calendar years, the ICCDE sends a team to the country to assess the countrys disease surveillance systems and to verify the countrys reports. The ICCDE can then formally recommend the WHO Director-General certify a country as free of dracunculiasis.Since the initiation of the global eradication program, the ICCDE has certified 15 of the original endemic countries as having eradicated dracunculiasis: Pakistan in 1997; India in 2000; Senegal and Yemen in 2004; the Central African Republic and Cameroon in 2007; Benin, Mauritania, and Uganda in 2009; Burkina Faso and Togo in 2011; Côte dIvoire, Niger, and Nigeria in 2013; and Ghana in 2015. Other animals
In addition to humans, D. medinensis can infect dogs.
This is down from 27 cases in 2020, and dramatically less than the estimated 3.5 million annual cases in 20 countries in 1986 – the year the World Health Assembly called for dracunculiasis eradication. Dracunculiasis remains endemic in just four countries: Chad, Ethiopia, Mali, and South Sudan.Dracunculiasis is a disease of extreme poverty, occurring in places where there is poor access to clean drinking water. Cases tend to be split roughly equally between males and females, and can occur in all age groups. Within a given place, dracunculiasis risk is linked to occupation; people who farm or fetch drinking water are most likely to be infected.Cases of dracunculiasis have a seasonal cycle, though the timing varies by location. Along the Sahara deserts southern edge, cases peak during the mid-year rainy season (May–October) when stagnant water sources are more abundant. Along the Gulf of Guinea, cases are more common during the dry season (October–March) when flowing water sources dry up. History
Dracunculiasis has been with humans for at least 3,000 years, as the remnants of a guinea worm infection have been found in the mummy of a girl entombed in Egypt around 1,000 BCE. Diseases consistent with the effects of dracunculiasis are referenced by writers throughout antiquity. The disease of "fiery serpents" that plagues the Hebrews in the Old Testament (around 1250 BCE) is often attributed to dracunculiasis.