November 18, 2016
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Eradication setbacks slow global decline of dracunculiasis

Although the CDC announced progress in overall dracunculiasis eradication, cases increased 25% during the first half of 2016 with reports from four endemic African nations, according to data from MMWR.

“The overall 83% reduction in cases from 2014 to 2015 is the largest such annual overall reduction achieved during this global campaign,” Donald R. Hopkins, MD, MPH, special advisor for Guinea worm eradication at The Carter Center, Atlanta, Georgia, and colleagues wrote. “During the first 6 months of 2016, however, cases increased 25% compared with the same period in 2015. Continued surveillance and aggressive detection and appropriate management of cases are essential eradication program components; however, epidemiologic challenges and civil unrest and insecurity pose potential barriers to eradication.”

A national dracunculiasis eradication program in each affected country receives monthly reports about outbreaks in villages under active surveillance for Guinea worm emergence and contaminated water sources. Villages are kept under active surveillance until active surveillance has been maintained for 3 years. Between January 2015 and June 2016, the CDC collected 209 active specimens of dracunculiasis that emerged from humans; two specimens from previously endemic Kenya and 207 specimens from four countries with current endemic dracunculiasis: Chad, Ethiopia, Mali and South Sudan.

Reports showed four cases in four villages from Chad early this year; in Ethiopia, two human cases, three infected dogs and one infected baboon during the study period; two infected dogs in Mali’s Tominian district in 2015 and early this year; and four human cases this year in South Sudan.

These 10 cases reported during the first half of this year represent a 25% increase from 8 reported cases during the first half of 2015; however, no worldwide dracunculiasis cases were reported between January and March. Therefore, according to the researchers, the greatest threat to global eradication is domestic dog infections in Chad and program disruptions produced by civil unrest and insecurity in South Sudan and Mali.

“The continued increase in infections of dogs in Chad and a lesser increase in Ethiopia in 2015 present a substantial challenge as the global program negotiates its final phase,” the researchers wrote. “Specific interventions and vigorous research to address these challenges could reduce infections in humans and dogs in Chad before the end of 2016.” – by Kate Sherrer

Disclosure: The researchers report no relevant financial disclosures.