Historical background and important dates
Ever a subject of curiosity because of its apparently supernatural aspect, the very large size and painful nature, dracunculiasis was documented since antiquity.
- It is believed that the 'fiery serpent' mentioned in the Old Testament referred to guinea worm.
- The occurrence of the 'fiery serpents' around the Red Sea suggests that the disease was common in Egypt during the Exodus or perhaps earlier. Several Egyptian texts suggested that it was common during the middle of the second millennium BC. The undoubted evidence of the existence of the worm in New Kingdom Egypt was confirmed by the calcified male guinea worm found in Manchester Egyptian Mummy Project. It is sometimes called Pharaoh Worm.
- It is believed that the closing verses of three stanzas of a poem in the Sanskrit book Rig-Veda, attributed to Vasistha of the 14th century BC, allude to guinea worm.
- The disease was probably brought to Mesopotamia by prisoners transported from Egypt to Assyria during the early part of the seventh century BC, as indicated by a text found in the library of King Ashurbanipal at Nineveh.
- The worm made a great impression on the classical authors during the Graeco-Roman period although it was not prevalent in the Europe but became acquainted with it while in Egypt and neighbouring countries, such as Galan, Agatharchides, Plutarch who mentioned that it was common around the Red Sea. It was called 'dracontiasis' by Galen.
- As early as the 9th century AD, Arab-Persian physicians such as Rhazes and Avicenna described the disease in great details and it was called Medina vein.
Photo captions from left to right:
The link between the symbol of medicine, the dragon (from where dracunculiasis is derived)and Avicenne work is illustrated (by Velschius, 1624-1677)
Persian physicians removing guinea worm from legs of patients (by Velschius, 1624-1677)
A plate by Fedchenko showing the guinea worm rolled up on a stick, larvae in the body cavity of cyclops
- The contribution of Avicenna in describing dracunculiasis syndromes and the name of the disease derived from dragon had an impression on Velschius (1624-1677) who illustrated this in his book about the disease
- From the Middle Ages through to the 18th century there were many varying opinions as to the nature of guinea worm –believed to be anything from exposed nerves to dead tissue. It was the celebrated Swedish naturalist, Carlus Linnaeus who first suggested that they were in fact worms. During this period it took its name 'guinea worm' as travelers described the prevalent of the disease in the Gulf of Guinea.
- The role of the intermediate host in the life cycle of Dracunculus was finally determined by Alesej Pavlovich Fedchenko in 1870. This was one of the milestones in the history of tropical medicine.
- The life cycle was demonstrated by later work of Robert Thomas Leiper in 1905 and Dyneshvar Atmaran Turkhud in 1913.
- By the end of the l9th century, the scientific community had become well aware of how the disease was transmitted and had started to advocate suitable protective measures.
- Between 1926 and 1931, dracunculiasis was totally eradicated from Uzbekistan following a series of effective health education, water purification and carrier control programmes in Boukhara and the surrounding areas. No recurrence of the disease has been recorded in this region since 1932.
- In the 1972, dracunculiasis was eradicated in Iran.
- In 1984 dracunculiasis was eradicated in the Indian State of Tamil Nadu, by 1989 in Gujarat, and by 1991 in Maharashtra.