Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-26T05:16:06.765Z Has data issue: false hasContentIssue false

Guinea worm: from Robert Leiper to eradication

Published online by Cambridge University Press:  27 June 2017

AHMED TAYEH
Affiliation:
P. O. Box 127162, Dubai, UAE
SANDY CAIRNCROSS
Affiliation:
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
FRANCIS E. G. COX*
Affiliation:
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
*
*Corresponding author: London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail: [email protected]

Summary

Guinea worm disease, dracunculiasis or dracontiasis, is an ancient disease with records going back over 4500 years, but until the beginning of the 20th century, little was known about its life cycle, particularly how humans became infected. In 1905, Robert Thomas Leiper was sent by the British colonial authorities to West Africa to investigate the spread of Guinea worm disease and to recommend measures to prevent it. While carrying out his investigations, he made important contributions to the aetiology, epidemiology and public health aspects of Guinea worm disease and provided definitive answers to many outstanding questions. First, he tested the validity of previous theories; second, he confirmed the role of water fleas, which he identified as Cyclops, as the intermediate hosts in the life cycle; third, he investigated the development of the parasite in its intermediate host; and fourth, he recommended measures to prevent the disease.

[The crustacean Order Cyclopoida in the Family Cyclopidae contains 25 genera, including Cyclops which itself contains over 400 species and may not even be a valid taxon. It is not known how many of these species (or indeed species belonging to related genera) can act as intermediate hosts of Dracunculus medinensis nor do we know which species Fedchenko, Leiper and other workers used in their experiments. It is, therefore, best to use the terms copepod, or copopoid crustacean rather than Cyclops in scientific texts. In this paper, these crustaceans are referred to as copepods except when referring to an original text.]

Leiper described the remarkable changes that took place when an infected copepod was placed in a dilute solution of hydrochloric acid; the copepod was immediately killed, but the Dracunculus larvae survived and were released into the surrounding water. From this, he concluded that if a person swallowed an infected copepod, their gastric juice would produce similar results. He next infected monkeys by feeding them copepods infected with Guinea worm larvae, and thus conclusively demonstrated that humans became infected by accidentally ingesting infected crustaceans. Based on these conclusions, he advocated a number of control policies, including avoidance of contaminated drinking water or filtering it, and these preventive measures paved the way for further research. The challenge to eradicate Guinea worm disease was not taken up until about seven decades later since when, with the support of a number of governmental and non-governmental organizations, the number of cases has been reduced from an estimated 3·5 million in 1986 to 25 in 2016 with the expectation that this will eventually lead to the eradication of the disease.

Type
Special Issue Review
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Current address: 7, Chessington Road, Epsom, Surrey KT17 1TS, UK.

References

REFERENCES

Cairncross, S., Muller, R. and Zagaria, N. (2002). Dracunculiasis (Guinea worm disease) and the eradication initiative. Clinical Microbiology Reviews 15, 223246.CrossRefGoogle ScholarPubMed
Cairncross, S., Tayeh, A. and Korkor, A. S. (2012). Why is dracunculiasis eradication taking so long? Trends in Parasitology 28, 225230.Google Scholar
Cox, F. E. G. (2017). Robert Leiper and the London School of (Hygiene and) Tropical Medicine. Parasitology. doi: 10.1017/S0031182016002079.CrossRefGoogle ScholarPubMed
Eberhard, M. L., Ruiz-Tiben, E., Hopkins, D. R., Farrell, C., Toe, F., Weiss, A., Withers, P. C. Jr., Jenks, M. H., Thiele, E. A., Cotton, J. A., Hance, Z., Holroyd, N., Cama, V. A., Tahir, M. A. and Mounda, T. (2014). The peculiar epidemiology of dracunculiasis in Chad. American Journal of Tropical Medicine and Hygiene 90, 6170.CrossRefGoogle ScholarPubMed
Fedchenko, A. P. (1870). Concerning the structure and reproduction of the Guinea worm (Filaria medinensis). In Russian. Translation: American. Journal of Tropical Medicine and Hygiene 20, 511523. 1971.Google Scholar
Geggel, L. (2015). Life Science September 1, 2015. Life Science Publishing, Calgary, Canada.Google Scholar
Grove, D. I. (1990). A History of Human Helminthology. C.A.B, Wallingford, UK.Google Scholar
GW Wrap Up (2016). Guinea Worm Wrap-Up. No. 245. WHO Collaborating Center for Research, Training and Eradication of Dracunculiasis. Centres for Disease Control and Prevention, Atlanta, Georgia, USA.Google Scholar
Hopkins, D. R. and Foege, W. H. (1981). Guinea worm disease. Science 212, 495.Google Scholar
Leiper, R. T. (1904). On the turbellarian worm Avagina incola, with a note on the classification of Proporidae. Proceedings of the Zoological Society of London 1, 17.Google Scholar
Leiper, R. T. (1906 a). Some results of the infection of monkeys with Guinea worm. Report of the British Association for the Advancement of Science 76, 600.Google Scholar
Leiper, R. T. (1906 b). The influence of acid on Guinea worm larvae encysted in Cyclops. British Medical Journal 1, 1920.Google Scholar
Leiper, R. T. (1907). The aetiology and prophylaxis of dracontiasis. BMJ 1, 129132.Google Scholar
Leiper, R. T. (1910). Guinea worm in domesticated animals with a note of its discovery by Mr Charles Grey in a leopard. Journal of Tropical Medicine and Hygiene 13, 6566.Google Scholar
Leiper, R. T. (1911 a). A method for dealing with town wells infected with Guinea worm. Journal of the London School of Tropical Medicine 1, 2830.Google Scholar
Leiper, R. T. (1911 b). Note on the seasonal incidence of dracontiasis in the gold coast. Journal of Tropical Medicine and Hygiene 14, 211212.Google Scholar
Leiper, R. T. (1913). Seven helminthological notes. A. The occurrence of Guinea worm in Nyasaland. Journal of the London School of Tropical Medicine 2, 175.Google Scholar
Leiper, R. T. (1936). Crustacea as helminth intermediates. Proceedings of the Royal Society of Medicine 29, 9.Google Scholar
Litvinov, S. K. (1991). How the USSR rid itself of dracunculiasis. World Health Forum 12, 217219.Google ScholarPubMed
Moorthy, V. N. (1938). Observations on the development of Dracunculus medinensis larvae in Cyclops . American Journal of Hygiene 27, 437465.Google Scholar
Muller, R. (1968). Studies on Dracunculus medinensis (Linnaeus). I. The early migration route in experimentally infected dogs. Journal of Hygiene 42, 331338.Google ScholarPubMed
Muller, R. (1971). Dracunculus and dracunculiasis. Advances in Parasitology 9, 73151.CrossRefGoogle ScholarPubMed
Onabamiro, S. D. (1950). The transmission of Dracunculus medinensis by Thermocyclops nigerianus as observed in a village in South-West Nigeria. Annals of Tropical Medicine and Parasitology 45, 110.Google Scholar
Palmer, S. R., Soulsby, L., Torgenson, P. R. and Brown, D. W. G. eds. (2011). Oxford Textbook of Zoonoses. Oxford University Press, Oxford, UK.CrossRefGoogle Scholar
Roubaud, E. (1918). Discussion of Chatton on infection of Cyclops through digestive tract. Bulletin de la Société de Pathologie Exotique 11, 347348.Google Scholar
Stothard, J. R., Kabatereine, N. B., Archer, J., Shehri, H. Al-, Tchuem-Tchuenté, L. A., Gyapong, M. and Bustinduy, A. L. (2017). A centenary of Robert T. Leiper's lasting legacy on Schistosomiasis and a COUNTDOWN on control of neglected tropical diseases. Parasitology. doi: 10.1017/S0031182016000998.Google Scholar
Tayeh, A. T. (1996 a). Dracunculiasis. In The Wellcome Trust Illustrated History of Tropical Diseases (ed. Cox, F. E. G.), pp. 287293. The Wellcome Trust, London, UK.Google Scholar
Tayeh, A. T. (1996 b). Eradication of Dracunculiasis in the Islamic Republic of Iran. Country Report prepared by the Directorate General Disease Prevention and Surveillance. Ministry of Health and Medical Education, Islamic Republic of Iran.Google Scholar
World Health Organization (2015). Eradication of Dracunculiasis: A Handbook for International Certification Teams. WHO Geneva, Switzerland.Google Scholar