Dracunculiasis

Historical background

Ever a subject of curiosity because of its apparently supernatural aspect, the very large size and painful nature, dracunculiasis was documented since antiquity.

  • Dracunculiasis has always been a subject of curiosity due to the large size of the worm and painful nature. The disease is documented in the Old Testament.
  • It is believed that the 'fiery serpent' mentioned in the Old Testament referred to the adult worm that emerges out of the human body.
  • Occurrence of the 'fiery serpents' around the Red Sea suggests that the disease was common in Egypt during the Exodus or perhaps even earlier.
  • Several ancient Egyptian texts suggest it was common during the middle of the second millennium BC. Undoubted evidence of the worm's existence in New Kingdom Egypt was confirmed by a calcified male guinea-worm found in Manchester Egyptian Mummy Project.
  • It is sometimes called Pharaoh's 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 not prevalent in Europe, famous Greek writers such as Aelius Galenus (better known as Galen), Agatharchides, Plutarch became acquainted with it while in Egypt and neighbouring countries. Galen called the worm 'dracontiasis'.
  • 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 eliminated from Uzbekistan following a series of effective health education, water purification and vector control programmes in Boukhara and the surrounding areas. No recurrence of the disease has been recorded in this region since 1932.
  • In the 1972, Iran successfully eliminated the disease.
  • In 1984 dracunculiasis was eliminated in the Indian State of Tamil Nadu; in Gujarat in 1989 and in Maharashtra in 1991.
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Last update:

5 August 2014 14:28 CEST