27.12.10

1 Down, Close On 2 More, Only A Few Dozen Thousand To Go

What do Pharaoh Ramses V of Egypt, Queen Mary II of England, Emperor Joseph I of Austria, King Luis I of Spain, Tsar Peter II of Russia, King Louis XV of France and Queen Ulrika Elenora of Sweden all have in common? Other than the obvious of being royalty, they were all killed by the only disease man has successfully eradicated from the natural world: Smallpox.

We should be glad that they managed to eradicate smallpox, because they never figured out how to cure the disease, or even manage it so that it was less lethal. And it was lethal, there were four strains, the one was so dangerous that they're not sure anyone ever survived it. All said around 30% of the people that got smallpox died, and that's taking into account a rare form which only killed about 1% of the people that caught it.

And of those that survived smallpox, over 60% had severe scarring, usually on the face, and about 30% were blinded. Scarred survivors included Queen Margaret of Scotland, Anne of Cleves, Mary I of England, Elizabeth I of England and Joseph Stalin.

But please, don't think this was a disease of the rich. During the the late 1700s it was killing 400,000 people a year in Europe alone, and from 1900 to its final deaths in 1978 it is thought to have killed up to a half billion people. Even into the 1960s it was still killing millions of people a year. To put that in perspective, the Black Death (aka bubonic plague) killed, in its entire recorded history, around two-hundred million people.  That's about half of what smallpox killed in the last 78 years that we were actively wiping it out.

Alas, in the 200+ years since Edward Jenner figured out the concept of vaccination, we've still only managed to eliminate that single disease, but we're getting close to adding two more to the list. One affects cattle (it's called rinderpest, which is German for cattle-plague) and is just waiting for a full year to go by without a suspected case to be declared officially eradicated, and they're hoping that 2010 will turn out to have been that year. The other is called the guinea worm, and it's a parasite that's species-specific to humans that vaccination can't help against. But it's almost gone too. All thanks to one of the least popular Presidents in United States history.

Jimmy freakin' Carter.

He is, for the record, not history's greatest monster despite what the Simpsons says. He's one hell of a man who's done boatloads of good for humanity. He was just a terrible president. Who at one point was attacked by a rabbit. Alright, so his legacy is a bit checkered, but the fact remains that it's largely due to him, his wife, and the Carter Center they formed, that we're almost rid of the guinea worm. Which is, arguably, history's greatest nonlethal monster.

The formal name for being infected, Dracunculiasis, means 'infected by tiny dragons' because of the extreme pain they cause. There's proof of it infecting Ancient Egyptians, there's records of it from 2c B.C.E. Greek documents, and some people think that the symbol of medicine, the rod of Asclepius (not to be mistaken for the Caduceus, which is a symbol of commerce and is only loosely connected to medicine through it's alchemical background), is a representation of the traditional method of removing guinea worms: Winding them around a stick to pull them out of the infected person. An agonizing process that can take almost a month to finish.

On the left, a symbol of alchemy.
On the right, a symbol of medicine.
Now you know more than 75% of American commercial medical associations.
The pain that the guinea worm causes is crippling, which its colloquial names, fire serpents and dragon worms, should make obvious.  The pain can last for months without treatment, which makes the increased agony of pulling it out worth it, just so that it's over more quickly.  I'd post a video, but they're incredibly disgusting and heartbreaking, since they seem to choose only cute children having them removed to film.

The good news is that since 1987 the Carter Center has been working to eliminate the guinea worm, and they've managed to do it in 16 countries. In the 1950s there were an estimated 50million people infected. By the time the Carter Center started doing its work, an estimated 3.5million people a year were becoming infected, largely due to better sanitation in the countries that it's endemic to. In 2010 there are (to date) less than 1,700 cases in only four countries: Sudan, Ghana, Ethiopia and Mali.  Under 100 of those were outside of Sudan.  Carter, who's 86 years old, intends to live to see the guinea worm totally eradicated, and it looks like he may be able to do it, since the number of incidents dropped 45% between 2009 and 2010.

The guinea worm: One of humanity's earliest parasites, hopefully just the first of many to be eradicated.


Sources:
Image of the Caduceus and the Rod of Asclepius taken from TotalPetMagazine.com
World Health Organization factsheet on smallpox
Centers for Disease Control smallpox pages
U.S. National Library of Medicine smallpox page
Mayo Clinic smallpox page
Associated Press article on the Carter Center fight against the guinea worm
Carter Center site on the guinea worm
Latest Carter Center report on the guinea worm (PDF)
Wikipedia pages on smallpox, the Black Plague, historic pandemics, Jimmy Carter and the guinea worm.

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