Guinea worm disease nears eradication
nature.com
nature.com
https://www.hsph.harvard.edu/news/multimedia-article/were-be...
https://medium.com/@DrWink/what-does-the-caduceus-represent-...
And in the age of Covid, perhaps the Caduceus "ancient and consistent associations with trade, liars, thieves, eloquence, negotiation, alchemy, and wisdom" is just perfect for the state of medical science and public health and laboratory gain of function experiments, horse dewormers, and mRNA vaccines which turn out to be no so much like the vaccines we're used to.
The point is the medical origin is older than the U.S.
“.. older representations from Syria and India of sticks and animals looking like serpents or worms are interpreted by some as a direct representation of traditional treatment of dracunculiasis, the Guinea worm disease.“
I am not sure if it’s related to the said logo but thought it might be interesting.
tldr: if you're bitten by a bronzelook at a copper snake wrapped around a pole and you'll live
> 6 Then the Lord sent venomous snakes among them; they bit the people and many Israelites died. 7 The people came to Moses and said, “We sinned when we spoke against the Lord and against you. Pray that the Lord will take the snakes away from us.” So Moses prayed for the people. 8 The Lord said to Moses, “Make a snake and put it up on a pole; anyone who is bitten can look at it and live.” 9 So Moses made a bronze snake and put it up on a pole. Then when anyone was bitten by a snake and looked at the bronze snake, they lived.
(Washington is 1st because he was the first ex-President)
That isn't to say he was blind to the dangerous precedent that would be set by remaining president until death. After all, he was president of the Society of the Cincinnati. (Named after Lucius Cincinnatus, a Roman who was given emergency dictatorial powers (two times?), which he relinquished when they were no longer necessary.) But he didn't want to remain president anyway, so the decision was not a fraught one.
Source: half-remembered details from Ron Chernow's "Washington: A Life"
But as far as I can tell, he's the only recent ex-President who's kept up a similar pace of work and results since: everyone else finishes and retires.
His book was a decent read too. In a "some things are just right and good" way. https://www.amazon.com/Hour-Before-Daylight-Memories-Boyhood...
After retiring from the Presidency, he was elected to the House of Representatives, where he was one of the leading opponents of slavery.
Washington didn't do much after retiring, because he died soon after.
And that was Carter's fault? I think you give him to much blame (or credit depending on your point of view).
the idea that one person can have such rapid effects seems to me to be one of the most pernicious in politics.
The causes of many of those late 70s problems were much earlier than Carter's presidency, And the oil crisis was largely over by then anyway.
Absolutely. We often judge Presidents as though the state of the country today was defined by their decisions yesterday. Or even by their predecessors a few months or years ago.
And they shouldn't avoid blame! They are in the most powerful seat in the US government.
But at the same time, economic timescales are lengthy, and often more than 4 or 8 years.
I get why: because the people pushing that framing are doing so as political PR (positive or negative). But we shouldn't confuse the inaccurate framing with the underlying truth.
Sure they don’t control the legislature but they do have quite a bit of leverage to make real compromises.
You can spin it however you want to try and defend poor Jimmy Carter, but I know Americans would not make the same effort for, say, Xi Xinping.
For example China can't just wake up on a Tuesday morning and become a thriving modern industrialised democracy. Even if Xi Jinping desperately wanted that (and I've no reason to think he does) it can't be done, so there's a huge gap between what you might wish and what these leaders can actually do with their power. Do you think that East Timor would have been stopped if Gerald Ford had won the 1976 election instead of Carter? Would he have picked up the phone and said "Sorry, changed my mind, if you don't pack up and leave East Timor I will bomb you into the stone age"? No?
Lots of countries tacitly supported Indonesia. Australia basically wanted to split the loot, which is in some sense morally worse than selling them arms; the UK sold guns and military aircraft to Indonesia during the fighting; India argued that such invasions are legitimate (and like the US it closed its eyes to the torture, rape and murder) because of its own history of such de-colonial activities. Lots of blame to go around so far as I can see. Carter deserves some share of that blame.
Remember, Carter won the vote in 1976! Just few years after the Vietnam war.
Carter lost due to (a) oil crisis inflation driven by OPEC and (b) the botched military operation in Iran, neither of which outcomes were really within his control.
(The emphasis on Benghazi used against Hilary Clinton was clearly driven by this strategy having worked previously)
is hipster now some politcal term?
the meaning I'm familiar with is from the 1940s, it just became in vogue again recently.
But I had he date wrong - apparently it was first observed in 2012, but only became a significant vector in 2016 (presumably as humans stopped being such accessible hosts).
Perhaps much sooner than that, at least with worms. This is a simple organism, it does not need 9 months in a womb like we do.
For some animals, maybe. I'm not so sure of those that require a womb.
A living organism born from a womb is not just the result of its genetics, but also of its interaction with its parent while in the womb.
If an animal is extinct, then you won't have an animal of its species to gestate in, so you'd be forced to either use a different animal or an "artificial womb" (if that ever becomes possible). In either case the environment it gestates in will be different from gestation in the real animal of its own species.
It's an open question whether the result of that will really be the same as the extinct animal, even if the genes are the same.
So, not really.
The good news is that the Taliban did a u-turn on this after taking over last year, and now vaccination efforts in Afghanistan are underway again. Small silver lining from the Taliban takeover I guess :-/
At any rate, current hopes for polio eradication seem to be for 2026[1], whereas Guinea worm is 2030.
I guess the torture program was regrettable, too. Not regrettable enough to prosecute anyone, though. Or even to allow the UN to prosecute, or to allow anyone indicted (e.g. in Spain) to be extradited.
Allowing CIA to corrupt vaccination efforts is better described as a disastrous debacle.
The trouble is the only way to stop cVDPV2 is to immunize for it - but that same immunization is what creates cVDPV2 in the first place.
Until a better vaccine arrives, it doesn't look like we'll ever eradicate it, Taliban etc aren't changing that. However there might be good news:
"March 2021 saw the first use of the modified nOPV2 vaccine in selected countries. This was engineered to allow vaccination against strain 2 poliovirus without the frequent spawning of cVDPV2 seen with the original OPV2. Full rollout was not expected until 2023."
If that works, then eradication might succeed.
There's no solution here - either option makes things worse.
So I hope the new version of the vaccine works, because otherwise this will fail.
Type 3 appears basically extinct - both in the wild, and vaccine derived. Only type 1 still exists in the wild, and vaccine derived type 2.
> There's no solution here - either option makes things worse.
That's false and misleading. The OPV2 vaccine will stop both vaccine-derived cvdpv2 virus from spreading and the wild type 2, which has been eradicated. Since OPV2 is a live attenuated virus, it will also continue to multiply and confer protection to any person drinking contaminated water, the vaccine "spreads". It is thus highly effective at stopping polio and in no way it can be said that it "causes more cases than it's stopping".
The problem with OPV2 is that it has a relatively higher chance of reverting to an variant that causes polio. This is not a problem if the population has a high level of vaccination, since the live attenuated virus cannot propagate and mutate. It's only problematic in low coverage areas where it can multiply extensively in many hosts.
Thus, the cvdpv2 epidemic is an expression of low vaccination rates, similar in every way to a wild poliovirus resurgence. The novel OPV2 vaccine will improve the genetic stability of the attenuated virus, allowing further "viral vaccinations" in low coverage areas - but we could eradicate cvdpv2 today with the existing OPV2 vaccine, if only we could get good vaccinations rates everywhere, as it has happened in most of the world.
What you write is what they hoped would happen. However it did NOT happen. The reason is that the more you try to vaccinate the entire population, the more cases of cvdpv2 you cause. Until you hit that magic 100% you cause more harm than you prevent.
And in the real world 100% is impossible. So yes opv2 "causes more cases than it's stopping" - there are zero cases of wild type 2, so it's stopping nothing except itself.
And in fact that people running this campaign noticed this and stopped vaccinating with opv2! (Which perhaps you did not know.)
The new version of it will hopefully help, and we can eradicate this.
But right now Polio eradication is failing, not because of Taliban, but because of cvdpv2.
I have high hopes for the new version, but it'll be years before we know.
This makes little sense if you understand that both wpv2 and cvdpv2 were eliminated in the poorest regions of the world using OPV2. If what you claim is true, elimination would have been impossible, you would simply replace wpv2 with cvdpv2, since any attempt at eradication would seed new cvdpv2 cases.
Inactivated injectable vaccine, which does not boost herd immunity, is inefective in these countries with limited health systems.
> And in fact that people running this campaign noticed this and stopped vaccinating with opv2! (Which perhaps you did not know.)
Perhaps you refer to the global coordinated action to move from trivalent vaccine to bivalent (wpv1+ wpv3) in 2016 after the wild type 2 virus was certified as eradicated. But monovalent OPV2 was still being used recently to target specific areas where cvdpv2 is endemic. It makes little sense to use it elsewhere and seed cvdpv2.
You are correct in your details, but are completely missing the bigger picture.
If you look at stats there is zero evidence that cvdpv2 is going away, it just shifts countries, goes up, goes down, but has no signs of ending.
If not for the new vaccine (and I hope it works), cvdpv2 indicates the failure to eradicate Polio. The new vaccine may change the picture, we shall see in about 2 years.
Right now the Taliban is not the biggest obstacle to Polio eradication, cvdpv2 is. And if you check my comments this has been my claim from the start, so I'm not sure what you are arguing against.
Just because vaccines are great, doesn't mean they are perfect, it's not necessary to reflexively defend them.
There have been dozens of cVDPV outbreaks that have been successfully contained in countries around the world. We know how to do it even with our existing vaccines. These outbreaks don’t just come and go at random, they happen in places with inadequate vaccination and are eliminated using a proven playbook.
New vaccines will make the process smoother and faster, but we’re certainly not at a dead end without them.
Is the plan to just keep vaccinating forever? Doesn't that mean that eradication failed? Wild type 2 is extinct, so why are we still fighting it? (Answer: Because we are fighting our own actions.)
> We know how to do it even with our existing vaccines.
You sure? Because it sure doesn't look like success from here.
> they happen in places with inadequate vaccination
If that were true why the switch to bivalent? How can you have "adequate" vaccination when we are not even vaccinating in the first place?
> and are eliminated using a proven playbook.
That's exactly the problem - they do not get eliminated. All we are doing is keeping outbreaks from getting huge, by creating small outbreaks.
This new vaccine is a complete game changer, not the incremental step you think it is.
What 'ars' seems to be missing is that this particular "forest" is very rapidly growing back, in some countries you have in excess of 5% of the population as infants each year. Those are new hosts that were never vaccinated, and due to the extreme contagiousness of the disease a few years of lack of coverage can reignite the fire. What happened after OPV2 withdrawal was that a whole new generation inoculated with only bivalent (type 1+3) vaccine became susceptible to cvdpv2 that was still circulating in small pockets.
Essentially, the campaign failed the end-game strategy, they proved they can reduce the infection to arbitrarily low levels using trivalent OPV, but once you take OPV away, as they attempted for a single strain, the epidemic reignites. It's irrelevant if it's a wpv or cvdpv strain. The end-game was always considered a challenge by experts, but a variety of reasons, Covid, political issues etc. conspired to make it very difficult.
This whole thread leaves me very pessimistic about the prospects of eradication. If a relatively inteligent and educated internet-person that has proper sanitation cannot understand these epidemiological dynamics and claims that "OPV causes more infections than it cures", what's the chance you can explain it to rural farmers, especially after the global rise of the antivax movement after Covid?
OPV2 (specifically 2) cures zero infections because type 2 is extinct in the wild. If causes some infections.
So explain how my sentence isn't true?
A decade ago when type 2 was in the wild, OPV2 was very valuable. Today though it's the greatest obstacle to eradication (and not because people are doing something bad, it's just unfortunate circumstance).
OPV2 prevents cvdpv2 infections. This is a virus similar in all respects to wpv2, except its lower rate of paralysis onset. It's effectively the same disease, just like in my forest fire analogy.
Before the advent of nOPV2, OPV2 was much more effective at this than any other option. So you could not simply cease OPV2 production, post 2016 it was targeted to cvdpv2 hotspots only.
(It's more complicated. For example country without recent cases and good vaccine coverage only use the injectable vaccine.)
There are those who feel sympathy for any living creature. There are those who espouse a non-human-centric philosophy of existence, some of whom view the elimination of other classes of organisms either neutrally or negatively. There are those who are hostile in varying degrees to the population afflicted by the guinea worm and who, disconnected from their suffering, are ambivalent about the cessation of that suffering.
Any individual in those groups might change their perspective if the guinea worm's menace were made more tangible to them — if they or those close to them were infected, or perhaps if they were to witness the suffering of the afflicted up close. But the range of human emotion and ideology is vast.
Apparently, in this case humans already are giving advantages to baboons and if they multiply too many - humans again will need to intervene to kill them to maintain their "normal" numbers.
The solution to the worm and other parasites is very simple - boil your water before using it. Swim only in pools that have been threated against parasites. Instead the offered solution is to sterilize all water in nature - in jungle environment, that is infested with life, that by nature is hostile to humans and others. I suppose, that the thinking of eradication of these worms comes from how they are dealing with malaria.
This is not the treatment approach and is not remotely feasible.
The guinea worm life cycle is largely human driven as well. It's like objecting to reducing heavy metals leaching into drinking water out of some notion of keeping it unchanged from its current state, when it's largely put there by human behavior in the first place.
This is from article: "They then prevent people from drinking the contaminated water and use pesticides to disinfect it."
Basically they contaminate water with pesticides, which locals are drinking afterwards... there are no imminent effects from pesticides - that is for sure.
from wiki: D. medinensis larvae reside within small aquatic crustaceans called copepods.
>>The guinea worm life cycle is largely human driven as well.
Not true. It affects mammals, including humans. Infected mammals becomes easier catch for predators. It is part of cycle of life, which humans are disrupting.
The main issue here is that hygiene of people in Africa is still on the same level that Europeans had couple of centuries ago, when they used water from the same water sources where they had dead cats and fecal matter, only European sources of waters are getting "sterilized" by cold weather, unlike in Africa where those water inhabitants thrive all year. USSR had very similar issues with infections from drinking water, until it educated population that only boiled water is safe to drink. Judging from the article - that is still the main issue and part of what they are doing.
You said:
> Instead the offered solution is to sterilize all water in nature
This article says in fourteen cases they've treated water, and pesticides that target water larvae aren't sterilizing.
>> The guinea worm life cycle is largely human driven as well.
> Not true. It affects mammals, including humans.
Until eradication efforts largely achieved their current success, absolutely this was true. And again, your original claim:
> Apparently, in this case humans already are giving advantages to baboons and if they multiply too many - humans again will need to intervene to kill them to maintain their "normal" numbers.
There have been 23 known baboon infections since the first one was found in 2013. Eliminating the guinea worm will have no effect on baboon populations.
> The main issue here is that hygiene of people in Africa...
I think I may see the problem here.
I also remember seeing that website years ago, and I feel like this isn't it (or at least that it's been redesigned). I seem to remember the classic unstyled text of the early web.