Talk:Dracunculiasis

Update and clean-up

Hello to any talk page watchers, this is the next article on my list for a pet project of cleaning up some of the WHO neglected tropical disease articles. I'll probably hit the sections in order, sporadically as I find time. Happy to have help, suggestions, et al. I'll also leave some clean-up notes to self here so other folks can work on them if they choose. Cheers! Ajpolino (talk) 20:15, 17 April 2021 (UTC)

Images - In the Signs and symptoms section I'd like to find an image of the blister pre-eruption (like Image 1 here) and then of course we can pick an image of the blister post-eruption with the worm coming out. Will looks around after going over the text Ajpolino (talk) 20:15, 17 April 2021 (UTC)

Hi @Ruslik0:, pardon me for undoing your big reversion a moment ago. I've been working on this improving this article for a while (see history). I've updated most of the sections (still working on history and eradication campaign!). Last week I started to update the lead, which I typically save for last. In the process, I removed some references from the lead per MOS:LEADCITE, with the exception of references to numerical data. Apparently those references were called upon elsewhere, but I'd removed the definitions. I could swear a bot used to swoop in and fix those errors by resurrecting the reference definitions from the page history, but apparently that's not working anymore? Anyway, the remaining calls to those references will probably be removed as I update the rest of the lead, since many of them are now dated. If the red error messages really bother you in the mean time, I can manually resurrect the reference definitions. Does that address your concern? Or did you have other issues with the content changes? Thanks and I hope all is well. Ajpolino (talk) 03:24, 15 September 2021 (UTC)

It is a bad style to leave a red mess after your edits. Ruslik_Zero 19:35, 15 September 2021 (UTC)

It is a borderline vandalism. Ruslik_Zero 19:36, 15 September 2021 (UTC)

Wikipedia:Vandalism Ajpolino (talk) 23:33, 15 September 2021 (UTC)

Why only humans, dogs and ferrets as hosts?

The article states than only humans, dogs and ferrets can be hosts. Why are other mammals not potential hosts? This should be explained if possible as it is an obvious question that came to my mind when reading the article. SmilingBoy (talk) 21:07, 7 July 2022 (UTC)

Comments

The article seems to be in good shape. I checked 8 random notes and only needed to make a correction to a page number. Two minor issues: I'm not sure if I'm reading the MOS correctly, but should (May – October) actually not be a spaced dash? Secondly, I would suggest shortening the lede which is at 460-ish words. While ledes for articles on diseases can be even longer, this is a disease with simple diagnostic and treatment procedures and I believe a reduction is achievable without sacrificing overall quality. Draken Bowser (talk) 14:23, 6 August 2022 (UTC)

Hi Draken Bowser, thanks for the comments. I've made the dash change you suggested. I'm all for shortening the lead, but I'm embarrassingly bad at seeing where my own writing should be shortened. Any recommendations are much appreciated. Ajpolino (talk) 00:04, 8 August 2022 (UTC)

Thanks to Spicy it is now down to 402 words, I've no further suggestions!

On another note (and with thanks to our friendly neighbourhood IP-editor): what do you think about including the claims about Eber's papyrus in the history section. They are repeated by Despommier (2019) p. 295. citing Cox (2002). Draken Bowser (talk) 14:03, 12 August 2022 (UTC)

Yes, thanks for bringing this back up. Unfortunately this topic is sometimes obfuscated by authors who write with expertise on medicine, but overreach on the armchair history (e.g. many modern medical sources state it as a matter of settled fact that the fiery serpents passage in Hebrews refers to dracunculiasis). I'm not opposed to adding it to the History section here, but I'll feel more comfortable if I can find a source written by someone with some expertise in ancient Egypt. I'll take a closer look as soon as I can, but if folks feel strongly about it, feel free to add it back in the meantime. Ajpolino (talk) 18:05, 12 August 2022 (UTC)

I'd contemplate taking If the eradication program succeeds, dracunculiasis will become the second human disease ever eradicated out of the lead because it's speculative, perhaps overly optimistic, and there are too many variables. But I don't feel strongly about that. SandyGeorgia (Talk) 19:05, 12 August 2022 (UTC)

Well, I haven't spent much time studying the history of medicine and I've already gathered that tracing any disease back to the oldest surviving medical document is almost a cliché at this point. Without going into to much detail I'd be ok with calling this a complex issue outside the scope of a GA-review, kicking the can down the road to be settled one way or the other during PR or FAC.

As for the sentence in the lead, I don't feel strongly about it either. Draken Bowser (talk) 11:10, 13 August 2022 (UTC)

Nothing medical gets decided at FAC these days; all of the involved medical reviewers who would/could/might weigh in at FAC are already present on this talk page. SandyGeorgia (Talk) 15:45, 13 August 2022 (UTC)

Oopsie, that is, except Colin. (I believe Graham Beards has already weighed in, but could be mistaken.) SandyGeorgia (Talk) 15:46, 13 August 2022 (UTC)

Fair enough. Looking at the four footnotes from Cox (2002), we have access to Grove (1990). I don't have access to the other three sources cited by Cox (2002). Cox himself is listed as the editor of Tayeh (1996), so in a sense it is self-citing. It seems Hoeppli was later disgraced for reasons not related to his research, but according to this biography his book published in 1959 was well received. As for Foster (1965), E. & S. Livingstone is legit, right?

So the claim has been around for a while and, dubious or not, is still being repeated in reliable sources in 2019. Even with the above caveats concerning translation/interpretation and wishful thinking, I think including it in the history section (as with the Old Testament, presented as an interpretation) is warranted. Draken Bowser (talk) 20:50, 13 August 2022 (UTC)

SG comments

The article uses both dmy and mdy; which date format is preferred (I will run the script to address them all). SandyGeorgia (Talk) 18:01, 8 August 2022 (UTC)

No strong opinion. Dmy I suppose (thank you!) Ajpolino (talk) 04:56, 9 August 2022 (UTC)

All of the CDC citations have old dates; those pages have last reviewed date at the bottom of each page, and we should make sure we are using the latest page and that the text is still verified. (I can check and update those when I have more time if no one gets to it before me, but I have two very busy days ahead.) SandyGeorgia (Talk) 18:05, 8 August 2022 (UTC)

I think I got all of them. Added something to the to-do list below. Ajpolino (talk) 04:56, 9 August 2022 (UTC)

The issue of three years with no cases = eradication requires some explanation or clarification, when we're looking at a table that shows Mali going four years with no cases, then back again. I've also come across a lot of information about the surging cases in dogs, which have thrown the whole eradication plan into ... <something> ... and I came across a mention of baboons. Will add that source here once I re-locate it from last night's reading. The eradication stuff seems overly optimistic, or something. Also, not comfortable using The Carter Center for data (should I be?). SandyGeorgia (Talk) 18:07, 8 August 2022 (UTC)

(1) I'll have to look into the three years/certification issue. Adding it to the to-do list so I don't lose track. (2) Dog infections derailing eradication was all the buzz ~5 years ago, but now canine cases are reliably decreasing year-over-year, and my impression is folks are far less concerned than they were as recently as ~2017. Funny enough, this month's "Guinea Worm Wrap-Up" (the WHO/CDC guinea worm newsletter) highlighted the decreasing dog cases in this ugly and confusing graph Fig 1. That said, perhaps I'm under-selling the dog infections? I'll add some text on the canine case counts and trends to the animal section, and if you think it deserves more sunshine I can add something to Prevention or Epidemiology as well. (3) Wow, I somehow missed the baboon thing completely. I now see it mentioned several places. Will look into it. (4) The Carter Center - I know it seems bizarre, but The Carter Center really is the major international force behind the eradication effort. See this CDC page where it lays out the surveillance system: village observers > national eradication programs > The Carter Center and WHO. Or the Hopkins, et al. ref on eradication which notes "[Eradication] has been led since 1986 by The Carter Center..." and it goes on to elaborate. I suppose I should emphasize that in the text in some way... Ajpolino (talk) 04:56, 9 August 2022 (UTC)

I wonder if there are any sources that discuss the accuracy of the case counts. I imagine it is difficult to carry out effective surveillance programs in impoverished areas of rural Africa, and when we are talking about counts of only a few dozen cases a year, a few missed cases could make a large relative difference. Spicy (talk) 20:03, 8 August 2022 (UTC)

Agree ... I saw divergent numbers in my reading last night, but didn't get out of bed to write them down :) In one report from The Carter Center, it mentioned the numbers weren't "official" until "certified", or some such. SandyGeorgia (Talk) 21:09, 8 August 2022 (UTC)

Hmmm, my impression is that the reliability of a country's surveillance system is the major consideration for the ICCDE when deciding whether to certify a country free of dracunculiasis. But how it goes about making that determination, and what experts think of the reliability of case counts I don't know. I'll look into it and get back to you. Ajpolino (talk) 02:01, 10 August 2022 (UTC)

This could use better clarification: When the wound touches freshwater, the female spews a milky-white substance containing hundreds of thousands of larvae into the water. We're left with the idea that if the infected individual never put the wound in water, it would never "burst" ... is that the case? It would just ... stay there forever, without expelling the larvae? SandyGeorgia (Talk) 18:09, 8 August 2022 (UTC)

I'm glad you noticed this, because it turns out I was dead wrong here. CDC says blister bursts in 1-3 days, and worm spews larvae in response to water. Updated in Signs & Symptoms; will tweak the wording in Cause as well. Thanks! Ajpolino (talk) 15:26, 4 September 2022 (UTC)

Is this link useful anywhere ? WASH SandyGeorgia (Talk) 18:15, 8 August 2022 (UTC)

Is it possible to avoid using the Merck Manual (website) as a source? SandyGeorgia (Talk) 18:25, 8 August 2022 (UTC)

Who are these people (MEDRS)? SandyGeorgia (Talk) 18:38, 8 August 2022 (UTC)

Understandable skepticism; it is a silly name. Parasitic Diseases is a textbook that has been running through occasional editions since the 80s, originally published by Springer (ridiculously, Springer still offers to sell you access to the 2nd edition for $80!!). I can't find an article on this right now, but the story I was told is that a few years ago the authors got together, decided selling a $100+ textbook on diseases of the poor was ridiculous, and wrote an updated edition on their own sans publisher. The last two(?) editions have been available free online, as well as a Spanish translation. "Parasites Without Borders" is just the name they made up to publish under, and presumably a vehicle for accepting donations. The book has a bit of a clunky look without the trappings of a textbook publishing company, but I believe it's seen as reliable. The 6th edition was reviewed in a relevant journal, and the authors are all well-known academics. Ajpolino (talk) 02:01, 10 August 2022 (UTC)

Got it, good. SandyGeorgia (Talk) 05:21, 11 August 2022 (UTC)

WP:ELNEVER, this looks wonky; does it have copyright permission to post? Who is that, what is that publisher? SandyGeorgia (Talk) 18:38, 8 August 2022 (UTC)

This book is a total gem, 850 pages on an extremely niche topic. A review at the time called it the "definitive history of helminthology". CAB International is Centre for Agriculture and Bioscience International. As far as posting that link, I admit I may be on uncertain ground. The author claims that he acquired the copyright from the publisher in 1995 and now distributes a Kindle version ($7) and the facsimile of the 1990 edition (free). His link to the 1990 edition download is now dead. I took the liberty of assuming it died due to neglect rather than choice, and so I included the link to the InternetArchive version of the text. I'm happy to remove the link if folks think that's an over-reach. Also he's still alive as best I can tell; I can reach out to him to see what he thinks... Ajpolino (talk) 02:01, 10 August 2022 (UTC)

• Put a range on the "about a year" to 10 to 14 months? https://www.who.int/news-room/facts-in-pictures/detail/dracunculiasis-(guinea-worm-disease)
• https://www.who.int/health-topics/dracunculiasis#tab=tab_1
  • Says "largest of the tissue parasite affecting humans" (how come I came across a gross youtube of something much bigger?)
  • Wow: "The adult female, which carries about 3 million embryos,"
  • "the cyclops is dissolved by the gastric acid of the stomach and the larvae are released and migrate through the intestinal wall"
  • "After 100 days, the male and female meet and mate."
• Baboons ??? https://www.idse.net/Parasitology/Article/12-21/Global-Eradication-of-Guinea-Worm-Disease-Nears-Despite-Complications/65395 Baboons

(And generally a lot of information that made it sound like eradication effort may be endangered because of the situation in dogs.) SandyGeorgia (Talk) 18:49, 8 August 2022 (UTC) Besides the differential diagnosis question on Spicy's talk, that's all I've got for now. I will watchlist and stay tuned in. SandyGeorgia (Talk) 18:51, 8 August 2022 (UTC)

Oops, forgot one ... read somewhere that the fleas are too small to be seen by the human eye, should mention that. SandyGeorgia (Talk) 18:52, 8 August 2022 (UTC)

Thank you for all the comments! I've just got a moment tonight, so I'll try to knock out a few easy ones. Ajpolino (talk) 04:56, 9 August 2022 (UTC)

Very busy here, too, but watching ... looking good. SandyGeorgia (Talk) 10:30, 9 August 2022 (UTC)

More to-do items

• Remove Slate, replace Merck
• IPA pronunciation

• " This is primarily accomplished by filtering drinking water to physically remove copepods." - Sources don't support that this is the primary aim of prevention strategies.
• "The first signs of dracunculiasis occur around a year after infection, as the full-grown female worm prepares to leave the infected person's body." - second half not supported by ref.
• What happens if the blister never touches water?
• Surgical removal?
• Incorporating Sandy's facts above (#larvae, more specific timeline, more details on stomach exit, the male and female meet a few months in)

• Historical range?

  "used to occur throughout Central Africa, Yemen, India, Pakistan, and to a lesser extent Latin America." (Despommier, et al. 2019 - holding out for a more specific description in another source)

• Look into certification process per SG's comment above regarding Mali's 3-year break.
• Clarify Carter Center's role.
• Any sources discuss reliability of case counts? How does ICCDE decide?

• Add some text on dog cases and trends per SG's comment above.
• Infections in baboons?

I'm sure I'll have more to add. Just separating out the less-easy stuff for when I have a moment. Ajpolino (talk) 04:56, 9 August 2022 (UTC)

Comments from Colin

• "public education campaigns to prevent people from" I don't think a campaign can "prevent" people from doing something, only laws and force could achieve that. How about "discourage"?
• "Humans have had dracunculiasis since at least 1,000 BCE" I'm not sure about the tense here. The body says "Dracunculiasis has been with humans for at least 3,000 years". But more importantly, it seems to be giving too much emphasis to our oldest evidence as though the 1000 BCE dates is significant for anything other than being our oldest evidence. Does anyone seriously suggest humans might not have had dracunculiasis in 2000 BCE or even stretching back into our origins as a species in those locations? The fact that it can infect other animals, and that there are other species worldwide that infect animals in a similar way, would suggest perhaps we have always had it in those regions of the world. Maybe the first half of this sentence could be dropped and we simply document that it has likely been described in antiquity. Similarly for the body text, I think saying "has been with humans for at least 3,000 years" is misleading, and is more really a reflection of the limits of how old documented medical history/archaeology is.
  • Reworded to de-emphasize this.
• I wonder if the eradication description in the lead could be made a bit less detailed and we add something about it affecting some other animals, and related species affecting other animals.
  • Took a crack at this.
• "migrates to its final site" the female worm leaves the body, so perhaps this isn't its "final site". Would "exit site" be better?
• The symptoms here only cover the female leaving through a sore. The Dracunculus medinensis article's pathology section mentions quite a lot that this article does not. Is there a reason those aspects (toxic chemical, non-emergence, inflammatory response, joint/CNS infection etc) are missing? This article covers an allergic reaction in some people, but if there are toxic chemicals and an inflammatory response to burst worms, etc, then that isn't allergy is it, which is a word more used to mean an abnormal immune response to a normally harmless thing. I would have thought having an unpleasant immune response to an 80cm worm bursting and dying in your leg would be "normal". The other article also mentions hand or scrotum as occasional exit points.
• "emerge from separate blisters at the same time" if it takes a year to reach the leg, would they really all emerge at the same time, or would one endure fresh ulcers appearing and resolving over months? Can we say any more about that?
• "male remains small at 4 cm (1.6 in) long". The Dracunculus medinensis article says "In contrast, the longest recorded male Guinea worm is only 4 cm (1+1⁄2 in)". So is 4cm a very typical length as well as being the longest, or is there more variation. I reckon the (1+1⁄2 in) text is more accurately approximate than (1.6 in).

  This has been more challenging to resolve than expected. The D. medinensis article cites the 2009 and 2012 editions of a textbook I can't seem to find (a local library has the 2000 edition of the same book -- can't decide if it's worth the trip...). The 2019 version of Parasitic Diseases I cited here claims "The smaller male typically measures 40 mm by 0.4 mm", hence the current text. To my surprise, all the other sources in the article are mum on the male's size. The only other source I could find on the matter is a 2002 review in Clinical Microbiology Reviews (which hosts infamously exhaustive reviews). It has a "Morphology" section which notes "Males have been recovered only doubtfully from humans, but those from experimental animals measure 15 to 40 by 0.4 mm." That review was written 20 years ago, but I suspect that's still the state of our knowledge (after all, you'd need to dig around in a human body ~3 months after infection to recover a male worm...). I'll reach out to the resource exchange folks to see if anyone can provide a photocopy of a recent chapter of the book cited in the D. medinensis article. If not, I'm gently inclined to believe the more detailed 2002 review over the more recent Parasitic Diseases claim. But we'll see if I can turn anything else up. Ajpolino (talk) 16:15, 4 September 2022 (UTC)

  Well would you look at that, I Googled the textbook title to get the details for a resource exchange request, and Google brought up an (almost certainly illegally hosted) online 2009 version. I won't link it here for obvious reasons, but it notes "A major difficulty in taxonomy of dracunculids is the sparsity of discovered males. The few specimens known range from 12 mm to 40 mm long." So another vote against the Parasitic Diseases text. Ajpolino (talk) 16:29, 4 September 2022 (UTC)

  I'm feeling sorry for these unloved unnoticed males. -- Colin°^Talk 09:30, 6 September 2022 (UTC)

• "the female is comparatively large, often over 100 cm (39 in) long".The Dracunculus medinensis article says "at up to 80 centimetres (31 inches) in length" and "females (length 70–120 cm)". We seem inconsistent here between the articles. Having a typical length as well as a range could be useful. Again, I think the inch conversions here are incorrect in that the cm figure has clearly been rounded to a single digit of precision and so "(40 in)" and "30 inches" would be more appropriate imperial unit values.
• "hundreds of thousands of larvae into the water". The Dracunculus medinensis article says "thousands of larvae". That's quite a significant difference in magnitude. Which is correct?
• "is unique to guinea worm disease" Perhaps better to say "unique to this disease", as we already name it at the start of the sentence and perhaps should avoid confusing with an alternative name (which we have presumably chosen not to use for the article title).
• "There is no vaccine or medicine to treat or prevent Guinea worm disease" See comment above about "Guinea worm disease" vs dracunculiasis. Also I think we should drop mention of vaccine here. I know some vaccines are useful in the treatment of some diseases, but that's not typical, and the Prevention section shortly after this leads with "There is no vaccine for dracunculiasis" so we end up repeating ourselves.

  Good point, I've changed up the wording of this sentence a bit to "There is no medicine to kill D. medinensis or prevent it from causing disease once within the body". I'm not sure I love my new wording; I was trying to get across that once you're infected there's no pharmaceutical intervention -- but I didn't want to say there's "no medication to treat..." since the CDC does recommend anti-inflammatories... What do you think?

• "When worms emerge near joints, the inflammation around a dead worm, or infection of the open wound can result in permanent stiffness, pain, or destruction of the joint" The grammar isn't right here, as the second clause is read as though it was following chronologically from the first (but a dead worm doesn't emerge). Instead this is a list of three scenarios that presumably lead to "permanent stiffness, pain, or destruction of the joint". And "the joint" is only clearly meaningful in the first scenario. The other two might affect a nearby joint, assuming there is one nearby.
  • Reworded this so hopefully the intended meaning is clearer. Ajpolino (talk) 20:01, 22 April 2024 (UTC)
• We don't really explain how the person is disabled. I get that it is very sore and the would needs attention, but is that really enough to mean a person couldn't walk or work or study or look after their family. Is it the pain or is it the concern the worm might get damaged and die? I think we need more explanation of the disability. How often are "some people" affected for 12 to 18 months after.
• "Additionally, sources of drinking water can be treated with the larvicide temephos, which kills copepods" Don't think "Additionally" is necessary.
• "Where possible, open sources of drinking water are replaced by deep wells that can serve as new sources of clean water". This repeats itself, as "new sources of clean water" is that same as "are replaced by". Would it be better to explain how/that deep wells are unlikely to be contaminated?
• "Sources of drinking water can also be protected through public education campaigns, informing people in affected areas how dracunculiasis spreads and encouraging those with the disease to avoid soaking their wounds in bodies of water that are used for drinking." This sentence loops round and begins and ends with water used for drinking. Maybe just shorten it to "Public education campaigns inform people in affected areas how dracunculiasis spreads and encourage those with the disease to avoid soaking their wounds in bodies of water that are used for drinking".
• "Dracunculiasis is nearly eradicated" I don't think the WHO source supports this claim, which describes the programme being "hindered" and non-human cases. Rather than using a crystal ball, how about we just describe the massive change in epidemiology: "The epidemiology of dracunculiasis has changed dramatically since 1986, when the World Health Assembly called for dracunculiasis' eradication. In that year there were an estimated 3.5 million cases across 20 countries. By 2020, there were only 21 cases in humans worldwide, and only 15 in 2021. Dracunculiasis remains endemic in just four countries: Chad, Ethiopia, Mali, and South Sudan."
  • Have reworded. Ajpolino (talk) 20:01, 22 April 2024 (UTC)
• "Cases tend to be split roughly equally between males and females, and can occur in all age groups." I wonder if we need to say this at all, which is a rather wordy way of saying there isn't a sex/age bias.
  • Gently disagree, but am open to changing it of course if others feel the same. Ajpolino (talk) 20:01, 22 April 2024 (UTC)
• "Within a given place, dracunculiasis risk is linked to occupation; people who farm or fetch drinking water are most likely to be infected". I don't understand why this should be so. Are such people likely to drink the water at-source rather than water that someone else has transported and left to settle? If you scoop up a bucket of infected water and carry it to your family, who then drink it, why would it affect the water carrier more than the other recipients? What is it about farming vs fishing or hunting or labouring, say, that makes one more at risk?
  • I don't have a source that spells this out per se, but my understanding is that at the village folks are more likely to have large nylon filters or even maybe a well. Out in the fields or at the body of water, people are more likely to drink directly from the water source.
• I wonder if the seasonal epidemiology section is more appropriate in the past tense. There are no longer cases along the Gulf of Guinea, and the data in the WHO report for the four other countries don't support much seasonal analysis (though the cases for dogs in Chad peak in June and are high from May through August).
• "flowing water sources dry". I'd have written "dry up" but maybe that's a English variation? "dry up" sounds fine to my (American) ear as well, so let's go with that.
• "The disease of "fiery serpents" that plagues the Hebrews" I don't think it is accurate to describe this as a "disease", using Wikipedia's voice, as it isn't so described in the Bible. We can just drop "disease of". This contentious speculation would be better explained in-text rather than with a footnote, though a footnote giving the Biblical reference and quotation is appropriate. I faced a similar issue at ketogenic diet where quite a few sources repeat the total rot that Jesus suggested fasting as a cure for epilepsy (and therefore presumably the ketogenic diet comes divinely recommended). I've got a scholarly book on the history of epilepsy and believe me if there was any evidence of this, we'd have recorded people with epilepsy fasting through history. The Bible has Jesus recommend the disciples pray with fasting (i.e. with great devotion) for the sick person, not that the sick person fasts for themselves. In fact, historical reference to this passage wrt epilepsy treatment mentions some people would carry a small piece of paper quoting those verses, as though the words themselves would offer protection. Anyway, I assume some ketogenic diet doctor got carried away with themselves one day and this nonsense gets copy/pasted without engaging brain cells. Our article doesn't mention it at all, on the basis that no scholarly Biblical or history of epilepsy works do either. Is this similar? Where some brain fart by a doctor in 1855 is destined to be forever repeated? I haven't read the criticism of this theory, though one can imagine that since dracunculiasis does not involve being bitten nor is death such a likely outcome that "many people of Israel died" would seem to be big negatives, and we are left clutching at "fiery serpent" for an explanation, but then any snake bit would cause a fiery pain. See Fiery flying serpent for more examples and text mentioning fiery serpents.
• Rod of Asclepius. This also appears to be nonsense. You can see from our article Rod of Asclepius, and Nehushtan, and Caduceus as a symbol of medicine and our source that this is an ancient symbol linked to dracunculiasis by some guy (Georg Hieronymous Velschius) who "saw drancunculi everywhere including on ancient Roman emblems, in the signs of the zodiac, among marine nemertines and polychaetes, in Arabic lettering, in many Greek sculptures and in the emblem of the medical profession". Note how our source places no more significance on this association than with Arabic lettering or ancient Roman emblems, and places it very firmly as the enthusiastic speculation of someone a tad obsessed (wrote a 456 page book in 1674) with the disease.

How to deal with this? My vote really is remove both entirely from this article, and certainly the image as that will stick this foolishness in people's head. The matter is covered by the other articles, placing it within scholarly historical analysis and giving it (we hope) appropriate weight and significance. If we value reliable sources backed up with serious evidence, and for history, what modern scholars really think, then both such topics are at the "inject bleach and invermectin" level of "someone once said something" significance. By continuing to cover this in an otherwise fact and evidence-based article we are doing our readers a disservice, planting ridiculous ideas into our readers heads along with all the good stuff. All we do is encourage future parasitologists desperate for a novelty factoid and image for the start of their PowerPoint presentation. -- Colin°^Talk 19:02, 14 August 2022 (UTC)

I've rewritten this bit to try to frame it in more appropriate context. I'm very hesitant to remove it completely, as these claims are often uncritically repeated in medical literature, and I'm concerned people will just add the contextless, no-doubt wrong version back. Ajpolino (talk) 20:01, 22 April 2024 (UTC)

Just popping by to say thank you for the comments -- and a reiterated thank you to everyone else who commented above. Pardon the silence. Real life has been taking all my time the last few days. It's looking like I'll get some chunks of time to do research and address comments in the latter half of this week. Looking forward to it. Ajpolino (talk) 23:57, 15 August 2022 (UTC)

Agreeing with Colin on the Rod of Asclepius bit. SandyGeorgia (Talk) 03:06, 16 August 2022 (UTC)

Did a few easy ones. I hope you don't mind I struck the suggestions for which I simply implemented your wording. I'm doing some research to address the others. Thanks all! Ajpolino (talk) 00:54, 21 August 2022 (UTC)

Yes that's fine. No rush. -- Colin°^Talk 08:16, 21 August 2022 (UTC)

Velschius and the Rod of Asclepius

Hi Herostratus. I've combined the previous wording (which I wrote) and your version into a compromise that I hope you'll find acceptable. To your edit summary about whether Velschius' view is "worth publishing". I think it should remain in the article because Velschius' claim about the Rod of Asclepius is widely and uncritically repeated in parasitology and public health texts, as if it were decided fact. Several of the otherwise excellent sources for this article that speak with authority to the medical aspects of the disease flub this, e.g. Parasitic Diseases (textbook, pg 289). If we don't mention it, I think we're doing the reader a disservice (and annoyingly, they'll probably keep adding the uncritical version). At the same time, to your point, I think a sentence in the History section is all it's due. So I tried to breeze through it quickly. You've added a bit more color to make the reader even more skeptical of Velschius' claim. That seems fine. Ajpolino (talk) 21:26, 26 January 2024 (UTC)

GA Review

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

This review is transcluded from Talk:Dracunculiasis/GA2. The edit link for this section can be used to add comments to the review.

Reviewer: Chiswick Chap (talk · contribs) 16:07, 6 March 2024 (UTC)

Comments

• "was widespread, it would often affect" -> "was widespread, it often affected"
  • Done.
• "moniker" -> "name" or perhaps "descriptor". Felt too casual really.
  • Done.
• " larvicide temephos" - perhaps gloss this "the organophosphate larvicide temephos". I don't know if we should get into a discussion of the wisdom of adding organophosphates to drinking water (...Organophosphate poisoning...), but no Western country would want to see anything like that in their water supply, so the recommendation is a bit startling. Though [19] says it's safer than Chlorine, so there. Maybe [18] is redundant for this claim.
  • My gentle preference would be not to. The textbook sources I use don't describe it in this way -- possibly because they don't want to surface negative associations, though possibly they just don't think it's important. "with a larvicide known as temephos (ABATE)" (Parasitic Diseases), "with the safe larvicide temephos" (Atlas of Pediatrics), "with the larvicide Temephos" (Galan-Puchades, 2019 - not a textbook, but I accidentally opened the PDF at the same time). Ditto the broad public-facing sources: "by using the larvicide temephos" (WHO), "using the approved chemical temephos" (CDC).
    • For the record, I hear the soft courtly tones of euphemism here, and I think I know why.
• "there could be as many as 48 million cases" in 1947: perhaps "could have been", or something of that sort. Fascinating paper by Stoll, by the way. (Loved the 3.3 billion prediction for world population in 2000...)
  • Done. Glad you liked it. Some sources state Stoll's estimate as gospel truth, so I was quite tickled when I found the actual paper.
• The large table in 'Eradication' goes to great length to say what the small graph says more clearly; I doubt we need annual data by country in an article of this kind, and the assembling of the data in this manner is a bit uncomfortable, as is the set of overlapping maps. The table's date range is in any case much too little (far too recent) to match the remarkable graph. I suggest the table should go. Better, if detailed illustration is thought necessary, would be a map from the 2011 dataset [45] and a matching map from the 2023 dataset [57] with countries coloured by their data values (or the numbers could be overlaid on the maps).
  • Agreed, removed. I do have space for another illustration or two. If I were to find/generate a visual aid for any part of the article, would the map you reference above be your first choice? If you think there's another illustration that would be better, happy to work on that instead.
    • I think the map would probably be best.
• Given that there is a "main" article Eradication of dracunculiasis, this section should be a short summary of that article (resembling its concise lead section) rather than an extensive treatise. No point keeping a dog and barking yourself, to quote an old proverb.
  • Amazing proverb, hadn't heard that before. I'm inclined to disagree. I think the somewhat large eradication section is due here. This is a disease that affects about as few people as any. It's primarily written about because of the success of the eradication effort.
    • So it's the exceptionally long, exceptionally important "main" article summary. Don't make a habit of it!

• "paratenic host" needs a brief explanatory gloss. Or just call it a "transport host" or "secondary host" for the sake of general readers: the terms are in common use and don't involve rare Greek etymologies ("to stretch out beside", for some reason, don't ask).
  • Sure, went with "transport host" which hopefully at least gets the right idea across to the uninitiated.
• "The only other reptile affected is the snapping turtle" - suggest "reptiles" and "snapping turtles" as 2 species are mentioned.
  • Done.
• The category "Parasitic infestations, stings, and bites of the skin" seems to be largely for insect bites and other such; Guinea worm is a penetrating, internal worm so the category isn't a good match for this article. Actually the category is a total mess and probably needs reworking into some better-defined entities, but that's not our problem.
  • Removed.

Images

• The images, all from Commons, appear to be correctly licensed. All are clearly relevant to the article.

Sources

• Spot-checks worked out fine.

Summary

This is a well-written and compact article on a sad but curious topic. I hope to see it as a GA very soon. Chiswick Chap (talk) 16:50, 6 March 2024 (UTC)

Many thanks for taking the time to review. I hope I'll have a moment to get to this tomorrow, but if not I'll be held up until early next week. So if there's a few days silence from me, just know your comments are appreciated and soon to be acted upon. Ajpolino (talk) 19:18, 6 March 2024 (UTC)

Ajpolino ?

• Thanks for the ping. Did the easy ones this morning, will get to the rest by the end of the weekend at the latest. Pardon my slow replies. Ajpolino (talk) 12:14, 15 March 2024 (UTC)
  • "at the lastest" Apologies. Man plans; god laughs. And all that. All done. There are two items I disagreed with and noted reasons above. If you feel the disagreement spots are worth pursuing, we can seek other opinions. I'm not sure the talk page gets much traffic, but we can certainly try posting there or perhaps WT:MED. Ajpolino (talk) 01:17, 20 March 2024 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

“Second”

The sentence “ If the eradication program succeeds, dracunculiasis will become the second human disease eradicated, after smallpox” is incorrect.

It will be the “second” only if it succeeds AND no other human diseases are eradicated first. If the disease is eradicated because of the program, but not until after polio, for example, is eradicated, I would still consider it a success, even though it will be the third, not the second. 47.139.46.124 (talk) 03:30, 29 April 2024 (UTC)

I think we take that sort of caveat as read in natural English: "when it is completed, the tower will be the tallest in the world" doesn't need "unless someone else builds a taller one in the meantime": we take "all unspecified context carrying on as normal" as an implied in any sentence of that kind. It does seem from the article that there are compelling reasons to assume that D. has a very good change of being the next human disease eradicated. UndercoverClassicist ^T·C 11:13, 29 April 2024 (UTC)