Talk:Dracunculiasis

message: 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)
replies: text: 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)

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

text: It is a borderline vandalism. Ruslik_Zero 19:36, 15 September 2021 (UTC)
replies: text: Wikipedia:Vandalism Ajpolino (talk) 23:33, 15 September 2021 (UTC)
thread_title: Update and clean-up

message: 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)
thread_title:  Why only humans, dogs and ferrets as hosts? 

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

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

text: (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)

text: 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)
replies: text: 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)

text: 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)

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

text: 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)

text: 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)

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

message: *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)
thread_title: More to-do items

message: *"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)
replies: text: 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)
replies: text: 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)

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

text: 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)
replies: text: Yes that's fine. No rush. -- Colin°Talk 08:16, 21 August 2022 (UTC)
thread_title:  Comments from Colin 

message: Hi . 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)
thread_title:  Velschius and the Rod of Asclepius 

message: 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)
replies: text: 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)
thread_title:  “Second”