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Guinea worm, beware. This was the message at the Seventh African Regional Conference on Guinea Worm Eradication held this spring in Bamako, Mali. More than 200 warriors in the battle against the dreaded disease gathered to plot their strategy for the final push toward eradication.

Former U.S. President Jimmy Carter praised the group for achieving a 95 percent reduction in cases but warned against complacency. "We need to concentrate our efforts on nations that still have even one case of Guinea worm (dracunculiasis)," he said. "Let's focus on eradicating this disease, making it only the second after smallpox to be wiped off the Earth. Then we can move on to other diseases."Gen. Amadou Toumani Tour‚, the former president of Mali, echoed President Carter's sentiments, issuing a "direct order" for everyone to win the war against the worm, which has existed for centuries.

People become infected by drinking stagnant water contaminated with fleas carrying Guinea worm larvae. Inside the human body, the larvae grow to as long as 3 feet. After one year, the threadlike worm emerges slowly through a blister on the skin. Many victims immerse the area in water to soothe the burning pain. When the female worm touches water, she releases tens of thousands of larvae, beginning the cycle again.

Although the disease cannot be cured, it can be stopped. Villagers must filter their water. They also can use the nontoxic chemical Abate to kill larvae or drill borehole wells for fresh drinking water. Today, about 150,000 cases remain compared to more than 3.2 million in 1986.

In Mali, conference participants focused on lingering obstacles to eradication such as educating nomadic groups.

"Nomadic people can contaminate water supplies of villages through which they pass and become infected themselves by drinking contaminated water while traveling," said Donald Hopkins, M.D., associate executive director of The Carter Center. "We must identify effective methods to educate this special population about prevention."

All 16 affected African countries except Kenya were represented at the conference, which was co-sponsored by the Government of Mali, The Carter Center, the World Health Organization, UNICEF, and the Centers for Disease Control and Prevention. After days of intense brainstorming, participants emerged newly energized for their continuing battle.

"Eradicating a disease is a very difficult challenge," President Carter said. "We all work together in an army that is on the verge of winning a great victory."