ATLANTA - The guinea worm inside the sealed vial held by Dr. Donald Hopkins looked more like a skinny strand of pasta than a menacing source of disease.

Guinea worm has plagued millions throughout history. Ingested when people drink water contaminated with water fleas, the microscopic worms develop to adult size - 2 to 3 feet long - within the body and then painfully exit the skin after a year to release thousands of infant worms into water.

"They come out through any part of the body; it takes them weeks to come out," said Hopkins, associate executive director of health programs at The Carter Center and a former deputy director for the Centers for Disease Control and Prevention. "We know how to prevent it. But there's no treatment and you can't cure it."

In 1986, there were 3.5 million cases of the disease. The Carter Center's efforts since then - creating deep wells or distributing cloth filters that keep people from drinking contaminated water - have brought guinea worm close to eradication. Only 55,000 cases were reported last year.

In working to reduce the number of cases, the Atlanta-based center continues its mission to improve the quality of life in developing countries.

"The Carter Center is a very important global player in neglected infectious diseases," said Dr. David Heymann, executive director of communicable diseases for the World Health Organization. "We have frequent interaction with them."

The center's efforts on guinea worm have been so successful that health officials believe guinea worm disease is neck-and-neck with polio for the distinction to be the first disease since smallpox to be eradicated from the planet.

"It's a friendly race" between health officials, Hopkins said. "But whether it's polio or guinea worm, sometime soon - they will be eradicated."

The center targets other destructive diseases that other health agencies may not have the resources to tackle. Each year it convenes a panel of international experts who identify which maladies should be targeted next for eradication.

River blindness is caused by parasitic worms that enter the body through a fly bite. The worms can damage the eyes and cause blindness, preventing people from working and caring for their children. The center has helped distribute more than 40 million treatments of a drug that can kill infant forms of the parasite.

The center also fights against trachoma - a bacteria that's the world's leading cause of preventable blindness - in Africa and Yemen. In Nigeria, the center has worked to prevent schistosomiasis (causes poor development, bladder damage and kidney dysfunction in children) and lymphatic filariasis (a parasite that lives in the lymphatic system and can cause dramatic swelling of limbs or genitals).

Guinea worm eradication is important because it can take a toll on a developing country's economy. Rice farms in Africa have lost up to $20 million a year in unharvested crops because of the disease, Hopkins said.

"It has an enormous impact on agriculture," Hopkins said. "In addition to being a horrible disease that's very painful, it greatly harms agricultural productivity. So many people become ill, (farms) couldn't harvest. It keeps children out of school."

ON THE NET

Carter Center: http://www.cartercenter.org