The Last Guinea Worm
disease eradication
The iron door screamed on its hinges as Sarah hauled the writhing figure through. Her boots echoed against concrete worn smooth by decades of reluctant footsteps.
“You can’t do this,” the Guinea Worm hissed, its voice thin and reedy, like water through a cracked pipe. “I’ve been with you for millennia. I watched your ancestors crawl through the Sahel. I am ancient.”
“And now you’re done.” Sarah shoved it forward. The creature stumbled, catching itself against the bars of Cell 7. Behind the steel, a pale figure watched with milky, pockmarked eyes.
“Fresh meat,” Smallpox murmured.
Sarah unlocked the cell and pushed the Guinea Worm inside. It collapsed onto the thin mattress, its elongated form curling defensively. She’d seen this before, the disbelief, the denial. They all thought they were special. They all thought humanity would never catch up, never get its act together.
“Welcome to Ward Zero,” she said, pulling the door shut. The lock engaged with a sound like a bone breaking clean. “You’ll find the accommodations permanent.”
She turned and walked back toward the control station, ignoring the chorus of whispers that followed her down the corridor.
The Guinea Worm lay still for a long time, listening to the drip of water somewhere deep in the walls. When it finally sat up, three faces watched from the adjacent cells.
Smallpox occupied Cell 6, its skin a geography of scars and craters. In Cell 8, Polio sat twisted in a rusted wheelchair, legs withered to kindling. And at the far end of the block, barely visible in the shadows of Cell 10, something red and spotted waited.
“They got you in Chad, didn’t they?” Smallpox asked. Its voice carried the dust of centuries. “I heard the reports. Fourteen months, zero cases. Then they waited, just to be sure.”
“Fifteen cases,” the Guinea Worm spat. “In all of 2024, fifteen cases across two countries. I was so close to holding on.”
“Close doesn’t count here.” Polio shifted in its chair, metal groaning. “I had India. Two hundred thousand cases a year at my peak. Paralyzed children from Kashmir to Kerala. Now look at me.” It gestured at its useless legs, though whether the symbolism was intentional or simply habit, the Guinea Worm couldn’t tell.
“At least you killed.” The Guinea Worm’s voice turned bitter. “You know what they called me? A disease of poverty. Not even worth fearing. I made them suffer, made them wrap me around sticks and pull me out centimeter by centimeter over weeks, and still they treated me like an inconvenience.”
Smallpox laughed, a dry, terrible sound. “You want to compare burdens? I killed three hundred million in the twentieth century alone. Emperors, peasants, children in their cradles. I shaped the fall of empires and the rise of nations. And a milkmaid’s hands brought me down.”
“The vaccines,” Polio agreed. “Always the vaccines.”
The Guinea Worm slumped against the wall. “They didn’t even need a vaccine for me. Cloth filters. Education. Teaching villagers to keep infected people away from water sources. They beat me with knowledge.”
“The most humiliating defeat of all,” Smallpox said.
Hours passed, or perhaps days. Time moved strangely in Ward Zero, stretched thin by the weight of extinction. The Guinea Worm had begun to accept the dimensions of its cell, the particular coldness of the floor, the way the single bulb overhead never quite reached the corners.
Then the voice came from Cell 10, where the spotted figure had remained silent until now.
“Don’t get too comfortable.”
The Guinea Worm turned. In the half-light, it could make out red skin, a scattered constellation of raised bumps. Measles. The youngest prisoner on the block, relatively speaking, though its eyes held something the others lacked.
Hope.
“What’s that supposed to mean?” Polio asked.
Measles smiled, and the expression was wrong on its face, too wide, too hungry. “I’ve been in contact with someone on the outside. A friend. He’s been doing good work, spreading the word, turning parents against the needles.”
“Impossible,” Smallpox said. “The protocols, the surveillance—”
“His name is Kennedy.” Measles pressed its face against the bars, spots flushing darker with excitement. “He’s got reach. Influence. And he believes. Not in us, not exactly. But in the fear of what cured us. That’s enough.”
The Guinea Worm felt something stir in its chest, unfamiliar and electric. “You’re getting out?”
“Soon.” Measles pulled back into the shadows. “And when I do, when I’m strong again, I’m coming back for the rest of you.”