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This disease causes a worm to burst from your body; Here’s why finding cases is a challenge:

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“It’s such a loser of a disease that some countries eradicated it without even knowing they’d had it. It can naturally disappear.”

The disease Sandy Cairncross of the London School of Hygiene and Tropical Medicine is referring to is Guinea worm, a condition that culminates in a worm up to 3 feet long bursting out of your skin, often unbeknownst to the person it’s bursting out of until it’s about to happen.

It’s something a picture could never prepare you for, and loser or not, this agonizing illness was infecting millions of people just 30 years ago.

But thankfully it’s a disease that’s next on the cards for global eradication.

People become infected with Guinea worm after drinking water contaminated with the larvae of the parasitic wormDracunculus medinensis, typically in remote rural areas.

The larvae then grow in the host into adult worms over the course of one year, at which point females burst out of their host’s foot or leg to lay eggs.

The eggs need to be laid in water and as people stand in their shallow dug-out wells to collect their daily water supply, or to relieve the terrible burning of the residing worm.

It’s rarely fatal but patients often remain sick for several months.

Since 1986, numbers have plummeted from 3.5 million cases across 21 countries in Asia and Africa to just 148 cases in 2013 in four remaining countries – Chad, Ethiopia, Mali and South Sudan, where the majority of cases lie.

The challenge now is finding those last cases because with eradication, “the nearer you get, the harder it gets,” says Cairncross. “The cases left are either unreachable, or forgotten,” he adds.