The tiny tropical island of Mauke is about as far as you can get from the rest of the world and about as close as you can get to paradise. It is a speck in the South Pacific, four miles long by two miles wide, fringed with windswept palms and ancient coral limestone reefs. Mauke is one of the Cook Islands, named for James Cook, the eighteenth-century British navigator who explored them. Its only connection to the outside world is a thrice-weekly plane from Rarotonga, the largest island of the group,
100 miles away. Almost all of Mauke’s 600 inhabitants are Polynesian. They fish the local waters, cultivate taro, banana, and breadfruit, and grow cash crops such as mango for export to New Zealand. On Sundays they congregate in their missionary-built churches for exuberant Maori celebrations of singing.
But there are less friendly residents on the island. One is a threadlike parasitic roundworm--a filarial worm--that is transferred from person to person by a mosquito, another of the island’s less pleasant occupants. The worms, in a tiny larval stage, crawl into their victim’s skin through the puncture made by the mosquito, migrate into the lymph nodes, then mate and produce more tiny offspring, which find their way into the bloodstream. In the process, the worms wreck the lymph system, which drains fluid from the body’s tissues, causing the massive fluid buildup that produces the painfully bloated limbs of elephantiasis.
It’s not just on Mauke that parasitic worms are unwelcome neighbors. Filarial worms of one sort or another, and their various cousins--hookworms, whipworms, pinworms, and flatworms--cause an immense amount of grief throughout the world. They affect more than 2 billion people, causing afflictions from elephantiasis to blindness to serious intestinal problems. At least 40 percent of the world’s population is infected by worms, says Eric Ottesen.
