Sleeping Sickness - East African Trypanosomiasis
What is African trypanosomiasis?
There are two types of African trypanosomiasis (also called sleeping sickness); each is named for the region of Africa in which they are found. The disease is caused by a parasite named Trypanosoma brucei rhodesiense (tri-PAN-o-SO-ma BREW-see-eye rho-DEE-see-ense), carried by the tsetse fly.Worldwide, approximately 25,000 new cases of both East and West African trypanosomiasis are reported to the World Health Organization each year. However, many cases are not reported due to a lack of infrastructure and the true number of new cases is undoubtedly much higher. Since 1967, thirty-six cases of East African trypanosomiasis have been reported within the United States, all among individuals who had traveled to Africa. (See also West African trypanosomiasis.)
How is East African trypanosomiasis spread?
An individual will get East African trypanosomiasis if they are bitten by a tsetse fly infected with the Trypanosoma brucei rhodesiense parasite. The tsetse fly is common only to Africa.
Is East African trypanosomiasis a serious illness?
Yes. If a person fails to receive medical treatment for East African trypanosomiasis, death will occur within several weeks to months.
Where can you become infected with East African trypanosomiasis?
East African trypanosomiasis is found in parts of Eastern and Central Africa, including Uganda, Kenya, Tanzania, Malawi, Ethiopia, Zaire, Zimbabwe, and Botswana. Areas where infection is spread are largely determined by the location of the infected tsetse fly and wild animal population.
What are the symptoms of East African trypanosomiasis?
A bite by the tsetse fly is often painful and can develop into a red sore, also called a chancre (SHAN-ker). Fever, severe headaches, irritability, extreme fatigue, swollen lymph nodes, and aching muscles and joints are common symptoms of sleeping sickness. Some people develop a skin rash. Progressive confusion, personality changes, slurred speech, seizures, and difficulty in walking and talking occur when infection has invaded the central nervous system. If left untreated, infection becomes worse and death will occur within several weeks or months.
How soon after infection will I have symptoms of East African trypanosomiasis?
Symptoms begin within 1 to 4 weeks of getting an infected tsetse fly bite.
What should I do if I think I may have African trypanosomiasis?
If you suspect that you may have East African trypanosomiasis, immediately consult with your health care provider who will order several tests to look for the parasite. Common tests include blood samples, a spinal tap, and skin biopsies, especially if you have a chancre.
What is the treatment for East African trypanosomiasis?
Medical treatment of East African trypanosomiasis should begin as soon as possible and is based on the infected person’s symptoms and laboratory results. Medication for the treatment of East African trypanosomiasis is available through the CDC. Hospitalization for treatment is necessary. Periodic follow-up exams that include a spinal tap are required for 2 years.
Once infected, am I immune to East African trypanosomiasis?
No one is immune from East African trypanosomiasis. Even if you had the disease once, you can get re-infected.
Who is at risk for contracting East African trypanosomiasis?
East African trypanosomiasis is usually found in woodland and savannah areas away from human habitation. Tourists, hunters, game wardens, and other persons working or visiting game parks in East and Central Africa are at greatest risk for illness.
Can I take a medication to prevent East African trypanosomiasis?
There is neither a vaccine nor recommended drug available to prevent East African trypanosomiasis.
How can I prevent African trypanosomiasis and prevent other insect bites?
- Wear protective clothing, including long-sleeved shirts and pants. The tsetse fly can bite through thin fabrics, so clothing should be made of thick material.
- Wear khaki or olive colored clothing. The tsetse fly is attracted to bright colors and very dark colors.
- Use insect repellant. Though insect repellants have not proven effective in preventing tsetse fly bites, they are effective in preventing other insects from biting and causing illness.
- Use bed netting when sleeping.
- Inspect vehicles for tsetse flies before entering.
- Do not ride in the back of jeeps, pickup trucks or other open vehicles. The tsetse fly is attracted to the dust that moving vehicles and wild animals create.
- Avoid bushes. The tsetse fly is less active during the hottest period of the day. It rests in bushes but will bite if disturbed.
For more information:
- McGovern TW, William W, Fitzpatrick JE, et al. Cutaneous manifestations of African trypanosomiasis. Arch Dermatol 1995;131:1178-82.
- Bryan R, Waskin J, Richards F, et al. African trypanosomiasis in American travelers: a 20-year review. Travel Medicine. Steffen R, Lobel HO, Haworth J, Bradley DJ, eds. Berlin: Springer-Verlag, 1989:384-8.
