What is East African Trypanosomiasis
East African trypanosomiasis, also called sleeping sickness, is a long-lasting (chronic) infection that is caused by a parasite found in Eastern Africa and Central Africa.
The infection spreads over time to affect the brain and spinal cord (central nervous system). Without treatment, this is a life-threatening condition.
What are the causes?
This condition is caused by the parasite Trypanosoma brucei rhodesiense. This parasite infects tsetse flies in parts of Eastern and Central Africa, usually in woodlands or savannah areas that are away from human habitation. A person can become infected after:
- Being bitten by an infected tsetse fly.
- Receiving blood or an organ transplant from an infected person (rare).
- Having unprotected sex with an infected person (rare).
An infected mother can pass along the infection to her unborn child.
What increases the risk?
This condition is more likely to develop in people who have spent long periods of time in rural parts of Eastern Africa or Central Africa. The risk of infection increases with the number of times that a person is bitten by tsetse flies.
What are the signs or symptoms?
Early symptoms of this condition may develop within 2 weeks of being infected. These symptoms may include:
- A painful sore at the site of the tsetse bite. The sore develops 1–2 weeks after the bite. The sore goes away within several weeks without treatment.
- A fever that does not go away.
- A rash.
- Swelling around the eyes and hands.
- Headaches.
- Feeling unusually tired (fatigue).
- Aching muscles and joints.
- Weight loss.
- Rapid heartbeat.
Later symptoms may take weeks or months to develop. These symptoms may include:
- Personality changes.
- Severe headache.
- Irritability.
- Loss of concentration.
- Gradually increasing (progressive) confusion.
- Daytime sleepiness and inability to sleep at night.
- Slurred speech.
- Seizures.
- Difficulty walking and talking.
How is this diagnosed?
This condition is diagnosed with tests. These may include:
- A blood test.
- A spinal tap (lumbar puncture). In this test, a small amount of the fluid that surrounds the brain and spinal cord is removed and examined.
- A skin biopsy. In this test, a sample of skin is removed and examined. If you have a sore, tissue will be removed from the sore.
How is this treated?
This condition is treated with medicines that are injected into the skin or a vein. Treatment is usually done at a hospital where a health care provider can watch for side effects of the medicines. You may have other kinds of treatment, depending on your symptoms and your test results.
During the 2 years after the condition has been treated, it is important to follow up regularly with your health care provider. During these visits, your health care provider will make sure that the treatment is successful. Your health care provider may need to perform a lumbar puncture during these visits.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
How is this prevented?
- Wear loose-fitting, long-sleeved shirts and long pants that are made of thick, neutral-colored material. The tsetse fly is attracted to bright colors and dark colors.
- Use insect repellent.
- When sleeping, use bed nets.
- Check vehicles for tsetse flies before you enter them. Avoid riding in open vehicles. The tsetse fly is attracted to the dust that is created by moving vehicles and wild animals.
- Avoid bushes. The tsetse fly rests in bushes during the hottest part of the day, but it may bite if it is disturbed.
Contact a health care provider if:
- You develop new symptoms.
- You
develop any of these symptoms:
- Sores at your injection site.
- Nausea or vomiting.
- Pain in your abdomen.
- Numbness or tingling in your hands or feet.
- A skin rash.
- Hearing loss.
- Your symptoms get worse.
Get help right away if:
- You have a seizure.
- You faint.
