West African Trypanosomiasis

African trypanosomiasis is also called sleeping sickness. West African trypanosomiasis, also called Gambian sleeping sickness, is caused by a parasite called Trypanosoma brucei gambiense. This disease can be contracted in parts of Western and Central Africa. There is no medicine or vaccine to prevent this illness.

CAUSES

This disease is caused by the bite of an infected tsetse fly that is found only in Africa. Getting the disease does not give you immunity against future disease. West African trypanosomiasis is usually found in areas with forests, thick shrubbery and trees, rivers, and water holes. Risk of infection increases with the number of times a person is bitten by flies. Tourists are not usually at great risk for contracting this disease unless they are spending long periods of time in rural areas of Western and Central Africa. If you are infected and pregnant, you may rarely pass the infection to your baby. This infection has also been contracted very rarely through a blood transfusion or organ transplant from an infected person.

SYMPTOMS

A bite by the tsetse fly is often painful. Symptoms follow several weeks to many months after the bite of an infected fly. Common symptoms include:

  • A painful sore at the site of the insect bite. The sore develops 1 to 2 weeks after the bite and disappears without treatment in several weeks.

  • Fever that may be present for days, then disappears, and reappears days later.

  • Swollen lymph nodes, especially around the neck.

  • Rash.

  • Swelling around the eyes and hands.

Other less common symptoms include:

  • Headaches.

  • Fatigue.

  • Aching muscles and joints.

  • Weight loss.

  • Rapid heartbeat.

The infection spreads to the central nervous system (brain and spinal cord) months or even years after the beginning of the infection. Symptoms then include:

  • Personality changes.

  • Severe headache.

  • Irritability.

  • Loss of concentration.

  • Progressive confusion.

  • Daytime sleepiness and inability to sleep at night.

  • Slurred speech.

  • Seizures.

  • Difficulty walking and talking.

If left untreated, the infection becomes worse and death will occur within several months to years.

DIAGNOSIS

Common tests include:

  • Blood samples.

  • A spinal tap to test the spinal fluids.

  • A test of fluid samples from the lymph nodes.

TREATMENT

Treatment should be started as soon as possible and is based on the infected person's symptoms and lab results. Medicine for the treatment of West African trypanosomiasis can be obtained through the Centers for Disease Control and Prevention. Hospitalization is frequently necessary because treatment requires injections of drugs as well as observation for side effects from the drugs. Periodic follow-up exams, including a spinal tap if the central nervous system was involved, are required for 2 years to make sure treatment was successful.

PREVENTION

  • Wear protective clothing, including long-sleeved shirts and pants, which are khaki or olive colored. The tsetse fly can bite through thin fabrics, so clothing should be made of thick material. The tsetse fly is attracted to both bright and dark colors. Flies are particularly attracted to clothing or objects that are blue.

  • 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.

  • When sleeping, use bed nets.

  • 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. They rest in bushes but may bite if disturbed.

HOME CARE INSTRUCTIONS

  • Only take medicines as directed by your caregiver.

  • Keep all follow-up appointments as directed by your caregiver.

SEEK MEDICAL CARE IF:

  • You develop concerning or persistent problems during or after treatment.

  • You develop sores at your drug injection sites.

  • You develop a skin rash.

  • You develop nausea or vomiting.

  • You develop abdominal pain.

  • You have numbness or tingling in your hands or feet.

  • You develop hearing loss.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a seizure.

  • You faint.