Trypanosomiasis (African) (Sleeping sickness)
There are two forms of trypanosomiasis, African and American. African trypanosomiasis occurs in tropical or Sub-Saharan Africa i.e. from north of South Africa to south of Algeria, Libya and Egypt.
African trypanosomiasis is a widespread tropical disease caused by a parasite and can be fatal if not treated. The parasite is transmitted to humans by the bite of an infected tsetse fly, a grey-brown insect the size of a bee. Tsetse flies inhabit rural areas, and are mainly found in vegetation by rivers and lakes, forests and large areas of wooded savannah. The bite from a tsetse fly is painful and may be remembered.
There are two stages to the illness. In the first stage, the tsetse fly bite becomes a red sore and within a few weeks the following symptoms may be felt; fever, swollen lymph glands, aching muscles, joint pains, headache and irritability.
The second stage of the illness is also known as the neurological phase and begins when the parasite invades the nervous system. Signs and symptoms of this phase include; confusion, sensory disturbances and poor coordination. Disturbance of the sleep cycle, which gives the illness its name, is an important feature of this phase.
Trypanosomiasis is rare in travellers, although cases have been reported in European visitors to some game parks in Tanzania. Travellers suspected of having this illness should be referred to a specialist in infectious diseases or tropical medicine for treatment. The type of treatment depends on the stage of the disease and medicines are available. The earlier treatment is started the better the outlook for the patient.
Recommendations for travellers
- No vaccine is available to prevent trypanosomiasis.
- Prevention is by avoidance of tsetse fly bites.
- If possible avoid risk areas as outlined previously.
- Tsetse flies are repelled by permethrin and soaking clothes is recommended.
- Available DEET insect repellents are ineffective against tsetse flies, wear wrist and ankle length clothing.
- Choose medium weight fabric as tsetse flies can bite through lightweight material.
- Choose neutral colours that blend with your surroundings as tsetse flies are attracted by movement and dark colours.
- Sleep under an impregnated mosquito net.
- In risk areas drive with the windows closed as tsetse flies have been known to follow moving vehicles.
- Report any fevers promptly on return from risk area.
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