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Information on African Sleeping Sickness (African Trypanosomiasis)

Introduction

Trypanosomiasis is a systemic disease cause by the parasite Trypanosoma brucei. It is transmitted by the bite of the tsetse fly, a gray-brown insect about the size of the honeybee. Signs and symptoms are initially nonspecific (fever, skin lesions, rash, edema, or lymph gland swelling); however, the infection progresses to brain swelling (encephalitis). Symptoms generally appear within 1 to 4 weeks of infection. East African trypanosomiasis is more acute clinically than the West African form of the disease, and central nervous system involvement occurs earlier.

Tsetse Fly

Occurrence

African trypanosomiasis is confined to tropical Africa between 15° north latitude and 20° south latitude, or from north of South Africa to south of Algeria, Libya, and Egypt.

Risk for Travelers

Tsetse flies inhabit rural areas only, living in the woodland and thickets of the savannah and the dense vegetation along streams. Although infection of international travelers is rare, cases have occurred and travelers visiting game parks and remote areas should be advised to take precautions. Travelers to urban areas are not at risk.

Prevention

Tsetse flies are attracted to moving vehicles and dark, contrasting colors. They are not affected by insect repellents and can bite through lightweight clothing. Areas of heavy infestation tend to be sporadically distributed and are usually well known to local inhabitants. Avoidance of such areas is the best means of protection. Travelers at risk should be advised to wear clothing of wrist and ankle length that is made of medium-weight fabric in neutral colors that blend with the background environment. Clothing should be pre treated with an insecticide (permethrin)-see travel supplies.

Treatment

Travelers who sustain tsetse fly bites (usually painful) and develop high fever or other manifestations of African trypanosomiasis should be advised to seek early medical attention. The infection can usually be cured by an appropriate course of anti-trypanosomal therapy. Travelers should be advised to consult an infectious disease or tropical medicine specialist.

Vaccination

No vaccine is available to prevent this disease.