East African Trypanosomiasis

What is African trypanosomiasis?

There are two types of African trypanosomiasis, also called sleeping sickness, named for the areas in Africa in which they are found. East African trypanosomiasis is caused by a parasite named Trypanosoma brucei rhodesiense (tri-PAN-o-SO-ma brew-see-eye rho-dee-see-ense). In the United States, twenty-one cases of East African trypanosomiasis in travelers to Africa have been reported since 1967.

Through the bite of an infected tsetse fly, found only in Africa.

Is East African trypanosomiasis a serious illness?

Yes. If untreated, death will occur within several weeks to months.

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 get 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 will I have symptoms of East African trypanosomiasis?

Symptoms occur within 1-4 weeks of infection.

Can I take a medication to prevent East African trypanosomiasis?

No. Neither a vaccine nor recommended drug is available to prevent East African trypanosomiasis.

What should I do if I think I have African trypanosomiasis?

See your health care provider who will order several tests 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?

Treatment should be started 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 is necessary for treatment. Periodic follow-up exams, including a spinal tap, are required for 2 years.

Once infected, am I immune to East African trypanosomiasis?

No. You can get reinfected.

Where can you contract East African trypanosomiasis?

East African trypanosomiasis can be contracted in parts of Eastern and Central Africa, including Uganda, Kenya, Tanzania, Malawi, Ethiopia, Zaire, Zimbabwe, and Botswana. Areas where infection is contracted are largely determined by the infected tsetse fly and wild animal population.

Who is at risk for contracting 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.

• 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 both bright 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.
• When sleeping, use bednets.
• Inspect vehicles for tsetse flies before entering.
• Don’t 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 may bite if disturbed.

For more information:

1. 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.
2. McGovern TW, William W, Fitzpatrick JE, et al. Cutaneous manifestations of African trypanosomiasis. Arch Dermatol 1995;131:1178-82.

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