Human African trypanosomiasis, the scientific name for what is popularly known as sleeping sickness, is a parasitic disease that needs a vector, in this particular case a fly, in order to infect. The fly infects the parasite after biting an infected human or animal. This fly is only found in Africa, so in most cases you can only get the disease from there. However, the continuous migratory and merchandise flows make it increasingly likely that this type of disease will spread to other areas of the world.
If this disease is not diagnosed and treated in time it can lead to brain inflammation, which gives one of the most representative symptoms of this disease: drowsiness. At ONsalus we tell you more about sleeping sickness: symptoms, treatment and sequelae so that you know everything you need about this disease.
Transmission and contagion of sleeping sickness
In most cases, the parasite requires the use of a vector, the tse-tse fly, for infection to occur. This fly is only found in Africa, so the disease can only be found in people who have traveled to this continent, the vector (the fly) is not spread throughout the continent, it is concentrated in some countries and areas: rivers, lakes, gallery forests or savannah. The countries that report the most cases of infections are:
- Democratic Republic of the Congo, where around 80% of reported cases are found.
- Central African Republic, It is the second country with the highest number of cases.
- Angola, Burkina Faso, Cameroon, Chad, Ivory Coast, Gabon, Ghana, Guinea, Equatorial Guinea, Kenya, Malawi, Nigeria, South Sudan, Uganda, United Republic of Tanzania, Zambia, and Zimbabwe, present cases but on very rare occasions: less than 100 cases per year.
However, other cases of infection in which the fly is not involved have been reported:
- Vertical transmission (mother-child): The parasite can cross the placental barrier and infect the child.
- Accidental needlesticks with needles containing the parasite.
- Sexually transmitted.
Sleeping sickness and its symptoms
Once the parasite has entered the body it begins to multiply. This occurs in different stages, there are three known phases of the disease:
Initial phase
It is the first phase and originates after the infection. The characteristic of this phase is the inflammation in the area of the sting, followed by the evolution towards a painful ulcer with a white frame around it. Finally, the ulcer becomes a hyper-pigmented lesion, very dark, after two or three weeks of evolution.
Hemo-lymphatic phase
In this phase, the parasite passes into the blood and lymphatic circulation, where it begins to replicate. In this phase, the following symptoms mainly occur:
- Episodes of high fever (1 to 3 days), followed by periods without fever. Each fever is the result of a new replication of the parasite.
- Severe, disabling headache
- Severe weakness
- Joint pain
- Anemia
- Winterbottom's sign: Swollen cervical lymph nodes, but not painful.
- Weight loss and itching.
Neurological phase
When this phase begins, the parasite has already crossed the blood-brain barrier, the protective barrier that filters what can pass into the Brain, therefore it can infect the system central nervous system. During this phase, symptoms of the hemato-lymphatic phase may occur at the same time. The characteristic symptoms of this phase are:
- Change in behavior and character
- Decreased concentration
- Irritability
- Sudden mood swings, going from happy to sad in short intervals of time
- Drowsiness begins during the day and progresses as the infection increases. Finally causes excessive sleep,
Sleeping sickness: treatment
The treatment must be started in patients in whom the parasite is found in the blood. Although there is a treatment, the disease can present high mortality rates In addition, a study of the Cerebrospinal Fluid (Central Nervous System) should be done to determine the presence, or not, of the parasite in the brain. Depending on the stage of the disease, the treatment is different:
- Disease that does not involve the brain: If the disease is diagnosed at this point, the chances of improvement are very high, and the damage caused by drugs is minor. The drugs used in this phase are pentamidine and suramin
- Disease that compromises the brain: The diagnosis is made when the parasite is found in the cerebrospinal fluid. At this point, drugs are used that can become very toxic, these are; melarsoprol and eflornithine
Sequelae and prevention of sleeping sickness
If there is no timely diagnosis, the disease can be fatal. Treatment can be very effective and eliminate the disease, but some mild sequelae may remain in the central nervous system, such as occasional small headaches. There are no vaccines for this disease. In countries where the infection occurs, you can try to control the fly that transmits the disease. To prevent sleeping sickness some individual measures can be taken:
- Avoid areas with disease-transmitting insects.
- Wear light, fresh clothing that covers most of the body.
- Apply plenty of repellent.
- Place mosquito nets.
- Use insecticides.
This article is merely informative, at ONsalus.com we do not have the authority to prescribe medical treatments or make any type of diagnosis. We invite you to go to a doctor in the event of presenting any type of condition or discomfort.
