Sleeping sickness is infection with germs carried by certain flies. It results in swelling of the brain.
Human African trypanosomiasis
Causes, incidence, and risk factors
Sleeping sickness is caused by two germs (protozoa), Trypanosoma brucei rhodesiense and Trypanosomoa brucei gambiense. The more severe form of the illness is caused by T. b. rhodesiense.
Tsetse flies carry the infection. When an infected fly bites you, the infection spreads through your blood.
Risk factors include living in parts of Africa where the disease is found and being bitten by tsetse flies. The disease does not occur in the United States. But travelers who have visited or lived in Africa can have the infection.
General symptoms include:
- Drowsiness during the day
- Insomnia at night
- Sleepiness (may be uncontrollable)
Swollen lymph nodesall over the body
- Swollen, red, painful
noduleat site of fly bite Weakness
Signs and tests
A physical exam may show signs of inflammation of the brain and its covering, the meninges (meningoencephalitis).
Tests include the following:
- Blood smear
Cerebrospinal fluid tests Complete blood count(CBC)
- Lymph node
Most antibody and antigen tests are not helpful because they cannot tell the difference between current and past infection. Specific IgM levels in the cerebrospinal fluid may be more helpful.
Medicines used to treat this disorder include:
- Eflornithine (for T. b. gambiense only)
- Pentamidine (for T. b. gambiense only)
- Suramin (Antrypol)
- Some patients may receive combination therapy
Without treatment, death can occur within 6 months from
- Injury related to falling asleep while driving or during other activities
- Gradual damage to the nervous system
- Uncontrollable sleep as the disease gets worse
Calling your health care provider
See your health care provider right away if you have symptoms. It is important to begin treatment as soon as possible.
Pentamidine injections protect against T. b. gambiense. But not against T. b. rhodesiense. Because this medicine is toxic, using it for prevention is not recommended.
Insect control measures can help prevent the spread of sleeping sickness in high-risk areas.