- This disease is caused by the
parasites Trypanosoma brucei rhodesiense or Trypanosma
brucei gambeinse. They are transmitted to humans by the
bites of tsetse flies, found in the moist climate regions in
- Stage 1: The area of the bite
causes an itching pain and swollen glands that lasts 2-4
- Stage 2: Occurs 3-10 days
after stage 1. The infection goes into the bloodstream and
lymph system. Symptoms include high fever, severe headache,
joint pains, lack of energy, and rashes. Weight loss may also
occur. Symptoms may temporarily disappear for two weeks at a
time, only to return for a second go around.
- Stage 3: "Sleeping Sickness Stage" occurs from 6 months to years after the original infection. Symptoms may include Insomnia (instead of
sleepiness), loss of appetite, personality changes, lack of
energy, and headaches. Severe sleepiness occurs late. This
is followed by severe weight loss and coma. Death occurs
from infections from other
- Stage 1: Examination may show
inflammation of the bite site and swollen lymph glands
- Stage 2: Examination may show mild enlargement of the liver and spleen, lower extremity edema, Ascites (fluid in the
abdomen), pleural effusions (fluid in the lungs) and
enlarged rubbery lymph nodes. Cardiac involvement
(myocarditis) may occur.
- Stage 3: Examination may reveal tremors, Speech Problems, gait
disturbances, and abnormal reflexes.
- Wet films after Giemsa staining
from bite lesion, lymph node aspirates, bone marrow, or
- Blood specimens need to be
examined daily for 15 days because the number of
trypanosomes in the blood can vary.
- Cerebrospinal fluid shows
increased lymphocytes and protein. A centrifuge of CSF may
be needed to find the parasites.
- Serologic (blood) testing for IgM
and IgG antibodies may be performed
- Other findings may include increased sedimentation
rates, anemia, decreased platelets, decreased total serum
protein, and increased serum
- Suramin for both parasites
(rhodesiense and gambiense)
- Eflornithine (DMFO) is a drug of
choice for gambiense. An alternative is Pentamidine.
- A third choice for both parasites
is Melarsoprol, but it has a severe amount of toxicity.
- Late stage diseases with Central Nervous System Involvement: Melarsoprol for both parasites or Eflornithine for gambeinse, are the leading drugs of choice. Alternative drugs for gambiense are Eflornithine or Tryparsamide plus Suramin.
treatment as soon as possible. This disease is often fatal
- Wear long sleeves and trousers and
avoid dark clothing.
- Use mosquito nets while sleeping
because repellents have no effect.
- Pentamidine may be used for
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