Sleeping sickness, scientifically known as human African trypanosomiasis, is a disease caused by the protozoan Trypanosoma brucei gambiense and rhodesiense, being transmitted by the bite of the tsetse fly, which is most often found in African countries.
The symptoms of this disease usually appear after a few weeks after the bite, however, it can take several months to appear and this depends on the species of the fly and the person's body response to the microorganism, for example.
As soon as the symptoms appear it is important to consult a general practitioner, because after diagnosing the sleeping sickness it is necessary to start the treatment as soon as possible, because if it evolves a lot it can put the person's life at risk, due to the injuries caused by the parasite in the system nervous system and various parts of the brain.
Main symptoms
The symptoms of sleeping sickness vary from person to person and depend on the stage of the disease, such as:
- Cutaneous stage: at this stage, it is possible to observe red papules on the skin that later worsen and become a painful ulcer, of a darker, swollen color, called cancer. This symptom appears approximately 2 weeks after the tsetse fly bite, it is more common in white people and is rarely seen in black people; Hemolymphatic stage: after a month of the insect's bite, the microorganism reaches the lymphatic system and the blood, leading to the appearance of water in the neck, headache, fever and red spots spread throughout the body; Meningo-encephalitic stage : it is the most advanced stage of sleep sickness and drowsiness, in which the protozoan reaches the central nervous system, causing brain damage that is observed by the appearance of mental confusion, excessive sleep, changes in behavior and balance problems of the body.
In addition, sleeping sickness can cause other changes in the body, such as disorders in the heart, bones and liver, and can also cause other types of diseases such as pneumonia, malaria. Check out more about the main symptoms of malaria.
How the diagnosis is made
The diagnosis of sleeping sickness is made by performing blood tests to check for the presence of specific proteins, called IgM immunoglobulins, and to identify whether there are antibodies circulating in the bloodstream. If the person has sleeping sickness, the blood test may also have other changes such as anemia and monocytosis. See more about what monocytosis is.
People with suspected sleeping sickness should collect bone marrow and lumbar puncture to analyze, in the laboratory, how far the protozoa have reached the bloodstream and the brain and also serve to count the defense cells in the cerebrospinal fluid, which it is the liquid that circulates in the nervous system.
How it is transmitted
The most common form of transmission of sleeping sickness is through the bite of the tsetse fly, from the family Glossinidae . In more rare cases, the infection can also arise due to the bite of another type of flies or mosquitoes, which have previously bitten a person infected with protozoa, for example.
The tsetse fly is found most often in rural areas of Africa, in places where abundant vegetation, heat and high humidity are found. Once infected, this fly carries the parasite for the rest of its life, and can contaminate several people.
Therefore, it is important to take some measures to prevent the tsetse fly bite, such as:
- Wear long-sleeved clothing, preferably neutral in color, since the fly is attracted by bright colors; Avoid being close to the bush, as the fly can live in small bushes; Use insect repellent, especially to ward off other types of flies and mosquitoes that can transmit the disease.
In addition, the parasite infection can also pass from mothers to children, arise from accidental bites with contaminated needles or happen after intimate relationships without a condom.
Treatment options
Treatment varies according to the person's age and depends on the degree of evolution of the disease, and if treated before affecting the central nervous system, the medications used are less aggressive, such as pentamidine or suramine. However, if the disease is more advanced, it is necessary to use stronger drugs with more side effects, such as melarsoprol, eflornithine or nifurtimox, which must be administered in the hospital.
This treatment must be continued until the parasite is completely eliminated from the body and, therefore, blood and other body fluids must be repeated to ensure that the parasite has been completely eliminated. After that, it is necessary to maintain a 24-month surveillance, observing the symptoms and making regular examinations, to ensure that the disease does not recur.
