| Disease/Syndrome |
African Trypanosomiasis |
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| Category |
Infection, Travel |
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| Acute/Chronic |
Subacute |
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| Synonyms |
Sleeping sickness; Human African trypanosomiasis (HAT); Trypanosoma brucei gambiense (West African); T.b. rhodesiense (East African); |
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| Biomedical References |
Search PubMed |
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| Comments |
FINDINGS: Common initial symptoms are intermittent fever, headache, and lymphadenopathy. Light-skinned patients may have a rash at about 6-8 weeks after infection. West African trypanosomiasis is a chronic disease lasting months to years with two distinct stages: hemolymphatic and meningoencephalitic. The inoculation chancre is not frequently seen in clinical practice. The chancre may ulcerate to reach a size of several centimeters, and it may be associated with regional lymphadenopathy. The onset of fever marks the beginning of the first stage. Winterbottom�s sign is the presence of lymphadenopathy in the posterior cervical triangle. A rash is often present on the trunk, shoulders, buttocks, and thighs. Typically, the rash consists of patches of erythema 5-10 cm in diameter with central clearing. Symptoms in the second stage include irritability, inability to concentrate, severe headache, impaired speech, tremors, fasciculations, ataxia, stupor, and coma. East African trypanosomiasis is an acute disease lasting less than 9 months. Recurrent fever and rash are present in both East and West forms, but lymphadenopathy is not prominent in East African trypanosomiasis. [PPID, p. 3166-7] Meningoencephalitis develops either a few weeks to months after the bite (East African form) or months to years after the bite (West African form). Myocarditis also develops. Without treatment, death ensues. [Merck Manual, p. 1570] EPIDEMIOLOGY: Tsetse flies live in rural areas. About 1-2 cases per year are reported among travelers from the USA. [CDC Travel, p. 332] Animal reservoirs include bushbucks, antelopes, and cattle for the East African form, a zoonosis and a disease of hunters, fishers, honey collectors, and visitors to wild game parks. Humans are the reservoirs for the West African form. Infected blood is a laboratory hazard, but transfusion or congenital infections are rarely reported. [CCDM, p. 554; ID, p. 2327] New cases every year: 100,000 for West African trypanosomiasis; and <1000 for East African trypanosomiasis; [Current Consult, p. 974] |
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| Latency/Incubation |
3 days to several weeks (T. b. rhodesiense); months to years (T. b. gambiense) |
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| Diagnostic |
Identify trypanosomes in blood, lymph or CSF; Card agglutination tests for trypanosomiasis (CATT, TrypTect CIATT) are used to screen populations at risk; [CCDM; PPID, p. 3168] CSF: lymphocytic pleocytosis; [Wallach, p. 1020] |
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| ICD-9 Code |
086 |
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| Effective Antimicrobics |
Yes |
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| Scope |
Between 15 degrees N & 20 degrees S in tropical Africa (home of the tsetse fly); Gambian: west & central; Rhodesian: east & south Africa; |
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| Reference Link |
CDC - African Trypanosomiasis |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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