SCRIPT NUMBER 161
AFRICAN SLEEPING SICKNESS - 2
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: AFRICAN SLEEPING SICKNESS - 2
PROGRAM NUMBER: 161
SUBJECT: CAUSES, MECHANISM OF INFECTION, SYMPTOMS,
TREATMENT, PREVENTION OF AFRICAN SLEEPING
SICKNESS.
KEY WORDS: TSETSE FLY, PARASITE, CONFUSION, COMA, SCREENING,
MINIMIZING CONTACT
DATE OF SCRIPT: APRIL 25, 2014
AUTHOR: RICHARD YUKL, MD, FACS
A man living in the United States went on an African safari to see the rich variety
of animals he had heard about his entire life but had never seen. The trip was
glorious, he saw so many creatures that God created, but that we have
destroyed in other parts of the world through our attempts at creating civilized
society. Two weeks into his safari, the man was overcome with a headache and
feelings of sleepiness. At first, he thought he wasn’t getting enough rest, but
when the skin at sites where he had been bitten by flies began to swell, he saw a
doctor who diagnosed him as having contracted African sleeping sickness.
Today, I want to talk about African sleeping sickness. It is a deadly parasitic
infection found in humans and domestic animals such as horses and cows.
Parasites are organisms that live in and feed on another organism while
contributing nothing to the wellbeing of their host. They merely use their host as a
food source. We become infected with the sleeping sickness parasite when we
are bitten by an infected tsetse fly, a fly that lives in warm and wet climates near
the equator. This includes an area covering much of the continent of Africa.
If a healthy tsetse fly bites a human or domestic animal infected with the sleeping
sickness parasite, the parasite enters the fly. The fly, in turn, passes the parasite
back to humans and domestic animals by biting them. Clinically, sleeping
sickness develops in two stages. In the first stage, the parasite multiplies in the
tissues under the skin, and in blood and lymph fluid, causing itching, fevers, joint
pains and headaches.
As the infection advances to its second and more serious stage, parasites cross
into the brain. Fever and headaches continue, but now, lymph nodes all over
your body enlarge. You will develop confusion, poor coordination, and changes in
your behavior. You will suffer uncontrollable sleepiness. At this stage,
complications of the infection become deadly, so you must have the infection
appropriately treated to have hope of survival.
Common deadly complications of sleeping sickness include injuries caused by
falling asleep while driving or while performing physical activities. Sleepiness
becomes ever more intense as brain damage from the infection worsens, and it
eventually leads to a coma. Another deadly complication is that the parasite
damages your heart muscle. Your heart enlarges and its rhythm becomes
irregular. Eventually the damaged heart muscle can no longer keep up with the
demands placed on it, and it fails.
As many as 400,000 people become infected with the sleeping sickness parasite
every year, and many of those infected die without proper treatment, often within
as little as 6 months. Sleeping sickness also kills up to three million head of
untreated cattle each year. It is a major reason there are few horses and cows in
some parts of Africa.
Proper treatment of the infection depends on the stage at which it is diagnosed.
The earlier the disease is identified, the better the possibility of a cure. The World
Health Organization has developed partnerships with several large drug
companies, allowing for creation of surveillance teams to identify infected people,
and also for effective drugs to be provided free of charge at the time of diagnosis.
Fortunately, the disease responds well to proper treatment.
How can a disease as widespread as sleeping sickness be effectively controlled?
The surest way is to develop the ability to screen, diagnose and immediately
treat people who are in an early stage of the infection. The man who became sick
during his African safari was treated immediately upon diagnosis, and he
recovered. There was a major epidemic of African sleeping sickness in 1920, and
that epidemic was controlled thanks to mobile teams that organized the
screening of millions of people at risk. By the mid-1960’s the disease had almost
disappeared, so screening efforts were lessened. Sadly, the disease has
reappeared in several regions where those efforts were lessened.
How can you avoid becoming infected with the sleeping sickness parasite if you
live in an at-risk area, or if you are planning to visit such an area? There is
currently no vaccine or drug that can prevent the infection. Preventive measures
are aimed at minimizing contact with the tsetse fly. If you are planning to visit an
area at risk for sleeping sickness, local residents are usually aware of the places
where fly populations are dense, and they can advise you which areas to avoid.
Tsetse flies are attracted to the motion and dust of moving vehicles, so check
your vehicle for an invasion of flies before reentering it following a dusty trip.
Tsetse flies are also attracted to bright and dark colors, so another helpful
preventative measure is to wear long-sleeved shirts and pants of neutral colors
that blend with background colors.
Rub insect repellent onto your scalp, and carefully spray all of your uncovered
skin. Because the tsetse fly can bite through lightweight clothing, spray insect
repellent onto areas of your body covered by clothing as well.
The flies will bite if disturbed, even during the hottest part of the day when they
are less active, so use plenty of insect repellent if it is available to you. Keep food
scraps at a distance. As food spoils, it attracts flies, putting you at a greater risk
of being bitten. Finally, cover any open wound. Tsetse flies live on blood, and
they can smell it from far away. Taking precautions to avoid contact with flies that
carry the sleeping sickness parasite can save you from some serious health
problems if you live in or travel to many parts of Africa.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may
differ for your particular health needs. If you need medical advice, please consult
a medical professional in your area.