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AFRICAN SLEEPING SICKNESS

the science

WHAT IS IT?

The African Sleeping Sickness, otherwise known as African Trypanosomiasis, is a microscopic sized parasite that enters the body through the area where a tsetse fly bites the human. If untreated, this "sickness" is fatal. These flies typically bite during the day and typically live in savanna areas, forests, areas with thick vegetation along rivers and waterholes, and most commonly- throughout bush areas. This allows the disease to be spread from the infected fly into the human where it travels through either the bloodstream or spinal fluid into the brain. There are two types of this disease- East African Tryanosomiasis (Trypanosoma brucei rhodesiense) & West African Trypanosomiasis (Trypanosoma brucei gambiense)- each a little different, but mainly only due to the time it takes for symptoms to set in. This disease is typically contracted in Central (and sometimes West) rural areas of Africa.

WHAT IS IT?

WHAT DOES IT DO IN YOU?

WHAT DOES IT DO IN YOU?

  • the parasite first is spread into the tsetse fly when it bites into an infected mammals blood, the infection then grows in the digestive system of the fly for a few weeks until the fly is then infectious too and then it can spread it onto other humans/animals that it bites
  • once a fly is infectious it remains that way for the rest of its life
  • when the parasites enter the body they reproduce through binary division (where one of the parasites splits into 2)
  • they get food from absorbing nutrients from the body fluids inside the body

SYPTOMS:

SYMPTOMS

the basics

THE BASICS

There are two stages to this infection once you get it. Each stages length depends on the version of the illness, but both have similar symptoms. Both wild animals and humans can be infected with this disease.

Here are some of the typical early stage 1 symptoms (when parasites are found in lymphatic and blood system):

  • swollen lympth glands at the back of the neck
  • urge to sleep often/insomnia at night
  • psyciatric symptoms start to occur like: irritability, violence, uncontrolled sexual impulses, etc
  • muscle twitches, tremors and slurred speech
  • painful sensations in arms and legs

Here are some of the typical stage 2 symptoms (when parasites invade nervous system):

  • urge to sleep often/insomnia at night
  • seizures
  • brain swelling
  • coma
  • progressive confusion and personality changes
  • other neurologic problems occur once it is in the central nervous system
  • you will die in a fatal sleep if you leave this illness untreated
  • fever
  • severe headaches
  • extreme fatique
  • sometimes a skin rash can occur

eastern version

east african trypanosomiasis

Trypanosoma brucei rhodesiense

This version is unique because symptoms typically start between 1-3 weeks after being bitten by an infected fly. It also progresses into the second stage faster than the Western version- taking only a few weeks. If you are infected by the Eastern version it can hurt and leave a red sore called a chancre.

western version

west african trypanosomiasis

Trypanosoma brucei gambiense

If you contract the western version of this illness, symptoms can be intermittent or minimal for the first few months after you are bitten, or throughout the beginning of the first stage. Symptoms start to show around a year after infection. This version of the parasite is different because it can take a few years to progress into the second stage.

This sickness was first occurant throughout the slave trade in the early/mid 1700s. But it was more specifically first discovered (that T. brucei was the cause of this illness in cattle) in 1895.

MORE FACTS

A pregnant mother, if infected, can sometimes pass it onto her baby. Otherwise, you can get this sickness through sexual ways, blood transfusions, and organ transplants. Most commonly however, people get it from the tseste fly when in rural areas of Africa.

Not all tseste flys are infected, only a small ammount of the total population of them actually carry the disease.

MORE FACTS

If you think you have it, you can test to check through a skin biopsy of the chancre, a spinal tap, or through blood tests. Once confirmed that you actually do have it, medical treatement should occur right away, depending on each specific persons lab results. Hospitalization is typically required in treatment, as well as sometimes a follow up lumbar puncture every 6 months for two years.

You can get reinfected, you are not immune after you have it once, As well, there are no drugs or vaccines to help prevent this yet.

TREATMENT & PREVENTION

TREATMENT

Treatment depends on what infection the patient has (Eastern or Western) and what stage the infection has reached. Pentamidine is the drug reccomended when someone is in the first stage of the Western version of this and is available in the US. However, suramin, melarsoprol, eflornithine, and nifurtimox when used in combination with eflornithine are other drug options that can be used to help treat this in the Eastern version and in other stages, but they are not so easily available. No matter what, patients must be watched closely for 2 years after the infection in case of relapse.

PREVENTION

Ways to lessen the chances of you getting African Sleeping Sickness if you visit rural areas of Africa:

For the first time in 50+ years, efforts to help control and decrease this disease have really been helping. Numbers have decreased from about 100,000 cases a year in the 1900s to less than a few thousand nowadays.

  • wear protective thick clothing, that way the tsetse fly will not be able to bite through it because it can bite through thin fabric
  • wear nuetral colored clothing- tsetse fly attracts to bright and dark colored clothing
  • the fly rests in bushes and will bite if disturbed so avoid bushes
  • check for flies inside vehicles before entering, they are attracted to moving vehicles
  • use insect repellent to prevent sickness from other insects

ARTICLE & OPINION

ARTICLE

ARTICLE I CHOSE:

The article I chose to read and summarize (linked at the bottom) is called

"THE DOCTOR’S WORLD; New Drug for Sleeping Sickness” from The NY Times by Lawrence K. Altman. It is dated July 16th, 1985. Below is a sumary of the information it encloses.

The corkscrew shaped parasite continued infecting brains to an unknown amount of people after not being stopped by standard drugs, due to the poor ability to keep record of the number of people infected during the time this article was written. In 1985, about 35 million Africans were at risk of contracting this parasite. The first new drug in 30 years had been found and when this article was written, had so far cured 97 patients with this disease. The drug is called difluoromethylornithine but is also called DFMO, scientists had even referred to it as the resurrection drug. The struggle was that when the patients felt better they would simply leave the hospital and return to the bush, not allowing follow up to be done. This drug was meant to block the action of key enzymes.

https://www.nytimes.com/1985/07/16/science/the-doctor-s-world-new-drug-for-sleeping-sickness.html?searchResultPosition=1

OPINION

OPINION:

In my opinion, this disease is very scary, especially since it doesn’t only give the typical symptoms someone thinks of when you get sick, it also affects your nervous system and your brain. One question I have is: how and why are these flies attracted to certain things (such as certain color clothing and moving vehicles). I wonder how people function differently when they have the disease regarding everyday life in comparison to someone who does not have the disease.

SOURCES

https://www.cdc.gov/parasites/sleepingsickness/index.html\

https://www.nytimes.com/1985/07/16/science/the-doctor-s-world-new-drug-for-sleeping-sickness.html?searchResultPosition=3

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2270819/#:~:text=In%201895%2C%20the%20Scottish%20pathologist,cattle%20nagana)%20%5B16%5D.

https://www.cfsph.iastate.edu/Factsheets/pdfs/trypanosomiasis_african.pdf

https://microbewiki.kenyon.edu/index.php/African_Sleeping_Sickness:_Trypanosome_Invasion_Mechanism

https://dana.org/article/a-wake-up-call-about-sleeping-sickness/

https://www.fao.org/3/x0413e/x0413e02.htm

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.yourgenome.org%2Ffacts%2Fwhat-is-african-sleeping-sickness&psig=AOvVaw0Py38jh0NK87pKW9wfw6zH&ust=1648818407970000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCLCX-8bP8PYCFQAAAAAdAAAAABAX

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.nbcnews.com%2Fscience%2Fscience-news%2Ftsetse-fly-genome-decoded-fight-against-african-sleeping-sickness-n89101&psig=AOvVaw2cJqpjOSfzXstnp0M6rRzW&ust=1648826816564000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCLiHztrU8PYCFQAAAAAdAAAAABAR

https://www.cdc.gov/parasites/sleepingsickness/treatment.html#:~:text=gambiense%20infection%2C%20is%20available%20in,can%20be%20obtained%20from%20CDC.

https://www.google.com/url?sa=i&url=http%3A%2F%2Fproducts.fresenius-kabi.us%2Fproduct-91.html&psig=AOvVaw1_fjh4p9a7SjWaKefvHwfb&ust=1648827396216000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCMD-8ffW8PYCFQAAAAAdAAAAABAD

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.nytimes.com%2F2018%2F11%2F16%2Fhealth%2Fsleeping-sickness-africa-cure.html&psig=AOvVaw3sEYyyvIy1zt-1LFt6fUtm&ust=1648827497412000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCKilwKDX8PYCFQAAAAAdAAAAABAD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1832067/#:~:text=Between%20approximately%201900%20and%201920,decline%20of%20the%20epidemic1.

SOURCES

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