Facts to Know About Sleeping Sickness

It sounds hilarious, right? Yeah, but it’s a deadly disease. It got its nickname or its common name from the disturbed sleeping pattern in its symptoms. It is usually transmitted by the tsetse fly(Glossina species) in humans. The vector-borne parasitic disease is carried around by infected tsetse flies. Sleeping sickness is so common in 36 sub-African countries. That is why it also carries the name African Trypanosomiasis disease. This infection is of two forms which shall be discussed in this article. Well, not all the existing species of tsetse fly carry the parasite. It spreads easily and is so common in rural areas, especially areas with fishing, agriculture, and animal rearing. Its infection is not only limited to humans, but it also infects animals as well. Sleeping sickness must be treated immediately after diagnose because if left untreated, it might be fatal. Annually, there are always about 11,000 reported cases.

Forms of Sleeping Sickness Disease

As mentioned earlier, certain species are responsible for this disease.

• Trypanosoma Brucei Gambiense- this is the most common form of sleeping sickness. It has the highest reported cases, about 98% of sleeping sickness. It is a chronic infection. It was reportedly found in 24 countries in the West and Central Africa. Its signs and symptoms are not obvious at the initial stage of infection until it affects the central nervous system.
• Trypanosoma Brucei Rhodesiense- takes 2% of the reported cases globally. It causes an acute infection. At the first stage of infection, the signs and symptoms are observed. It also affects the central nervous system if not taken care of on time.

Tsetse Fly

However, tsetse fly is known as the main causing factor of sleeping sickness. It is an insect- a brown-biting insect. The disease of sleeping sickness occurs from the interaction between the insect and the parasite- Trypanosome. It houses the parasite playing the role of host and also transmitting the parasite, playing the role of vector: tsetse fly is a host and vector of Trypanosome.

The insect has a mouth structure that allows it to pierce the skin. On piercing the skin, it releases metacyclic Trypomastigotes into your skin tissues. It lingers there for a while until it multiplies and develops into Trypomastigotes in the spinal fluid, blood, and lymph nodes.

Means of Transmission

African Trypanosomiasis disease is transferrable from one person to the others through its vector- tsetse fly. There are some other ways by which sleeping sickness can spread.

• Blood transfusions: when the donor’s blood is not properly examined before transfusion, it can result in the transmission of the parasite.
• Sexual intercourse. During the period of intimacy, body fluids are released. This can help the parasite get transmitted.
• Laboratories carelessness when handling infected blood.
• Mother to child. If there’s a presence of sleeping sickness, it moves through the placenta and infects the child.
• The use of unsterilized needles.

Signs and Symptoms of Sleeping Sickness

Sleeping sickness shows some signs and symptoms either after the first week of infection or after a very long time. Trypanosoma Brucei Gambiense takes a longer period of time to bring out its symptoms, but the other form of this disease- Trypanosoma Brucei Rhodesiense- shows its signs and symptoms on the first week of infection.

The signs and symptoms are divided into two stages:

First Stage

This initial stage of infection is also known as the Haemolymphatic phase. After you’ve experienced a bite from an infected tsetse fly, the infection gets transmitted into your body through the skin. It stays under your skin and multiplies, which later causes an inflammatory reaction to your skin capable of causing damage to your lymph nodes. The Haemolymphatic phase is mostly mistaken for malaria, and prior attention is not given, which later progresses to the life-threatening stage, which is the second stage. The symptoms of the Haemolymphatic phase include:

• Hemolytic anemia
• Swelling skin
• Enlarged lymph nodes
• Hepatomegaly
• Abnormal liver function
• Endocrine disturbance
• Cardiac conditions like pericarditis, cognitive heart failure
• Splenomegaly
• Ophthalmic condition
• Weight loss
• Fever
• Lymphadenopathy

The Second Stage

This is the final stage of infection which is life-threatening. It is also called the neurological phase. The infection under the skin moves through the blood barrier into the spinal region, where it attacks the spinal fluid. This phase affects the central nervous system- the brain. The Trypanosoma brucei rhodesiense- lasts for 300- 500 days before it develops into the neurological phase, while the Trypanosoma Brucei Gambiense lasts for 21- 60 days. Its signs and symptoms include:

• Sleeping disorders
• Neurological/ neurocognitive symptoms
• Change in behavior leading to psychiatric symptoms
• Poor coordination
• Speech difficulty
• Systemic organ failure
• Coma
• Death

The infection develops into the neurological phase in the absence of early diagnosis and treatment. The worst result is death.

In addition, when the parasite in the human body, it secretes a chemical compound called Tryptophol, which induces sleep- sleeping the whole day and finding it difficult to sleep at night.

Diagnosis of Sleeping Sickness

Various diagnosis method has been used, where some were effective while some hasn’t been effective. These diagnoses keep you informed or reveal the progress of the parasite in your body. Early diagnose of this parasite is always difficult because of its passive symptoms, mostly mistaken as malaria.

• The serological test- in African countries, where these parasites are so rampant, this method is employed. It is a passive screening and surveillance for the populace. It is used due to lack of electricity and adequate infrastructures. The serological test is effective for detecting Trypanosoma brucei gambiense.
• From tests on body fluids, Trypanosomiasis disease can be detected. The blood is collected and undergoes many tests like blood smear, blood centrifugation, Buffy coat examination, anion exchange centrifugation techniques, and microhematocrit centrifugation technique.
• Staging: this method of diagnosis involves the clinical examination of your cerebrospinal fluid. The fluid is acquired with a lumbar puncture. Followed by a microscopic light test. This is the most effective method- the microscopic light test. Unfortunately, if the parasite is found present in the Cerebrospinal fluid, it typically denotes the progressed stage of infection to the neurological phase.

Moreover, a Cerebrospinal fluid test, complete blood count, lymph nodes aspiration, and blood smear have been effective to check for parasites.

Prevention of Sleeping Sickness

Prevention of African Trypanosomiasis disease has been an effective control system that has reduced the reported cases of sleeping sickness. There’s a saying that goes thus: “prevention is better than cure/ treatment.” These preventive measures should be followed:

• Tsetse fly gets attracted to dust. Always put on long sleeves shirts and pants covering almost part of the body. Those wearings should be made of thick and strong fabrics because tsetse fly can bite through materials. Put on neutral clothes; they get attracted to bright and dark clothes.
• Avoid bushes around your dwelling place. They always stay in the bushes. Clear off bushes, which might also serve as hidings for other harmful insects or animals.
• The use of insecticides can prevent tsetse flies. Insecticides kill them.
• Protect yourself from tsetse fly’s bite.
• The isolation of other infected individuals and proper treatment. It put a stop to the spreading of this parasite among the mass. The insects cease transmitting it from one person to the other.

Treatments for Sleeping Sickness

Treatments for this parasite are dependent on the disease stage. The best treatment can be administered only when diagnosed very early. The earlier the detection, the faster the cure. Treatment requires hospitalization for closer observations and isolation of the infected individuals.

Medication has been an effective treatment. Both the Haemolymphatic phase and the neurological phase require drugs.

Drugs such as pentamidine and suramin are the two recommended drugs for the first stage. They pose low or no side effects on the body. The summary can cause urinary tract infections or allergic reactions. They are both administered as an injection.

Melarsoprol, Eflornithine, and Nifurtimox are toxic drugs that are capable of crossing the blood barrier to kill the parasites. They have a complicated means of administration. They pose undesirable side effects such as disorders of the brain. It is usually administered intravenously.

Fexinidazole drugs are meant to be taken orally. It is used for both phases.

In conclusion, now that the secrets behind the name sleeping sickness have been unveiled by this article. The ball is in your court. Always put on a long sleeve shirt and pants to prevent this parasite. Use insect repellent and clear out your environment of bushes. Lastly, ensure you observe your medical check-ups regularly. Stay safe, stay healthy.