Silent killer disease known as “sleeping sickness” – 4 important signs to look out for

The World Health Organization has warned people about the risks of contracting a disease commonly known as “sleeping sickness,” which can be fatal without treatment.

African trypanosomiasis (TTS) is transmitted to humans through the bite of tsetse flies that have transferred the parasites from infected people or animals. These flies live in sub-Saharan Africa and only certain species transmit the disease. People most at risk are those living in rural areas and who depend on farming, fishing, livestock farming or hunting. Travellers who spend a lot of time outdoors or visit game parks in sub-Saharan Africa are also at risk of becoming infected. There is no vaccine or medication that prevents African trypanosomiasis.

The main symptoms of the disease are fatigue, high fever, headache and muscle pain. If left untreated, the disease can be fatal. Depending on the parasite subspecies, HAT occurs in two forms, explains the WHO. Trypanosoma brucei gambiense, which is found in 24 countries in West and Central Africa, currently accounts for 92% of reported cases and causes a chronic disease. A person can be infected for months or even years without experiencing any major signs or symptoms – and by the time obvious symptoms appear, the disease is often well advanced and the central nervous system is already affected.

The other form is Trypanosoma brucei rhodesiense, which is found in 13 countries in eastern and southern Africa, accounts for 8% of reported cases and causes an acute illness. The first symptoms appear a few weeks or months after infection and the disease progresses rapidly, often affecting other organs, including the brain.

Treatment options depend on the type and stage of the disease. The chances of success in treating HAT are greater if symptoms are detected early. One of the most commonly used drugs to treat the first phase of TB gambiense infection is pentamidine. Other drugs used include suramin, melarsoprol, eflornithine and nifurtimox in combination with eflornithine.

After treatment, patients must be closely monitored for 24 months and monitored for relapses, as the parasites may still be viable and reproduce the disease many months later. The first case of sleeping sickness was reported in the late 14th century, and now health experts hope a new experimental drug could help eradicate the disease, which is widespread in the Democratic Republic of Congo (DRC).

The drug, called acoziborol, is taken orally in a single dose and there are hopes that it could stop transmission of the disease. There are 10 clinical trial centers in the Democratic Republic of Congo and Guinea where the drug is being tested as part of the Medicines for Neglected Diseases initiative. According to Science News, the drug was found to be safe and effective after a small trial last year. Results from a larger trial currently underway are expected by the end of this year.

Emmanuel Bottieau, an infectious disease specialist at the Institute of Tropical Medicine in Antwerp, Belgium, who is not involved in the clinical trial, said acoziborol could be “a game changer” if the results are confirmed. He said a single-dose drug was “really a dream for us after having such a long history of very difficult or toxic or cumbersome treatments.”

HAT, called sleeping sickness because one of its most striking features is sleep cycle disturbances, is on a short list of neglected tropical diseases that the WHO aims to eradicate by 2030. This means reducing cases to zero in certain areas, knowing that control efforts may still be needed. In 2021, the WHO reported 747 cases of the predominant form of HAT, up from more than 37,000 in 1998. José Ramón Franco, a WHO medical officer based in Geneva, said: “We are making very good progress, but we [haven’t] the last mile has been reached.”