Trypanosomiasis is an infection caused by the Trypanosoma parasites. Trypanosomiasis can be found in Africa, commonly known as sleeping sickness, and in Central and South America where it is known as Chagas disease.
African trypanosomiasis is found throughout sub-Saharan Africa and is spread by the bite of a tsetse fly.
There are two forms of the infection depending on the Trypanasoma parasite involved. A chronic form where a person can be infected for months or years before symptoms of the disease develop is found in west and central Africa or an acute form where the first symptoms are observed within a few weeks or months of the infection of the infection is found in east and southern Africa.
Symptoms can start following a tsetse fly bite. A tsetse fly bite is painful and can develop into a red sore, several weeks later people develop fever, headaches, joint and muscle aching. At a later stage people can develop confusion, personality changes and extreme fatigue with disturbance of the sleep cycle with excessive sleeping during the day. Without treatment the disease is fatal and death will occur usually within months.
Medical treatment is available for African trypanosomiasis and would be managed by an infectious diseases specialist.
American trypanosomiasis is commonly known as Chagas disease.
Chagas disease is caused by infection with the parasite Trypanosoma cruzi (T.cruzi).
People become infected with T.cruzi in several ways. The main way is transmission by the triatomine insect. These insects bite infected animals and people and ingest their blood which contains the parasite. The insect will then bite another person; whilst ingesting their blood the insect passes faeces containing the parasite onto the bite where the skin is broken or through faeces entering mucous membranes (e.g. mouth and eyes).
T.cruzi can also be transmitted from a pregnant woman to her baby, via blood transfusion, organ transplantation and consumption of uncooked food which is contaminated with faeces from infected bugs.
Chagas disease is found mainly in rural parts of Central and South America where the triatomine insect can be found. However, it can be transmitted through the other mechanisms anywhere in the world.
Chagas disease presents in 2 phases. During the first phase many people have mild symptoms or they can be symptom free. Symptoms can include headaches, muscle aches, fever and a rash. People can develop a swelling at the site of the bite and swelling of the eyelids. The acute phase can be severe in young children and those who are immunosuppressed. During the second phase the parasites ‘hide’ in different parts of the body and will settle on different organs, commonly the heart or intestines. Over years this can lead to the destruction of those organs and ultimately death.
Chagas disease is a potentially life threatening illness, but if treatment is initiated early after infection then it can be curable.
Travellers should be aware of the risk of trypanosomiasis at the destination to be visited. Information about trypanosomiasis risk in affected countries can be found in the ‘Outbreaks’ and ‘Other risks’ section of our Country Information pages.
There is no vaccination or medication to prevent African trypanosomiasis.
The key to prevention is insect bite avoidance.
Tsetse flies bite during daylight hours and are found in rural woodland and savannah areas. Travellers visiting game parks are most likely to be exposed to the infection.
Triatomine insects are most active at night and infest the cracks and holes of poor-quality dwellings. Travellers should also be aware of blood-borne and food-borne routes of transmission.