Sleeping That Kills

Today on the Alarm Clock Blog, we’re taking the theme of sleeping disorders to a serious place and we’re going to talk about a very perilous disease. African Sleeping Sickness (also called African Trypanosomiasis ) is a parasitic disease found in some parts of Africa. This disease is unfortunately 100% fatal if untreated.

The plight of the people in Sub-Saharan Africa is no secret. The stalwart people of Africa are no strangers to stark conditions, tragedy, and rampant disease. The conditions that the people endure seem incredibly alien to those of us who live in a Western culture. The problems associated with African Sleeping Sickness are compounded by the rough conditions that exist in many villages in Africa. Before going any deeper into that, let’s take a moment to talk about the disease itself.

African Sleeping Sickness is caused by two related parasites. Trypanosoma brucei gambiense is found in western and central Africa. This is the most common version of the disease and comprises 90% of the cases. Trypanosoma brucei rhodesiense is found in the eastern and southern areas of Africa. T. b. rhodesiense becomes symptomatic more quickly than T. b. gambiense and is considered more acute than it’s more common cousin. A person with T. b. gambiense may go months or years without showing symptoms.

With both versions, there are two stages of this Sleeping Sickness disease. In the first stage, the parasite is in the blood. If people are tested and treated during this phase, the medication is fairly well tolerated and the prognosis is good. There are two medications available to treat the first stage of the disease. By Western standards they’re fairly easy to administer. When one is dealing with a country where clean water is quite scarce, the medication can be very difficult to acquire and administer.

In the second stage, the parasite has crossed the blood-brain barrier and has infected the brain itself. (Some people reading this have stopped reading and are staring at that last sentence. A parasite that has broken the blood-brain barrier is positively chilling.)Once the organism has reached the brain, it starts to destroy the neurological tissue on a cellular level. At this stage, the treatment is very difficult to administer and can be quite trying upon the patient. One medication is so caustic that it must be kept in glass containers. It will eat through plastic and it must be injected directly into a vein. If the needle misses the vein, the treatment is extremely painful. This medication kills one out of every twenty patients.

There is another medication that can be used to treat the second stage of the disease for some patients. This medication is less dangerous, but it very difficult to administer in most parts of Africa. The medication must be given as an IV drip. The patient will need a dose every six hours for two weeks for a total of 50 doses. The amount of medication needed for one course of treatment for one patient is 20 kilos (44 lbs). The logistics of treating an epidemic of African Sleeping Sickness is mind boggling.

The key to surviving African Sleeping Sickness is early detection. The tests for the parasite can also be difficult and this is where the standard of living of most villages comes back into play. The clinics in many villages commonly affected by the parasite are very sparse. Most clinics are severely understaffed with only one or two nurses. Most clinics lack solid walls and stable roofs as well as electricity and running water. The clinics are under-supplied and unsanitary (by Western standards). The first test is called a CATT test. This is a relatively simple finger prick blood test. The second test draws fluid from a lymph node. The third test is a spinal tap. Getting fluid directly out of the spinal column is considered risky in sanitary Western hospitals. It’s dangerous in the village clinics, but it is necessary.

The disease is commonly called “African Sleeping Sickness” because of one of the second stage symptoms is prolonged sleeping during the day and insomnia at night. The World Health Organization estimates there are 300,000 cases a year, but only about 30,000 people are able to get treated.

If you’re dealing with personality changes, anxiety, agitation, numbness in the extremities, and a disruption of your sleep cycle, chances are you do not have African Sleeping Sickness. However, if you’ve been to Africa and you were bitten by a tsetse fly, it’s wise to at least get the blood test.

Tags: Africa, African Sleeping Sickness, African Trypanosomiasis, alarm clock blog, disease, parasite, sleep disorders, sleeping sickness, sleeping sickness disease, Sub-Saharan Africa, Trypanosoma, Trypanosoma brucei, tsetse fly

Related Alarm Clock Blog Posts:

• The Answer To Why We Sleep (February 23, 2010)
• Sleepwalking And Somnambulism (February 2, 2010)
• Eyes Open Sleeping (February 7, 2010)
• Your New Job as Human Alarm Clock (January 11, 2009)
• What’s the Deal with Clockwise? (March 16, 2009)