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Sleeping sickness in travelers - do they really sleep?
Karin Urech1, Andreas Neumayr, Johannes Blum
1Swiss Tropical and Public Heath Institute, Basel, Switzerland. karin.urech@stud.unibas.ch
Plos Neglected Tropical Diseases
|November 10, 2011
Summary
Imported Human African Trypanosomiasis (HAT) cases are rising in non-endemic areas. This study details HAT clinical presentations in Caucasian travelers, noting differences from endemic populations and frequent missed diagnoses.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Travel Medicine
Background:
- Imported cases of Human African Trypanosomiasis (HAT) in non-endemic countries are increasing.
- Clinical presentation of HAT in Caucasian travelers requires specific characterization.
Purpose of the Study:
- To describe the clinical presentation of Human African Trypanosomiasis (HAT) in Caucasian travelers.
- To compare HAT clinical features in travelers versus endemic populations.
Main Methods:
- Literature screening of MEDLINE and PubMed for "Human African Trypanosomiasis", "travelers", and "expatriates".
- Inclusion of publications in European languages (excluding Slavic).
- Analysis of clinical parameters from 45 Caucasian T.b. rhodesiense and 15 T.b. gambiense infections.
Main Results:
- Fever, headache, and trypanosomal chancre were common in Caucasian travelers infected with both T.b. rhodesiense and T.b. gambiense.
- Sleeping disorders were rare in travelers, unlike in endemic regions.
- Jaundice was observed in 24.2% of Caucasian T.b. rhodesiense patients, a finding not reported in endemic regions.
Conclusions:
- HAT in Caucasian travelers typically presents as an acute illness with frequent chancres.
- Clinical manifestations in travelers differ significantly from those in endemic populations.
- Delayed diagnosis of HAT in travelers and expatriates is common, leading to advanced disease stages.
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