Sleeping sickness, or human African trypanosomiasis - a dangerous pathology, which is the causative agent of the simplest kinds of trypanosomes. They are two types of, Both are transmitted by the bite of an infected tsetse fly. Cases of disease are frequent in rural areas, where the insect vectors lives.
What is known about the sleeping sickness
Common in Africa, there are annually about 70 thousand people receive such a diagnosis. but, because of the quality of life in developing countries, with this number is gradually decreasing every year.
Basically there are two types of this disease:
- Gambian sleeping sickness
Main place of distribution - the coast of the rivers and large bodies of water.
- Rhodesian sleeping sickness
Places of distribution - the African savannah and treeless areas.
The causative organism is flat, a membrane along the body and easily moves.
How do you get infected
Fly, which proved to be infected, It carries African trypanosomiasis throughout his life. To people infected, only one bite - fly- into carriers salivates, which contains the number of pathogens in the, sufficient to infect thousands of people!
After a bite under the skin remain viable microorganisms, representing trypanosomes in the infective stage of development.
Some of them immediately into the blood stream, but most of the remains at the site and begins to proliferate. At the site of the lesion formed painful chancre, He is typical of this type of disease.
From this point, a great number of parasites on the body begins to attack. At the same time a great number of them killed immediately, because the immune system produces antibodies. However, a new generation is formed of microorganisms, resistant to them. When the parasite mutation appears several hundred variations of strain, that enables the parasite to survive and, if there is no treatment, beat.
How does the disease
At the beginning of sleeping sickness appear fever and headache, then join them itching, joint pain. Onset - haemolymphatic stage - is the period of one to three weeks.
Symptoms defeat in haemolymphatic stage:
- indisputable sign of illness - chancroid or tripanoma
He appears a week after the bite, It can be anywhere on the body, but more often on the head or limbs. very painful, It has a characteristic appearance. After one or two weeks, he heals.
- tripanomy simultaneously with the appearance on the trunk or extremities spots appear pink-purple color with a diameter up to decimeter - tripanidy
- appear facial swelling, hands and feet
- fever
Evidence of a large number of parasites in the blood. It has intermittent character, alternating periods with high, to 400, temperature with a complete loss of strength and lowering the temperature.
- swollen lymph nodes, especially zadnesheynyh
They can reach 2-4 cm in diameter, gradually compacted
- increased liver and spleen
- sleep disturbances
- headaches
- gradually increasing tachycardia
- skin rash
- swelling of the eyelids, a permanent character
This feature can result in damage to eye.
The rate of development of sleeping sickness depends on the condition of the body, but even a strong and healthy person through quite a long time (from several weeks to several months) sleeping sickness symptoms begin to appear.
Haemolymphatic stage can last for many months or even several years, but sooner or later it will begin to move in the terminal phase - late.
At this stage, the trypanosomes affect the brain.
- A characteristic feature of the onset of the second stage of the disease is constant daytime drowsiness. A person can fall asleep while talking or eating, a phenomenon that is gradually increasing.
- You may receive a limb tremor
- Permanent retardation, which can be replaced by mania
- Sometimes pathology develops in a different direction - ill shows complete apathy, This is often accompanied by severe headaches. In this case, the patient often feels calm, which gradually goes into apathy and stupor. Appears indifferent to food, they do not ask, although not refuse, if it stands in front of them. Cease to communicate with others.
- Gradually it joined cramps, seizures, possibly coma.
So long development and course often characterized Gambian sleeping sickness, Rhodesian form may be a transient and severe. Fever, depletion step on a person with such intensity, it may die long before the second stage of the disease.
In the absence of immediate medical interventions disease ends seizures, paresis of the limbs and body, coma. All this leads to death.
Diagnostics
Trypanosomes can be detected in a blood smear or lymph fluid. Sometimes a lumbar puncture is performed, It may be a means for clarifying stage of disease.
Lumbar puncture is carried out to analyze the composition of cerebrospinal fluid - in the space of the spinal cord needle is inserted at a lumbar level. Diagnosis becomes exact in severe infectious lesions of the central nervous system, if it based on the data of this study.
It is also used for the study of other biomaterials:
- puncture shankra
- the contents of the lymph node
- blood.
treatment of the disease
The disease is curable, but to deal with it a lot easier, if diagnosed before the onset of the second neurological phase.
In the first stage treatment is performed using the following drugs:
- «Pentamidine»
An antibiotic based on natural ingredients, It has an impact on protozoa and gram-negative (especially drug-resistant) bacteria.
Oral does not apply, since it is not absorbed in the intestine. When parenteral administration may have adverse effects, so there are some contraindications to its use.
It affects the trypanosomes, but only at the beginning of the disease, in a first step. On the second, neurological stage, It becomes almost useless, because they do not have the ability to penetrate the BBB.
BBB - the blood-brain barrier, It is protected boundary between the blood and central nervous system. A protective function, It protects the brain from toxins, microorganisms, other factors. However, sometimes an obstacle to the penetration of therapeutic agents.
At an early stage of treatment is 10 days.
- 'Request'
Effective means protivoprotozoynoe, used in the treatment of sleeping sickness, It affects both types of pathogen. intravenously, excretion from the body for a long period.
Can have side effects, sometimes severe.
It is effective in the first stage of disease.
In the second stage of the disease are applied:
- Eflornitin
The drug is the latest generation, It used to treat CNS trypanosomiasis in step. It is effective against the two types of parasite, however, possible variation of therapeutic action. The drug is rapidly distributed throughout the body, pressed in the CNS, Write mainly kidneys.
It may cause side effects medium and mild, they are reversible - disappear at the termination of receipt of the active substance. May start vomiting, diarrhea, sometimes temporarily impaired hearing. Considered to be less dangerous drug, than "Suramidin" and "Pentamidine".
- "Nifurtimox"
effective drug, trypanocidal both species. Particularly good effect in the early stages of the disease. Side effects mild, used in the treatment of children.
- «Benznidazole»
It is used in the treatment of acute forms, therapeutic effect and toxicity almost the same, like "nifurtimox". The mechanism of action of this drug has not been studied.
prevention
Warn the disease is only possible by regular blood sampling in humans, living in areas of the possible spread of the disease. So it is possible to identify cases of infection in the early stages.
Besides:
- to reduce the risk of illness should not visit potentially dangerous areas
- walk in bright clothing, sleeves should be long
- always carry a repellent agents, Active against flies
- if there is a need for a long stay in a potentially dangerous area, should be to inject "Pentamidine" every six months.
Tsetse be widespread destruction, To do this, apply insecticides - this is an important measure in the prevention of disease. It is also recommended to carry out regular cutting of bushes and shrubs around settlements.
Injections of pentamidine is recommended not only for visitors and tourists, but for all the residents of areas, in which outbursts of sleeping sickness.
Other means of prevention and protection against the parasite is not, immunoprophylaxis African trypanosomiasis is not carried out.
annotation
What is sleeping sickness, and what causes it? symptoms, ways of infection, diagnostics and treatments. What You Should Know, not to get infected.
