African Trypanosomiasis in USA (ex Botswana and Zambia)
29 Dec 2016
A media report of 22 December 2016 advised that a man from Baltimore (USA) fell ill the day after he returned home from Africa. The man had spent approximately 4 weeks on safari in Botswana and Zambia during November 2016.
After experiencing a week of feverish illness the man presented at the Greater Baltimore Medical Center where he was admitted to the intensive care unit. Microscopy of a blood film showed that the patient was infected with trypanosomes causing sleeping sickness (African trypanosomiasis). The disease has 2 forms, both transmitted by the tsetse fly, which lives only in rural Africa. The man was then transferred to Hopkins, an academic medical centre with greater resources and expertise, where he was treated and eventually discharged on 8 December 2016.
Advice for Travellers
Travellers to endemic areas should be aware of the risk and avoid contact with tsetse flies if possible. Avoiding bites is very difficult as tsetse flies can bite through clothing. Tsetse flies are repelled by permethrin and soaking clothes is recommended. They are not repelled by currently available DEET insect repellent products.