African Sleeping Sickness in Tourists Returning from Tanzania: The First 2 Italian Cases from a Small Outbreak among European Travelers

Abstract

A recent cluster of cases of African trypanosomiasis in humans (HAT) has been reported in tourists (most of whom were European) returning from Tanzania; we describe the first 2 patients (both of whom were Italian travelers) with HAT, who have been treated successfully. Because neither vaccine nor drug prophylaxis is currently recommended and/or available for persons traveling to areas of endemicity, physicians should be alerted about this uncommon but potentially life-threatening disease.

Efficacy of the Novel Diamidine Compound 2,5-Bis(4-Amidinophenyl)- Furan-Bis- O -Methlylamidoxime (Pafuramidine, DB289) against Trypanosoma brucei rhodesiense Infection in Vervet Monkeys after Oral Administration

“…The clinical signs described in this report for acute infection mirror those described in previous reports for syringe passage of T. brucei rhodesiense infections in vervet monkeys (15,21), tsetse-transmitted infections in vervet monkeys (28), and earlystage infections in sleeping sickness patients (16,18,22). These clinical manifestations are evidence of hemolymphatic system involvement.…”

Human African trypanosomiasis in endemic populations and travellers

“…rhodesiense HAT has a short incubation period of a few days in travellers (less than 3 weeks). It is an acute, life-threatening disease with the cardinal symptoms of high fever, headache, and a trypanosomal chancre [7,10,11,[42][43][44][45][46][47]. For T.b.…”

“…ECG alterations due to myopericarditis [48] and conduction abnormalities such as transient second-and third-degree atrioventricular block [49], supraventricular tachycardia, and ventricular premature captures [50] have been reported. In a few travellers HAT has been complicated by renal failure requiring haemodialysis [47], multiorgan failure [44,46], disseminated intravascular coagulopathy [46], and coma with even fatal outcome [7,9].…”

“…rhodesiense HAT, elevated creatinine (81%), liver enzymes (82%), low platelets (92%), and elevated levels of C reactive protein are frequent. Severe haematological disorders and elevated liver and kidney function tests have been reported [10,11,44,47].…”

Seasonal epidemiological variation of human African trypanosomiasis in Babati District, Tanzania

“…These reports have brought this disease to the attention of the international medical community, highlighting its importance not only as a public health problem among the people in endemic areas but also as a threat to travellers in Africa (Ripamonti et al, 2002;Jelinek et al, 2002). In June 2005, there were reports of some American tourists who contracted the disease during their visit of the National Parks in northern Tanzania (http://www.fit-for-travel.…”