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African trypanosomiasis (Sleeping Sickness) ANDREA BRADY BIOL 062 Epidemics have killed hundreds of thousands since 1900. http://www.microbiologybytes.com/introduction/Trypa no.html http://www.doctorswithoutborders.org/images/news/sleeping/344 76.jpg Tens of thousands continue to die each year WHO estimated that in 2001, there were 48,000 deaths caused by sleeping sickness. www.dcp2.org/pubs/DCP/23/Section/3154 Tens of thousands continue to die each year WHO estimated that in 2001, there were 48,000 deaths caused by sleeping sickness. Currently, it is estimated the number of deaths per year has increased to 50,000 or as high as 100,000. http://www.dcp2.org/pubs/DCP/23/Section/3154 As many as 500,000 are currently infected. http://www.kfwh.org/information.asp Most cases are found in Sub-Saharan Africa. Chart from World Bank, 2006 http://www.dcp2.org/pubs/DCP/23/Table/23.1 How can an infectious disease be contained to such a specific region of the world? How can an infectious disease be contained to such a specific region of the world? Let’s take a closer look at how the disease is spread… Disease Transfer The disease is caused by two parasites of the Trypanosoma Genus and brucei Species. http://en.wikipedia.org/wiki/Sleeping_sickness http://farm3.static.flickr.com/2110/1760532740_20189a8cdc.jpg Disease Transfer The disease is caused by two parasites of the Trypanosoma Genus and brucei Species. More commonly called Trypanosomes http://www.who.int/mediacentre/factsheets/fs259/en/ http://farm3.static.flickr.com/2110/1760532740_20189a8cdc.jpg Trypanosomes are protozoans. http://www.who.int/mediacentre/factsheets/fs259/en/ http://jcs.biologists.org/content/vol115/issue12/images/medium/jo ces11512cvf.gif Trypanosomes are protozoans. (unicellular eukaryotes) (single flagellum) http://www.who.int/mediacentre/factsheets/fs259/en/ http://jcs.biologists.org/content/vol115/issue12/images/medium/jo ces11512cvf.gif http://www.modares.ac.ir/elearning/Dalimi/P roto/images/Lectures/fig77_1.JPG Disease Transfer The trypanosomes are mainly transferred by the tsetse fly, which is found primarily in SubSaharan Africa. the tsetse fly The tsetse fly http://www.microbiologybytes.com/introduction/Trypano.html http://library.truman.edu/test/carol/Tsetse_fly.gif Areas Infested by the Tsetse Fly http://www.fao.org/ag/icons/map.gif Distribution Map for African Sleeping Sickness http://www.medicalecology.org/diseases/af rican_trypano/clip_image002.jpg Areas Infested by tsetse fly Distribution of the disease Trypanosoma brucei: Two different parasites African Sleeping Sickness is caused by two different parasites. http://www.microbiologybytes.com/introduction/Trypano.html Trypanosoma brucei: Two different parasites African Sleeping Sickness is caused by two different parasites. Trypanosoma brucei gambiense Trypanosoma brucei rhodesiense http://www.microbiologybytes.com/introduction/Trypano.html Trypanosoma brucei: Two different parasites Trypanosoma brucei gambiense Accounts for 90% of reported cases of African Sleeping Sickness. Causes the chronic form of the disease Prevalent mostly in West and Central Africa. http://www.microbiologybytes.com/introduction/Tr ypano.html http://www.dmacc.cc.ia.us/instructors/Image11.gif Trypanosoma brucei: Two different parasites Trypanosoma brucei rhodesiense Accounts for 10% of reported cases of African Sleeping Sickness. Causes the acute form of the disease. Prevalent mostly in Eastern and Southern Africa. http://www.microbiologybytes.com/introduction/Tr ypano.html http://www.uoguelph.ca/~pwoo/fig6.jpg Method of Infection Begins with the bite of the tsetse fly http://www.who.int/mediacentre/factsheets/fs259/en/ http://www.mimg.ucla.edu/faculty/Hill/fig2.jpg Method of Infection The bite will become red and swollen. http://www.who.int/mediacentre/factsheets/fs259/en/ http://io.uwinnipeg.ca/~simmons/16cm05/1116/28-11-TrypanosomaLM.jpg Method of Infection The bite will become red and swollen. From here, the infection will enter the bloodstream. http://www.who.int/mediacentre/factsheets/fs259/en/ http://io.uwinnipeg.ca/~simmons/16cm05/1116/28-11-TrypanosomaLM.jpg Method of Infection The bite will become red and swollen. The infection will enter the bloodstream. Long asymptomatic phase. http://www.who.int/mediacentre/factsheets/fs259/en/ http://io.uwinnipeg.ca/~simmons/16cm05/1116/28-11-TrypanosomaLM.jpg The disease has three distinct stages. The disease has three distinct stages. Asymptomatic Phase http://www.who.int/mediacentre/factsheets/fs259/en/ The disease has three distinct stages. Asymptomatic Phase First Stage (haemolymphatic phase) http://www.who.int/mediacentre/factsheets/fs259/en/ The disease has three distinct stages. Asymptomatic Phase First Stage (haemolymphatic phase) Second Stage (neurological phase) http://www.who.int/mediacentre/factsheets/fs259/en/ First Stage The pathogens will spread throughout the blood and the lymph. http://www.who.int/mediacentre/factsheets/fs259/en/ http://www.pnas.org/content/100/3/F1.medium.gif First Stage Symptoms Fever Headache Sweating Joint Pain Itching Swollen Lymph Nodes www.who.int/mediacentre/factsheets/fs259/en http://upload.wikimedia.org/wikipedia/commons/thumb/8/88/Wi nterbottom%27s_sign.jpg/200px-Winterbottom%27s_sign.jpg Second Stage Eventually, the disease will manage to cross the blood-brain barrier. Second Stage Eventually, the disease will manage to cross the blood-brain barrier. This will cause an infection of the Central Nervous System www.who.int/mediacentre/factsheets/fs259/en Second Stage Symptoms Confusion Sensory Disturbances Poor Coordination Disturbances of Sleep Cycles www.who.int/mediacentre/factsheets/fs259/en http://www.msf.org.uk/UploadedImages/e64ac496-41d9-4b8b8cac-423baecb957f.jpg If not treated, the disease is fatal. www.who.int/mediacentre/factsheets/fs259/en Diagnosis and Treatment Treatment varies depending on the stage of the disease. www.who.int/mediacentre/factsheets/fs259/en http://www.sawitfirst.co.uk/media/pill_clockbig.gif Diagnosis and Treatment The disease is easier and more effective to treat the earlier it is diagnosed. http://www.who.int/mediacentre/factsheets/fs259/en/ Diagnosis and Treatment The disease is easier and more effective to treat the earlier it is diagnosed. Much harder after the pathogens have crossed the blood-brain barrier. http://www.who.int/mediacentre/factsheets/fs259/en/ Diagnosis and Treatment Four drugs are available for treatment http://www.pet-comfort-products.com/images/colorful-pills01.gif Diagnosis and Treatment Four drugs are available for treatment Two available for firststage treatment Two available for second-stage treatment www.who.int/mediacentre/factsheets/fs259/en www.pet-comfort-products.com/images/colorful-pills-01.gif Diagnosis and Treatment The two drugs available for second- stage treatment are significantly more dangerous. http://www.who.int/mediacentre/factsheets/fs259/en/ Diagnosis and Treatment So, in summary, treatment during the first-stage is… Diagnosis and Treatment So, in summary, treatment during the first-stage is… More effective http://images.thescientist.com/content/figures/images/yr2002/may13/iv.jpg Diagnosis and Treatment So, in summary, treatment during the first-stage is… More effective Safer http://images.thescientist.com/content/figures/images/yr2002/may13/iv.jpg Diagnosis and Treatment Therefore, early diagnosis is imperative http://www.who.int/mediacentre/factsheets/fs259/en/ http://www.bayerscheringpharma.de/html/images/upload/gesells chaftliches_engagement/aerztin_patient_205.jpg Like with malaria, if we could reduce the number of people with the disease, we could reduce transmissions and eventually eradicate the disease. http://www.ecdl.com/countries/images/map_africa.gif Organizations like WHO have began efforts to eliminate the risk of this disease http://www.who.int/mediacentre/factsheets/fs259/en/ http://www.who.int/mediacentre/factsheets/fs259/en/ Organizations like WHO have began efforts to eliminate the risk of this disease HAT programme http://www.who.int/mediacentre/factsheets/fs259/en/ http://www.who.int/mediacentre/factsheets/fs259/en/ Due to lack of funds and turmoil, there are an estimated 7 nations currently at “epidemic” level for the disease. http://www.kfwh.org/information.asp Like many other infectious diseases in third world countries, much change is needed in world health policies before we can effectively eradicate African Sleeping Sickness. THE END.