Last updated: March 10, 2025
Presented by Crestwood General | crestwoodgeneral.com

Quick Summary

Sleeping sickness is a serious disease caused by a parasite spread by tsetse fly bites
It only occurs in rural areas of sub-Saharan Africa — you cannot get it in the United States
Early symptoms look like the flu; later symptoms affect the brain and can be life-threatening
Prevention focuses on avoiding tsetse fly bites; treatment is available and can be lifesaving
If you traveled to rural Africa and feel sick, tell your healthcare provider right away

What Is Sleeping Sickness?

Sleeping sickness, also called human African trypanosomiasis (HAT), is a disease caused by a tiny parasite called Trypanosoma brucei.

In Simple Terms

A parasite is a small living organism that survives by living on or inside another living thing
In sleeping sickness, the parasite enters the body through the bite of a tsetse fly
If not treated, the disease can be fatal
With early diagnosis and proper treatment, most people recover

Where Does It Occur?

Sleeping sickness is found only in rural areas of sub-Saharan Africa. It does not occur in cities, and it cannot be caught in the United States or other parts of the world.

Two Types of Sleeping Sickness

There are two forms of the disease, named for the regions of Africa where they are most common.

Feature	West African Sleeping Sickness	East African Sleeping Sickness
Parasite	T. b. gambiense	T. b. rhodesiense
How fast it progresses	Slow — symptoms may take months or even a year to appear	Fast — symptoms can start within 1 to several weeks
Where it is found	Rural parts of Central and West Africa	Rural parts of Eastern and Southern Africa
How common	More commonly reported	Less commonly reported
Travel notice	None currently	Level 1: Practice usual precautions in Zambia and Zimbabwe

Note: The World Health Organization (WHO) tracks and publishes annual case counts for both types.

Signs and Symptoms

Sleeping sickness happens in two stages. Symptoms depend on which type you have and how long you have been infected.

Stage 1: Early Symptoms (Mild, Flu-Like)

These symptoms may appear weeks to months after a tsetse fly bite:

Fever
Headache
Joint pain
Itching
Swollen lymph nodes (especially in the neck)
Feeling tired or weak

Some people develop a red, sore spot at the bite site called a chancre. This usually appears within 2 days to 2 weeks but is not always noticeable.

Stage 2: Late Symptoms (Brain and Nervous System)

If untreated, the parasite moves into the brain and spinal cord. Symptoms become more serious:

Confusion or difficulty concentrating
Changes in behavior or personality
Trouble sleeping (sleeping during the day, awake at night — hence "sleeping sickness")
Poor coordination, tremors, or weakness
Slurred speech
Seizures (in severe cases)

West African sleeping sickness progresses slowly, so stage 2 may take months or years to develop. East African sleeping sickness moves quickly — stage 2 can appear within weeks.

Who Is at Risk?

Highest Risk Groups

Sleeping sickness affects people in rural African communities. Those at higher risk include:

Hunters and people who spend time in bush or forest areas
Villagers who live near or work with cattle (which can carry the parasite)
Tourists visiting game parks or rural safari areas
Aid workers, researchers, or others working in remote regions

Lower Risk Groups

Travelers staying only in urban areas or major cities
People who take precautions to avoid insect bites

Important Facts

Tsetse flies live only in certain rural parts of Africa
Most tsetse flies in these areas do NOT carry the parasite
Risk increases with more exposure — the more bites you receive, the higher your chance of infection
You cannot catch sleeping sickness from casual contact with an infected person

How Sleeping Sickness Spreads

Main Way: Tsetse Fly Bites

You get sleeping sickness when an infected tsetse fly bites you and passes the parasite into your bloodstream.

About Tsetse Flies

Fact	Detail
Where they live	Rural sub-Saharan Africa only
When they bite	Mostly during the day
What attracts them	Movement, dark or bright colors, dust from vehicles
What they look like	Larger than houseflies; fold wings like scissors when resting

Rare Ways (Very Uncommon)

In rare cases, the parasite may spread through:
- A pregnant person passing it to their unborn baby
- Blood transfusion or organ transplant (extremely rare)
- Sexual contact (not well documented)
- Accidental exposure in a laboratory setting

You cannot get sleeping sickness from food, water, casual contact, or mosquitoes.

How to Prevent Sleeping Sickness

There is no vaccine or preventive medicine for sleeping sickness. The best protection is avoiding tsetse fly bites.

Practical Prevention Tips for Travelers

Dress to Protect

Do This	Why It Helps
Wear long-sleeved shirts and long pants	Covers skin so flies cannot bite
Choose neutral colors like khaki, olive, or beige	Tsetse flies are attracted to bright or dark colors
Wear socks and closed shoes	Protects ankles and feet, common bite sites
Avoid perfumes or strong scents	Scents can attract flies

Avoid High-Risk Areas and Behaviors

Do This	Why It Helps
Stay away from bushes and thick vegetation	Tsetse flies rest in shaded, bushy areas
Inspect vehicles before entering	Flies can hitch rides on cars or safari vehicles
Use insect repellent on exposed skin	Adds an extra layer of protection (though tsetse flies are less deterred by repellent than mosquitoes)
Sleep in screened or air-conditioned rooms	Reduces exposure to flying insects at night

If You Are Bitten

Clean the bite area with soap and water
Watch for signs of infection or illness
If you develop fever, headache, or other symptoms after travel, seek medical care promptly and mention your travel history

When to See a Healthcare Provider

Seek Care Right Away If:

You recently traveled to rural sub-Saharan Africa
You were bitten by a fly that looked like a tsetse fly
You have flu-like symptoms (fever, headache, joint pain) that do not go away
You notice confusion, sleep changes, or other neurological symptoms

What to Tell Your Provider

Where you traveled (specific countries and rural areas)
When you traveled and when symptoms started
Any insect bites you remember
Photos of bites or rashes, if available

Early diagnosis is critical. The sooner treatment begins, the better the outcome.

How Sleeping Sickness Is Diagnosed

Diagnosis involves several steps and specialized testing.

Typical Diagnostic Process

Travel and symptom history: Your provider will ask about your trip and symptoms
Blood tests: To look for the parasite or antibodies your body makes against it
Lymph node fluid test: If nodes are swollen, fluid may be examined under a microscope
Spinal tap (lumbar puncture): If stage 2 is suspected, fluid from around the spinal cord is tested to see if the parasite has reached the brain

These tests are not available everywhere. If sleeping sickness is suspected, samples may be sent to specialized labs or public health agencies like CDC.

Treatment: What to Expect

If diagnosed with sleeping sickness, treatment should begin as soon as possible.

General Treatment Approach

Stage	Treatment Focus	What to Expect
Stage 1 (early)	Medicines that kill the parasite in blood and lymph	Usually shorter treatment; may be given by IV or injection; hospital stay often required
Stage 2 (late)	Medicines that reach the brain and spinal cord	Longer, more intensive treatment; close monitoring for side effects; hospitalization required

After Treatment

Follow-up care is essential
You may need spinal taps every 6 months for up to 2 years to ensure the parasite is gone
Report any returning symptoms (headache, fever, confusion) to your provider immediately

Important Notes

Treatment medicines can have side effects; your care team will monitor you closely
Do not delay treatment — sleeping sickness can be fatal if untreated
With timely care, most people recover fully

Travel Guidance: CDC Level 1 Notice

CDC has issued a Level 1 Travel Notice ("Practice Usual Precautions") for East African Sleeping Sickness in:

Zambia
Zimbabwe

What Level 1 Means

Risk is low for most travelers
Standard travel health precautions are sufficient
Focus on avoiding insect bites and seeking care if symptoms develop after travel

For the latest travel notices, visit: CDC Travelers' Health

Resources for Travelers and Providers

For Travelers

CDC Sleeping Sickness Overview — Symptoms, prevention, and treatment basics
CDC Travelers' Health: Africa — Country-specific health advice
WHO African Trypanosomiasis Facts — Global data and updates

For Healthcare Providers

Clinical Guidance for African Trypanosomiasis — Diagnosis, testing, and treatment protocols
CDC Parasite Diagnostic Services — How to submit specimens for specialized testing
Consultation Support — Contact CDC for case guidance

Emergency Contact

If you or someone you know may have sleeping sickness:
- Contact your healthcare provider immediately
- In the U.S., providers can consult CDC's Parasitic Diseases Hotline: 404-718-4745 (weekdays, 8 AM–4:30 PM ET)

How Crestwood General Supports Travel Health

At Crestwood General, we help travelers stay healthy before, during, and after international trips.

Pre-Travel Services

Travel health consultations: Personalized advice based on your itinerary, activities, and health history
Vaccine planning: Recommendations for routine and travel-specific vaccines
Prevention education: Tips on avoiding insect bites, food/water safety, and recognizing warning signs
Medication planning: Prescriptions for travel-related prevention or treatment if needed

Post-Travel Care

Symptom evaluation: Assessment of fever, rash, or other concerns after international travel
Testing coordination: Help arranging specialized tests if a travel-related illness is suspected
Referral support: Connection to infectious disease specialists or public health agencies when needed
Follow-up care: Monitoring recovery and ensuring complete treatment

Questions We Can Help Answer

Do I need any vaccines or medicines before traveling to Africa?
How can I tell if a bug bite is serious?
What symptoms after travel should prompt a doctor visit?
How do I find a provider experienced in travel-related illnesses?
Where can I get reliable, up-to-date travel health information?

Frequently Asked Questions

Can I get sleeping sickness from a pet or animal?

No. Sleeping sickness is spread only by tsetse fly bites. Animals like cattle can carry the parasite, but you cannot catch it directly from them.

How long after a bite do symptoms appear?

West African type: Weeks to months, sometimes over a year
East African type: Usually 1 to several weeks
If you feel sick after travel to rural Africa, do not wait — seek care promptly.

Is sleeping sickness contagious between people?

No. You cannot catch it from coughing, touching, sharing food, or sexual contact. Rare cases of mother-to-baby transmission have been reported, but person-to-person spread is not a concern for travelers.

Can sleeping sickness be cured?

Yes. With early diagnosis and appropriate treatment, most people recover fully. The key is recognizing symptoms and starting treatment quickly.

What if I was bitten but feel fine?

Most tsetse fly bites do not transmit the parasite. However, if you develop fever, headache, or other symptoms within weeks to months after travel, tell your healthcare provider about the bite and your travel history.

Are there long-term effects after treatment?

Most people recover completely with no lasting problems. Rarely, neurological symptoms may persist if treatment was delayed. Follow-up care helps ensure full recovery.

Travel Smart: Simple Steps to Stay Healthy

Before You Go

Visit a travel health provider 4–6 weeks before departure
Learn about health risks in your destination
Pack protective clothing, insect repellent, and a basic first-aid kit
Save contact information for your travel insurance and local emergency services

While You Travel

Wear long, neutral-colored clothing in rural areas
Avoid bushy or wooded areas where tsetse flies rest
Inspect vehicles before entering
Use insect repellent on exposed skin
Stay in screened or air-conditioned lodging when possible

After You Return

Monitor your health for several weeks
Seek care promptly if you develop fever, headache, confusion, or sleep changes
Always mention your travel history to healthcare providers

Connect with Crestwood General for Travel Health Support

Planning a trip to Africa or concerned about symptoms after travel? We are here to help.

Visit crestwoodgeneral.com to:
- Schedule a pre-travel health consultation
- Access free travel health checklists and symptom guides
- Learn about post-travel evaluation services
- Contact our care team with questions about travel-related illnesses

Your health matters — at home and around the world.

Travel safely. Stay informed. Protect your health.