Key points
- Sleeping sickness occurs in two stages—the first causing flu-like symptoms and the second affecting the central nervous system.
- Sleeping sickness can be fatal if left untreated.
- If you think you have sleeping sickness, talk with your healthcare provider right away.
Symptoms
Sleeping sickness occurs in two stages. The specific symptoms and duration of each stage can vary depending on whether you have East or West African sleeping sickness. However, many of the signs and symptoms are common to both stages, making it difficult to distinguish between the two stages by clinical features alone.
East African sleeping sickness
First stage, 1 – 3 weeks
The first stage starts when you are bitten by an infective tsetse fly and the parasite enters your bloodstream.
Second stage, a few weeks – two months
The second stage of infection begins as the parasite infects your brain and central nervous system.
If you have East African sleeping sickness, you are more likely to experience issues with your endocrine system (thyroid, adrenal glands), hormones, and cardiac issues (myocarditis or inflammation of the heart).
West African sleeping sickness
First stage, 1 month – 1 year
West African sleeping sickness disease progresses more slowly. Your symptoms in the first stage may be minimal or irregular in the first few months and can take a few months to a year to be apparent.
First stage symptoms
The first stage of sleeping sickness generally causes mild symptoms:
- Raised, red sore (chancre) at the site of the bite (appears within 2 – 14 days; not always present or noticed; more common with East African sleeping sickness)
- Headache
- Fevers that come and go
- General discomfort (malaise), weakness, and fatigue
- Itchy, irritated skin
- Achy muscles and joint pain
- Loss of appetite or weight loss
- Swollen lymph nodes in the armpits, groin, or inner and upper arm near your elbow
Second stage, one year or more
West African sleeping sickness can take longer than a year to progress to the second stage of infection. If you don't get treatment, your symptoms can become worse. You can die within months of the second stage of infection.
Second stage symptoms
The second stage of sleeping sickness affects your brain and central nervous system, causing more severe symptoms:
- Sleep/wake cycle reversal (sleepy during the day, awake at night)
- Unusual anxiety
- Unstable or fluctuating (labile) emotions
- Hallucinations (experiencing things that don't exist) or delirium (mental state of confusion)
- Sensory disturbances (sensitive skin, loss of sensation, itching, visual problems)
- Tremors (ataxia) or slurred speech
- Seizures
- Coma (prolonged unconsciousness)