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The disease is transmitted with the bite of the tsetse fly. At first the trypanosomes multiply in the blood, and that process can last for years with T.b. gambiense.
· Mother-to-child infection: the trypanosome can cross the placenta and infect the fetus, causing abortion and perinatal death.· Accidental infections can occur in laboratories, for example, through the handling of blood of an infected person, although this is fairly rare.
The early phase entails bouts of fever, headaches, pains in the joints and itching. The second, known as the neurological phase, begins when the parasite crosses the blood-brain barrier and infests the central nervous system. This is when the characteristic signs and symptoms of the disease appear: confusion, sensory disturbances and poor coordination. Disturbance of the sleep cycle, which gives the disease its name, is the most important feature. Without treatment, the disease is fatal. If the patient does not receive treatment before the onset of the second phase, neurological damage is irreversible even after treatment.
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