Trypanosomiasis, also known as African sleeping sickness, has been reported in the United Kingdom for the first time in four years—in two men returning from Africa.
In the first case, a man in his 30s was admitted with the disease to the Hospital for Tropical Diseases in London on 21 October after returning from a holiday in Zambia. Dr Peter Chiodini and his registrar at the hospital phoned several other hospitals and healthcare institutions in the United Kingdom and elsewhere in search of suramin, the drug used for treating the disease. The only stock in the United Kingdom was at the Liverpool School of Tropical Medicine, which immediately sent what stocks it had to the doctors in London by taxi.
Dr Anne Moore of the Centers for Disease Control and Prevention in Atlanta also arranged for a supply to be airfreighted to London. A second man with the disease, who had just returned from a game park holiday in Tanzania, was admitted to the London hospital three days after the first man's admission. The disease is carried by the tsetse fly, which transmits a parasite from wild animals to humans by biting them. There is no vaccination against the disease.
There are two types of trypanosoma, each of them transmitted by a different parasite. Each of the two patients in London contracted the acute form of the disease, caused by Trypanosoma brucei rhodesiense, prevalent in east and southern Africa. A chronic form of the disease, caused by Trypansoma brucei gambiense, occurs in parts of western and central Africa. Up to 500000 people are thought to have the disease in 36 countries of sub-Saharan Africa.
Dr Bertie Squires, the senior lecturer at the Liverpool school who received the emergency call from London, said that it was worrying that two cases had emerged so close together after such a long absence of the disease in the United Kingdom. “It could be coincidence,” he said, “But we believe that it is more likely to be due to the fact that because of civil unrest in central Africa, the tsetse fly control measures have broken down. This could be the beginning of a growing number of cases from Africa.” In its early stages, said Dr Squires, the disease causes severe headaches, muscle pain, and fever. If the parasite reaches the brain, the patient's neurological functions begin to slow down.
Dr Chiodini said that each patient he had treated with the drug had been well enough to be discharged within a day or two. The Hospital for Tropical Diseases had now found more supplies of suramin. 
Figure.
EYE OF SCIENCE/SPL
Tsetse fly