What happens physically to someone when they get African sleeping sickness?

African sleeping sickness is caused by the protozoan parasites _Trypanosoma brucei rhodesiense_ or _T. b. gambiense_, spread through the bites of tsetse flies found in sub-Saharan Africa. The disease has two stages, an early “haemolymphatic” stage, and a late “neurological” stage.

Haemolymphatic stage (lasting days to months)

The parasite multiplies in the bloodstream and lymphatic tissues. Symptoms include:

- Fever

- Headache

- Joint pains

- Itchy skin rashes

This stage is often so mild it may be completely missed or misdiagnosed.

Neurological stage (lasting weeks to years)

The parasites cross into the central nervous system (CNS), especially the meninges and cerebrospinal fluid, and multiply. Symptoms include:

- Severe headaches

- Convulsions

- Paralysis

- Progressive sleep disturbances (after which the disease is named)

- Personality and behavioral changes, including irritability and apathy

- Tremor

- Progressive cognitive impairment

- Swelling around the lymph nodes of the neck and armpits

- Coma and eventually death if untreated

This stage is fatal if untreated, and can even be fatal if treatment is delayed significantly.