Human African trypanosomiasis

The history of sleeping sickness

Opening up towards Europe

As from the 15th century trade routes overseas were established. Initially by the Portuguese, later followed by French, British and Dutch trade-companies. The first publications on sleeping sickness in the medical literature are from ship doctors or medical officers stationed at the Atlantic coast trade stations. Atkins, in 1734 made the remarkable statement about his view on the pathology of the disease "..... a super abundance of phlegm or serum extravasated in the brain.....", in other words cerebral oedema as it became known later. Winterbottom reported about the slave traders who apparently aware of the ominous sign of swollen cervical lymph glands used to palpate the necks of the slaves before buying them.

The slave trade (15th to 19th century) took millions of Africans from the interior to the coast for transport overseas, no doubt some of them were infected while underway. Between 1806 and 1869 some hundred and fifty Sleeping Sickness cases amongst slaves were reported from the Antilles and detailed clinical studies published by Moreau de Jonnès, Nicolas and Guérin.

The first report ever on the harmful effects of tsetse bites was from the hand of David Livingstone whose "Missionary Travels and Researches in South Africa" of 1857 shows a drawing of a tsetse fly on the title- page. He described tsetse as "poisonous insects to ox, horse and dog". Although he himself and his companions had been heavily exposed to tsetse he referred to their "perfect harmlessness to man". Possibly only few human pathogenic trypanosomes circulated around the Zambezi river at the time when Livingstone travelled there.

Émile Brumpt made for the first time the link between tsetse and sleeping sickness. He took part in a scientific mission across Africa from Djibouti to Brazzaville from 1901 till 1902 when he noticed that the geographic distribution of tsetse flies corresponds with that of sleeping sickness.