Persons with West African trypanosomiasis sometimes develop a chancre 1 to 2 weeks after the tsetse fly bite. Other symptoms occur several weeks to months later and include fever, rash, swelling around the eyes and hands, severe headaches, extreme tiredness, and aching muscles and joints. Some people develop swollen lymph glands on the back of the neck. Weight loss occurs as the illness worsens. Infection of the central nervous system causes personality changes, irritability, loss of concentration, confusion, slurred speech, seizures, and difficulty in walking and talking.
Many patients sleep for a long time during the day and have trouble sleeping at night.
Without treatment, the illness gets worse and results in death several months to years after infection. Trypanosomiasis can be diagnosed by laboratory tests on blood and spinal fluid. East African trypanosomiasis is usually confined to woodland and savannah areas away from places where people live. Tourists, hunters, game wardens, fishermen, and other persons who work in or visit game parks in East and Central Africa are at greatest risk for illness. The tsetse flies that spread West African trypanosomiasis can be found in Western and Central African forests and in areas of thick shrubbery and trees by rivers and waterholes.