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Human African trypanosomiasis, also known as sleeping sickness, is a parasitic disease transmitted by tsetse flies. The infection can be contracted in several endemic areas in sub-Saharan Africa and, unless correctly diagnosed and properly treated, the disease is usually fatal.

While the vast majority of cases of sleeping sickness are detected in endemic countries, a few are diagnosed in non-endemic ones, notably in travellers or migrants who have visited or resided in the transmission areas. An accurate and early diagnosis of these exported cases is crucial to improve their prognosis. In this study we reviewed cases of trypanosomiasis detected in non-endemic countries in 2011–2020. The data were gathered by the World Health Organization (WHO) thanks to its exclusive distribution of antitrypanosomal medicines.

A total of 49 exported cases of sleeping sickness were detected in the 10 years we studied. Half of them were diagnosed in Europe, 22% in South Africa—a non-endemic country, 14% in North America and 12% in Asia. Only one case was detected in South America. Despite its rarity, travel medicine must maintain alertness on this disease, especially in patients with a history of exposure in endemic areas, with febrile and neuro-psychiatric syndromes and without a clear alternate diagnosis.

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