African

African trypanosomiasis caused by Trypanosoma bru-cei gambiense has not been reported in Italy. We report 2 cases diagnosed in the summer of 2004. Theses cases suggest an increased risk for expatriates working in try-panosomiasis-endemic countries. Travel medicine clinics should be increasingly aware of this potentially fatal disease. Human African trypanosomiasis (HAT), also known assleeping sickness, is caused by a flagellated try-panosome protozoan and transmitted by Glossina (tsetse) flies. It is classified into 3 subspecies: Trypanosoma brucei gambiense, T. brucei rhodesiense, and T. brucei brucei (the third subspecies is not pathogenic to humans). These sub-species cannot be distinguished morphologically. T. b. gambiense, which is found in western and central Africa, causes chronic disease, while T. b. rhodesiense, which is found in eastern and southern Africa, causes acute severe disease. The epidemiology of these subspecies also differs and follows distribution of their main vectors, Glossina palpalis and G. morsitans, respectively. G. palpalis prefers areas of vegetation near rivers and cultivated fields, and G. morsitans feeds on wild animals in savannah areas, far from human settlements. Trypanosomiasis rhodesiense is a zoonosis, and humans visiting affected areas (usually for hunting or tourism) are accidental hosts. Humans are the only mean-ingful reservoir of T. b. gambiense. Untreated infections may persist for years. This disease is highly prevalent in Africa; ≈500,000 people are infected in 36 countries because of poor health systems in regions of civil and mil-itary turmoil (1). Despite its sporadic occurrence among travelers, T. b. rhodesiense has been reported more often in European (2) and American tourists (3) than T. b. gambi-ense because T. b. rhodesiense is present in areas not visit-ed by expatriates. We report 2 cases of imported trypanosomiasis gambiense in Italy during the summer o