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JAMA 100 Years Ago
August 26, 2009

SLEEPING SICKNESS

JAMA. 2009;302(8):905. doi:10.1001/jama.2009.1162

Sir Henry Hesketh Bell, Governor of the Uganda Protectorate, claims to have sleeping sickness under control in the region under his supervision. This feat was not accomplished, however, by any successful medical treatment. Professor Koch's work seems to have been unavailing, so far as finding any really curative method against the disease. The success was obtained by the most drastic measures. For several hundred miles along the shore of Lake Victoria, a strip two miles in width has been depopulated by order and the inhabitants removed inland. This was done by cooperation with the native chiefs, and the only people who remain within reach of the Glossina carrying the disease are the dwellers on a few islands from which it was not practicable to remove them. The mortality, which had ranged from 20,000 to 30,000 a year in the protectorate, fell during 1908 to less than 2,000, and the deaths occur now almost exclusively in the segregation camps; and it is believed that the new cases of infection are very few. The ultimate good result which is hoped for is that in a comparatively short time the disease will disappear from lack of sources of infection. Such a measure could only be carried out successfully with a docile population living under almost absolute authority, and constant vigilance will be required hereafter to hold the ground gained in the contest against the disease. It is not likely that so extensive a tract along the border of a navigable lake, the largest in Africa, can remain always unutilized, and the investigations into the cause and cure of sleeping sickness, the finding of the host of the protozoon, will have to be continued until some conclusive and valuable results are obtained. The sleeping sickness does not appear to exist along the shores of other African lakes, at least not to any such extent as has been the case in Uganda, which is an encouraging fact so far as the prospect of the complete success of Sir Henry Hesketh Bell's methods is concerned. Thus far certainly the outlook is encouraging.

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