Only on rare occasions can free-living amebas such as Naegleria fowleri cause meningoencephalitis in human beings. Residents and visitors to a wide swath of tropical Africa, however, are at risk of contracting African sleeping sickness, caused by the flagellated protozoan parasite, Trypanosoma brucei, and transmitted by a biting insect, the tsetse fly. These protozoa can circulate in the bloodstream for extended periods by changing their surface antigens to escape the host's antibodies. Eventually they are able to penetrate the CNS, causing indifference, sleepiness, coma, and death.
■ How likely is it that a person who swims in warm fresh water will contract primary amebic meningoencephalitis?
■ How can one explain repeated abrupt increases in T. brucei in the blood of African sleeping sickness victims?
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