Nodding Syndrome is a disease of unknown origin which is affecting children, typically of ages 5 - 15 in Eastern Africa including South Sudan, Uganda, and Tanzania. It is named for the “nodding-head” seizures which afflicted children undergo, though some fall into more severe epileptic fits and some undergo tonic-clonic seizures. Though research is limited and much investigation by the CDC is underway, the actual pathological mechanism is still unknown. The lead investigator from the CDC stated that there was “clear evidence that this is an epidemic”.
The disease begins with the characteristic “nodding-off” symptom and inability to concentrate. Neurologists note that with MRI scans brain atrophy can be seen and much physical and mental growth stops when the syndrome occurs. The location of the disease may hold a clue to its cause, though. All the areas affected by Nodding Syndrome are home to Onchocerca volvulus, a parasitic filarial worm transmitted by the black fly.
O. volvulus has been detected in nearly 94% of the affected children, which is much higher than that of the unaffected population. It’s still unclear why the syndrome is just appearing (first descriptions of it were in the 1960’s) while O. volvulus has always affected these regions. Speculations to whether it’s a new disease or toxin carried by the parasite, or if it’s a poison or chemical from another source, if it’s a vitamin deficiency, or any combination of the aforementioned causes are all being investigated.
This past year, conferences have been held and reports were given which stated the known information about the disease and possible treatment methods (mostly symptomatic treatments of anti-convulsants thus far). Many treatment methods have been tried, though none have been promising yet. Scott Dowell, the director of the CDC’s Division of Global Disease Detection and Emergency Response had this to say after some analysis: “We did repeated exams on several of these children and found that some of the children had stayed the same, some of the children had gotten worse, none had improved”.