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Symptoms of African sleeping sickness may appear at once, after several weeks, or even after years in the Gambian type. Early disturbances include inflammation at the site of the bite, intermittent fever, enlargement of the spleen; in the Gambian variety the lymph nodes are enlarged. Subsequent signs of heart damage, personality changes, and headache develop. The final stages are marked by tremor, disturbed speech and gait, emaciation, and a prolonged comatose state.
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