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About the Authors:
Jennifer L. Foltz
* E-mail: [email protected]
Affiliation: Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Issa Makumbi
Affiliation: Uganda Ministry of Health, Kampala, Uganda
James J. Sejvar
Affiliation: Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Mugagga Malimbo
Affiliation: Uganda Ministry of Health, Kampala, Uganda
Richard Ndyomugyenyi
Affiliation: Uganda Ministry of Health, Kampala, Uganda
Anne Deborah Atai-Omoruto
Affiliation: Uganda Ministry of Health, Kampala, Uganda
Lorraine N. Alexander
Affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention Uganda, Entebbe, Uganda
Betty Abang
Affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention Uganda, Entebbe, Uganda
Paul Melstrom
Affiliation: Division of Environmental Hazards and Health Effects, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Angelina M. Kakooza
Affiliation: School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
Dennis Olara
Affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention Uganda, Entebbe, Uganda
Robert G. Downing
Affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention Uganda, Entebbe, Uganda
Thomas B. Nutman
Affiliation: Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
Scott F. Dowell
Affiliation: Division of Global Disease Detection and Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
D. K. W. Lwamafa
Affiliation: Uganda Ministry of Health, Kampala, Uganda
Introduction
An unusual syndrome referred to as “nodding disease” or “nodding syndrome” (NS) due to characteristic spells of repetitive head bobbing has been reported among populations in Africa, perhaps as early as 1962 in Tanzania. [1] The syndrome is characterized by stereotypic head nodding, along with variable other features including apparent seizures, cognitive and physical impairment, and progressive functional difficulties, with onset during childhood. In the late 1900s, “rhythmic dorsoventral head movements” in Liberia [2], [3] and “repetitive head movements” in Western Uganda [4] were noted to resemble the same “head nodding” though they may not represent one distinct seizure type. More recently, the syndrome termed NS has been investigated among internally displaced people in southern Sudan in 2001–02 [5], [6] and among children in the Mahenge region in Tanzania in...