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Giardiasis

Definition:
Giardiasis is a gastrointestinal infection. It is one of the most common parasitic diseases in the world. It may be responsible for up to a billion cases annually worldwide.

Causes:
Giardiasis is caused by a tiny parasite called Giardia lambia. Giardia cysts are a resistant form of the parasite that can survive outside a human or animal body. These cysts cause the spread of this disease. For infection to occur, a person must ingest Giardia cysts by mouth. Once cysts are ingested, the parasites start growing and multiplying in the small intestine. Ingesting as few as ten parasitic cysts can cause an infection.

Giardiasis can be contracted by:

  • Contact with feces containing the parasitic cysts. Infected feces can be:
    • Human
    • Animal (less often); this includes beavers, cats, dogs, and cows
  • Eating food, drinking water, or swimming in water contaminated by the parasitic cysts
  • Contact with a person's hands that are contaminated with parasite cyst-infected stool
Risk Factors:
A risk factor is something that increases your chances of getting a disease or condition.
  • Age group: Young children and elderly adults
  • Unsanitary or crowed living conditions
  • Drinking untreated water, such as:
    • Well water
    • Stream or lake water
  • Low stomach acid, often found in:
    • Elderly people
    • People on ulcer drugs
  • Oral-anal sex
  • An impaired immune system
  • Working or staying in a daycare center or nursing home
  • International travelers
  • Hikers, campers, and swimmers
Symptoms:
Symptoms usually start 5-28 days after infection. Not all people who are infected have symptoms. But, all people who are infected can transmit the disease.

Symptoms may include:

  • Diarrhea, acute or chronic
  • Loose, greasy, foul smelling stools
  • Abdominal pain or cramps
  • Bloating
  • Gas
  • Nausea or vomiting
  • Weight loss
  • Mild fever (rare)
Diagnosis:
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
  • Laboratory exam of several (usually three) stool samples
  • Stool testing for Giardia proteins (called the Giardia antigen test)
  • In some cases, testing of a fluid or tissue sample from the intestine

If you are diagnosed with giardiasis, everyone living in your household should be tested for infection as well.

Treatment:
Giardiasis is treated with a prescription antiparasitic drug. The medication is usually given for 5-10 days and may be one of the following:
  • Metronidazole
  • Furazolidone
  • Paromomycin
  • Quinacrine
  • Nitazoxanide
  • Tinidazole

Giardia may be resistant to any of these medications or to several others occasionally used. Resistance may complicate treatment and prolong illness.

Prevention:
To prevent getting or spreading giardiasis:
  • Maintain good personal hygiene
  • Wash hands several times a day, especially:
    • Before eating or preparing food
    • After a bowel movement
    • After changing a diaper
  • When camping:
    • Bring bottled water for drinking, cooking, and brushing teeth
    • Purify untreated water before using; boil, filter, or otherwise sterilize
  • Thoroughly wash or peel raw fruits and vegetables before eating
  • When traveling overseas:
    • Use only bottled water for drinking, cooking, or brushing teeth
    • Only eat food that is adequately cooked and served steaming hot
  • Do not let children with diarrhea go into swimming pools
  • Keep swimming pools adequately chlorinated
  • Stay home from work and keep children home from school or daycare until the infection is gone
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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