Giardiasis overview: Difference between revisions
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Revision as of 21:20, 10 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Giardiasis is a disease caused by the flagellate protozoan Giardia lamblia (also sometimes called Giardia intestinalis and Giardia duodenalis) [1]. The giardia organism inhabits the digestive tract of a wide variety of domestic and wild animal species, including humans. It is a common cause of gastroenteritis in humans, infecting approximately 200 million people worldwide.
Pathophysiology
Giardiasis is passed via the fecal-oral route. Primary routes are personal contact and contaminated water and food. People who spend time in institutional or day-care environments are more susceptible, as are travelers and those who consume improperly treated water. It is a particular danger to people hiking or backpacking in wilderness areas worldwide. Giardia is suspected to be zoonotic—communicable between animals and humans. Major reservoir hosts would include beavers, dogs, cats, horses, and cattle.
Causes
Giardiasis outbreaks can occur in communities in both developed and developing countries where water supplies become contaminated with raw sewage. It can be contracted by drinking water from lakes or streams where water-dwelling animals such as beavers and muskrats, or domestic animals such as sheep, have caused contamination. It is also spread by direct person-to-person contact, which has caused outbreaks in institutions such as day care centers. Anything that comes into contact with feces (poop) from infected humans or animals can become contaminated with the Giardia parasite. People become infected when they swallow the parasite. It is not possible to become infected through contact with blood.
Diagnosis
History and Symptoms
Symptoms include loss of appetite, lethargy, fever, explosive diarrhea, loose or watery stool, stomach cramps, upset stomach, projectile vomiting (uncommon), bloating, and flatulence. Symptoms typically begin 1–2 weeks after infection and may wane and reappear cyclically. Symptoms are caused largely by the thick coating of Giardia organisms coating the inside of the small intestine and blocking nutrient absorption. Most people are asymptomatic; only about a third of infected people exhibit symptoms.
Laboratory Findings
While most sources suggest that commonly used tests for giardia are unreliable, a new immunologic test referred to as ELISA, for enzyme-linked immunosorbent assay are now available. These tests are capable of a 90 percent detection rate or more. [2]
Treatment
Medical Therapy
Drugs used to treat adults include metronidazole, albendazole and quinacrine. Furazolidone and nitazoxanide may be used in children. Treatment is not always necessary, as the body can defeat the infection by itself.
References
- ↑ Huang, White. An Updated Review on Cryptosporidium and Giardia Gastroenterol Clin N Am 35 (2006) 291–314
- ↑ Giardia Lamblia and Giardiasis by Robert L. Rockwell, PhD