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$Unique_ID{BRK03770}
$Pretitle{}
$Title{Giardiasis}
$Subject{Giardiasis Lambliasis Beaver Fever Amebiasis Hookworms Threadworm
(Strongyloidiasis)}
$Volume{}
$Log{}
Copyright (C) 1987, 1989 National Organization for Rare Disorders, Inc.
492:
Giardiasis
** IMPORTANT **
It is possible the main title of the article (Giardiasis) is not the name
you expected. Please check the SYNONYMS listing on the next page to find
alternate names, disorder subdivisions, and related disorders covered by this
article.
Synonyms
Lambliasis
Beaver Fever
Information on the following diseases can be found in the Related
Disorders section of this report:
Amebiasis
Hookworms
Threadworm (Strongyloidiasis)
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Giardiasis is an infectious disorder of the gastrointestinal tract caused
by a genus of protozoan parasite known as Giardia lamblia. This disorder may
not cause noticeable symptoms, but when many of these parasites are present,
absorption of nutrients is diminished. Additionally, acute gastrointestinal
discomfort, chronic or acute diarrhea, and other digestive system
abnormalities can occur. This disorder has occurred in epidemics associated
with contaminated water in which infected beavers live because parasites in
the cyst stage from beavers are infectious to humans. These cysts can
survive in cold water for several months.
Symptoms
Giardiasis may not cause symptoms if a patient has ingested only a few
protozoan parasites known as Giardia lamblia. When there is an initial
concentration of many parasites in the intestines, acute abdominal
discomfort, diarrhea, excessive gas (flatulence), and foul-smelling stools
may result. When recurrent unexplained abdominal discomfort develops along
with these symptoms, Giardia parasites may be lodged in the duodenum. Acute
attacks usually last approximately three or four days, although symptoms may
persist for several weeks. Infection may resolve spontaneously in some
patients, but treatment is usually required.
In long-term infestation, patients may experience chronic diarrhea,
malabsorption of nutrients, weight loss, upper abdominal (epigastric)
cramping, loss of appetite (anorexia), nausea, vomiting, and/or excretion of
fat in the stools. The disease affects only the intestines.
Causes
Giardiasis is caused by the protozoan parasite known as Giardia lamblia.
Humans are infected by the parasites in the cyst stage (e.g., when they are
excreted by beavers. After beavers have contaminated the water supply in
which they live, cysts often exist for several months, even in cold water.
Person-to-person (fecal-oral or sexual contact) and foodborne cases also
occur. Giardiasis has also been known to be transferred to humans by dogs
and other animals.
Affected Population
Giardiasis affects persons coming in contact with the protozoan parasite
known as Giardia lamblia. This disorder occurs worldwide. Epidemics have
occurred in the United States when parasitic cysts are excreted by beavers in
public water reservoirs. Epidemics have also occurred in day care centers
and custodial institutions such as prisons and long-term care facilities.
Related Disorders
Symptoms of the following disorders can be similar to those of Giardiasis.
Comparisons may be useful for a differential diagnosis:
Amebiasis is a disease of the intestinal tract caused by the protozoan
parasite, Entamoeba histolytica. The infection is spread person-to-person or
indirectly via contaminated food or water. The organism invades the colon
and rectum and produces ulcers and inflammation. Symptoms begin gradually
with an increasing number of stools reaching as many as fifteen per day.
Stools may be semi-solid to liquid and they often carry blood. Fever, local
bowel tenderness and cramping abdominal pain occur. If the liver is
affected, tenderness will develop in that area. In the United States,
Amebiasis primarily affects visitors returning from countries with poor
sanitation. Treatment with the drug metronidazole (Flagyl) is often
effective in eliminating the disorder.
Hookworms are a parasitic organism which penetrate the skin and migrate
to the intestines where they attach themselves by their mouth and suck blood.
Abdominal pain is the most common symptom, but an asymptomatic anemia which
can limit growth in children may also occur. Approximately twenty-five
percent of the world population may be infected with hookworms. Parasites
attach themselves to a person walking barefoot in soil contaminated with
hookworm larvae. Several effective drugs are available for treatment.
Threadworm (Strongyloidiasis) is a parasitic intestinal disorder
characterized by upper abdominal (epigastric) pain and tenderness, vomiting,
and diarrhea. This disorder is usually found in the tropics in areas of poor
sanitation. It can exist in crowded and unsanitary institutions anywhere.
Threadworm can persist for decades. Treatment with the drug thiabendazole is
often effective for Threadworm patients.
Therapies: Standard
The treatment of choice for Giardiasis patients is the drug quinacrine. Mild
cases may respond to the drug furazolidone (Furoxone). The most important
factor for preventing this disorder is proper treatment of infected water.
Chlorination may not kill cysts; sedimentation, flocculation and filtration
should also be performed. Water can be boiled for one minute, or mixed with
halazone or iodine to eliminate contamination. Travelers to areas with
contaminated water should drink only boiled or treated water and should not
consume uncooked fruit or vegetables.
Therapies: Investigational
Treatment with the drugs tinidazole, ornidazole or metronidazole for
Giardiasis may be effective. However, these medications have not yet been
approved for use in the United States for this condition.
This disease entry is based upon medical information available through
September 1989. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Giardiasis, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Allergy and Infections Diseases (NIAID)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5717
Centers for Disease Control (CDC)
1600 Clifton Road, NE
Atlanta, GA 30333
(404) 639-3534
References
INTERNAL MEDICINE, 2nd ed.: Jay H. Stein, ed.-in-chief; Little, Brown and
Co., 1987. Pp. 1785-1786.
MANAGEMENT OF GIARDIASIS: E.D. Gorski; Am Fam Physician (November 1985,
issue 32(5)). Pp. 157-164.
SELECTIVE PRIMARY HEALTH CARE: STRATEGIES FOR CONTROL OF DISEASE IN THE
DEVELOPING WORLD. XIX. GIARDIASIS: D.P. Stevens; Rev Infect Dis (July
1985, issue 7(4)). Pp. 530-535.
TREATMENT OF INTESTINAL E. HISTOLYTICA AND G. LAMBLIA WITH METRONIDAZOLE,
TINIDAZOLE AND ORNIDAZOLE: A COMPARATIVE STUDY: S. Bassily, et al.; J Trop
Med Hyg (February 1987, issue 90 (1)). Pp. 9-12.