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Giardiasis Infection 

What is giardiasis? It is an intestinal infection caused by the parasite giardia (Giardia intestinalis, Giardia lamblia, or Giardia duodenalis). The microscopic parasite is found in soil, food or water that is contaminated with feces of infected humans/animals, especially in places with poor sanitation and unsafe water. 

Giardia parasite is covered with an outer shell hence it can survive outside the body for longer periods (weeks to months) and makes it resistant to chlorine disinfection. People usually contract through ingestion of contaminated water from swimming pools, spas, lakes and wells. It is less likely to be transmitted through food as heat kills the parasites unless its raw salad/sashimi. However poor food hygiene may allow parasites to spread. 

Giadiasis can also spread from personal contact for example unprotected anal sex with infected person. Changing a child's diapers which has parasites in feces may also be a potential way of transmission especially those who work in child care centres. 

It is not spread by blood. 

Signs and symptoms of Giardiasis

Some people may remain symptom-less despite carrying the giardia infection in them, they however can spread the disease to others. 

​Those who get sick, symptoms and signs will start about 1-3 weeks after infection. The symptoms include: 
- Diarrhea with greasy stools 
- Fatigue 
- Abdomen colic and bloatedness 
- Gas or flatulence
- Nausea and vomiting 
- Loss of appetite and weight loss
- Dehydration due to fluid loss from diarrhea and vomiting

Symptoms of giardiasis may last 2 to 6 weeks, some people even longer. Treatment will reduce the duration of condition. 

Risk factors for contracting Giardiasis 

- Especially children who are on diapers, going through toilet training in child care centers. They are more prone to be exposed to infected stools 
- Drinking contaminated water 
- People who have unprotected anal sex with another infected person
- Close contact with those who have giardiasis infection 


Complications of Giardiasis 

Although giardiasis is never fatal in devloped countries but they can cause lingering and serious complications especially in infants and young children. Some complications include: 

- Failure to thrive : Prolonged diarrhea and loss of appetite may result in malnutrition in children and may affect their physical and mental development. 
- Dehydration: as a result of diarrhea and vomiting 
- Lactose intolerance: Inability to digest milk sugar may persists after recovery from Giardiasis
Diagnosis of giardiasis 

Stool samples, often a few may be needed to be sent to the laboratory to look for presence of the parasite giardia. Eradication of disease also is determined by the absence of parasites after treatment. 


Treatment of Giardiasis 

In some cases, the patients recover on their own so they do not need treatment. But if the disease is prolonged or serious then antibiotics are prescribed: 
- Metronidazole (Flagyl) : Taken for up to a week. Side effects include nausea and a metallic taste
- Tinidazole : as effective as flagyl and given as a single dose hence it is more convenient. Same side effects as flagyl. 
- Nitazoxanide (Alinia): comes in syrup hence it's suitable for children. Side effects include bright yellow urine, nausea and flatulence
- Paronomycin: has lesser chance of causing birth defects in pregnant women as compared to the rest of medications. But if symptoms are mild and patient is stable, it's best to delay treatment after delivery. 

Re-hydration of any fluid loss to prevent dehydration is also important. 

Prevention of Giardiasis 
  • Good hand hygiene : Wash your hands after toilet use and changing diapers 
  • Drink safe water: bottled water 
  • Do not drink tap water
  • close your mouth when swimming in lakes/rivers/swamps to prevent ingesting contaminated water 
  • Practice safe sex 
Prognosis of Giardiasis 

Usually giardiasis infection will last up to 6-8 weeks. But lactose intolerance may persist longer even after treatment. 

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