Giardiasis
What is giardiasis?
Giardiasis (GEE-are-DYE-uh-sis) is a diarrheal illness caused by Giardia intestinalis (also known as Giardia lamblia), a one-celled, microscopic parasite that lives in the intestine of people and animals. The parasite is passed in the stool of an infected person or animal. The parasite is protected by an outer shell that allows it to survive outside the body and in the environment for long periods of time. The parasite is found throughout the world. The sickness that this parasite causes is called giardiasis
( "gee-ar-dye-a-sis.")

What are the symptoms of giardiasis?
Symptoms include sudden diarrhea, stomach cramps, loose or watery stool (clay colored and foul smelling), belching, gas, and indigestion or upset stomach (slight nausea or loss of appetite.) These symptoms may lead to malabsorption, weight loss and dehydration. To avoid dehydration maintain an adequate fluid intake of at least 8 glasses of water or liquid a day. Slight fever is very uncommon. Occasionally persistent symptoms recur over weeks and months. Some people have no symptoms.

How long after infection do symptoms appear?
Symptoms generally begin 1-3 weeks after being infected.

How is giardiasis spread?
Giardia lives in the intestine of infected humans or animals. Millions of germs can be released in a bowel movement from an infected human or animal. You can become infected after accidentally swallowing the parasite. Giardia may be found in soil, food, water, or surfaces that have been contaminated with the feces from infected humans or animals. Giardia is not spread by contact with blood.

Giardia can be spread:
¡ñ By putting something in your mouth or accidentally swallowing something that has come in contact with the stool of a person or animal infected with Giardia.
¡ñ By swallowing recreational water contaminated with Giardia. Recreational water is water in swimming pools, hot tubs, jacuzzis, fountains, lakes, rivers, springs, ponds, or streams that can be contaminated with sewage or feces from humans or animals.
¡ñ By eating uncooked food contaminated with Giardia. Thoroughly wash with uncontaminated water all vegetables and fruits you plan to eat raw. See below for information on making water safe.
¡ñ By accidentally swallowing Giardia picked up from surfaces (such as toys, bathroom fixtures, changing tables, diaper pails) contaminated with stool from an infected person.
¡ñ Some people who get giardiasis don't become ill, but they may spread the parasite to other people. Giardiasis maybe spread from person to person if good hygiene and hand washing techniques are not followed.
¡ñ Although Giardia can infect all people, young children and pregnant women may be more susceptible to the dehydration resulting from diarrhea and should drink plenty of fluids while ill.

How can this disease be prevented?
You should be very careful about the water you drink and avoid using ice. Boil water before you use it. Drink only bottled or canned carbonated soft drinks or commercially packaged noncarbonated soft drinks and fruit juices that do not require refrigeration until after they are opened. Wash your hands carefully several times a day (with an antibacterial soap, if possible), especially before meals to avoid catching the infection from other people. If you are traveling, don't brush your teeth or wash dishes with water that hasn't been boiled. Peel raw fruits and vegetables before you eat them, and don't eat uncooked (raw) food. If you are unable to avoid drinking or using water that might be contaminated, then treat the water yourself by heating the water to a rolling boil for at least 1 minute.

If the methods above cannot be used, then try chemical inactivation of Giardia by chlorination or iodination. Chemical disinfection may be less effective than other methods because it is highly dependent on the temperature, pH, and cloudiness of the water. If someone in your family gets giardiasis, it's likely that this problem will spread to everyone in your home--specially to the children.

How can my doctor tell if I have this disease?
Your doctor can usually diagnose giardiasis by looking at stool samples under a microscope, although several samples may have to be checked before the diagnosis can be made. Giardia is very difficult to isolate from stool samples and stool examinations are frequently false-negative, so your doctor may diagnose and treat you based on the clinical history and exam. Sometimes other tests may be necessary.

I have been diagnosed with a Giardia infection. Should I worry about spreading infection to others?
Yes, Giardia can be very contagious. Follow these guidelines to avoid spreading Giardia to others.

¡ñ Wash your hands thoroughly with soap and water after using the toilet, changing diapers, and before eating, handling or preparing food (people having diarrhea should not prepare food for other people.)
¡ñ Avoid swimming in recreational water (pools, hot tubs, lakes or rivers, the ocean, etc.) if you have Giardia and for at least 2 weeks after diarrhea stops. (essential for children in diapers.) You can pass Giardia in your stool and contaminate water for several weeks after your symptoms have ended. This has resulted in outbreaks of Giardia among recreational water users.
¡ñ Avoid fecal exposure during sex.

How is this disease treated?
Giardiasis is usually treated with the following medicines:

ADULTS (nonpregnant)
1. Albendazole 400mg by mouth once a day for 5 days
2. Furazolidone 100mg by mouth 4 times a day for 7 Ð 10 days
3. Metronidazole (brand name: Flagyl). 250mg by mouth taken 3 times a day for 5 Ð 7 days. Side effects may include a metallic taste in the mouth or nausea. If you take Flagyl, you should not drink any alcohol as the interaction may cause abdominal cramps and nausea. This medicine shouldnÕt be taken in the early stages of pregnancy.
4. Paromomycin 500mg (30mg/kg/day) by mouth 3 times a day for 7 days
PREGNANT WOMEN
1. Paromomycin 500mg by mouth 3 Ð4 times a day for 7 days
CHILDREN
1. Albendazole 400mg by mouth once a day for 5 days
2. Furazolidazole 6 Ð 8 mg/kg/day by mouth divided 3 Ð 4 times day
for 7 Ð 10 days
3. Metronidazole 15 mg/kg/day by mouth divided 3 times a day for 5 days
with a maximum dose of 300 mg/day
4. Paromomycin 30 mg/kg/day by mouth divided 3 times a day for 7 days

It's usually best if a whole family is treated at the same time, because giardiasis is so easily spread. Sometimes you may need to take medicine for a longer time, or your doctor may want you to take another medicine for a complete cure.

The Beijing United Family Hospital is having its monthly blood bank drive on October 26th, from 10 am to 1 pm at the Beijing United Family Hospital, located just two blocks east of the Lido Holiday Inn. The actual address is as follows: 2 Jiangtai Lu, Chaoyang District, Beijing 100016. Their website address is www.beijingunited.com and email address is bjunited@bjunited.com.cn

Beijing Family United Family Hospital presently operates and houses the ONLY FOREIGNERS BLOOD BANK IN CHINA and it was just granted that status this past January. All blood donations are pre-screened according to strict international safety standards before being stored at BJU's on-site blood bank. For more information, call 010-6433-3960, ext 350 or email Liaison@bjunited.com.con

Since the blood bank started (a few months ago) there have already been several expat receipients of donated blood during surgical procedures that would have had to been medivaced to Hong Kong or elsewhere.