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Giardiasis

Giardiasis (also known as beaver fever) is a disease caused by the flagellate protozoan Giardia lamblia (also Giardia intestinalis). The giardia organism inhabits the digestinal tract of a wide variety of domestic and wild animal species as well as humans. It is a common cause of gastroenteritis in humans, infecting approximately 200 million people worldwide. more...

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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. It is zoonotic -- communicable between animals and humans. Major reservoir hosts include beavers, dogs, cats, horses, and cattle.

Symptoms include loss of appetite, lethargy, diarrhea, loose or watery stool, stomach cramps, upset stomach, 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.

Antibiotics used to treat adults include metronidazole, albenzazole and quinacrine. Furazolidone and nitazoxanide may be used in children. Treatment is not always necessary, as the body can defeat the infection by itself.

Outside North America the drug Tinidazole trade name Fagisyn or Tindamax can treat Giardiasis in a single treatment of 2,000 mg. instead of the longer treatment of the other medications listed, with less distress due to the shorter treatment duration.

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Antigen testing for giardiasis - Tips from Other Journals
From American Family Physician, 1/1/93

Infection with Giardia lamblia is an increasingly common problem in the United States, especially among children in day care centers. Diagnosis of giardiasis can be difficult, however, because it has traditionally depended on the microscopic identification of Giardia cysts in stool specimens. Chappell and Matson evaluated a new immunodiagnostic test for giardiasis.

The study included 13 patients with either acute or chronic gastrointestinal symptoms. Stool samples were obtained from each of the patients and evaluated by enzyme-linked immunosorbent assay (ELISA). All but one patient had been previously evaluated for ova and parasites in the stool. All stool microscopy examinations for Giardia were negative, but six of the 13 patients were antigen-positive.

Seven of the stool samples were divided for direct comparison, with conventional stool microscopy performed for ova and parasites on one-half of the sample and antigen detection testing performed on the other half. Three samples were negative on both tests and four were negative on examination for ova and parasites but positive on antigen testing. All patients with positive antigen tests were treated with metronidazole and had prompt resolution of symptoms.

The authors conclude that the ELISA test for Giardia is sensitive and may contribute to early diagnosis. (Journal of Family Practice, July 1992, vol. 35, p. 49.)

COPYRIGHT 1993 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group

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