In our daily lives, we are usually surrounded by clean drinking water. While we may choose to avoid tap water in many cities, in general it is safe to drink and cook with. Outside of developed communities in the US and in many other countries around the world, however, the water is not so clean. In the past I’ve looked at water cleanliness in general, this week I’ll specifically examine giardiasis.
Giardiasis is one of the most common water-borne diseases in the US. It is caused by ingesting a one-celled parasite called Giardia lamblia. This parasite hatches and feeds in the intestines of the host, and during the feeding phase can be the cause of intense discomfort and inconvenience.
Infection can come from several activities, but the most common is drinking or otherwise ingesting infected water. Rivers, creeks, and lakes in the wilderness are often contaminated, as is the occasional recreational water source such as swimming pools. Another common infection opportunity is eating something that has come in contact with a contaminated source. This can occur, for instance, from eating food handled by an infected person who has not properly cleaned their hands, or eating food that was washed with contaminated water. Boiling water is enough to kill the parasite if you are unsure of your water source.
Any surface that becomes contaminated can be infectious for up to a month. This is because the reproductive phase of giardia is a hard shelled cyst that is well-protected against the environment. Coming into contact with such a cyst and transferring it to your mouth begins the cycle again, which can be both the cause of reinfection in an already infected person and new infections within a group living or working in the same space.
Once infected, it will take several days for a person to experience symptoms; typically symptoms will show in about seven days, but can take up to two weeks (and some people don’t show symptoms at all). When they do occur, they include diarrhea, fatigue, stomach cramps, gas, bloating, upset stomach, and greasy stools. In particular, the gas (and sometimes affiliated belching) smells strongly of sulfur. During this period, which lasts from two to six weeks, the host can be highly contagious to others if they do not maintain strict cleanliness standards and vigilance.
At the end of the symptomatic phase, the host can still cause infections for a few weeks. Even an infected person who is not showing symptoms can cause infections in others. Then, after a few weeks, the infection clears completely in most people. In some cases, a person may be symptomatic chronically, but this is uncommon.
Treatment for giardiasis covers two aspects. First, treatments are designed to prevent spreading the disease to others. Second, treatments address easing the symptoms, especially relieving the discomfort and keeping the individual hydrated. For adults treatment is only necessary if the symptoms persist more than a week or two or are very severe, otherwise they are recommended but not vital. However, in children, the elderly, and some other cases, treatment may be very important. You can find out more from the CDC or your healthcare professional.
Giardiasis is not pleasant, but it is also not life-threatening in most cases. A little common-sense and care can be enough to avoid it altogether, and avoidance and prevention is preferable to infection. If you are traveling, take care in obtaining water to drink and food to eat. If you are camping, treat your water appropriately. And if you do get giardiasis, make sure you stay hydrated. And stock up on toilet paper.
Resources:
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Healthy thoughts,
Jeff
