Guard Yourself Against Giardiasis

A couple of weeks ago, an old friend on mine was on Facebook, complaining that public health officials in her city had warned people in her area not to drink tap water. Apparently, there had been a big storm where she lived and the local water supply might have been contaminated. My friend was upset and annoyed by the restriction and wanted to know if the filtered water that came from her refrigerator was okay. Remembering an unpleasant experience I'd had as a Peace Corps Volunteer in the Republic of Armenia, I warned her to take all appropriate precautions. Fourteen years ago, I drank contaminated water that made me sick with a disease called giardiasis. It's an illness I wouldn't wish on my worst enemy.

What is giardiasis?

Giardiasis, otherwise known as Giardia, is a waterborne illness caused by a microscopic parasite called Giardia intestinalis. This parasite can infect humans and animals; once it gets into the body, it resides in the intestines and gets passed through the host's feces. The Giardia parasite is very common and can be found in soil, food, water, and on surfaces. The organism that causes giardiasis is very rugged, covered by a protective shell that allows it to live outside of a host for months.

Symptoms of giardiasis usually show up within one to two weeks after infection and, for most people, last from two to six weeks. Taking medication can shorten the duration of the illness significantly. Some people suffer from giardiasis symptoms longer than six weeks.

What are the symptoms of giardiasis?

From personal experience, I can attest that being sick with Giardia is not fun at all. It's also not fun for anyone around you because it causes profuse diarrhea, intestinal gas, and occasional vomiting. When I had giardiasis, I completely lost my appetite, had stomach cramps, and generally felt very sick. I did not want to eat at all. Unfortunately, I didn't lose any weight, but some people do.

At first, I thought I had just eaten something that didn't agree with me, but the symptoms didn't go away. I had diarrhea for two solid weeks before I finally went to the doctor and got a diagnosis.

Some people can get giardiasis and have no symptoms. Others might have persistant bad breath or belch a lot. The belches might smell of sulfur.

The symptoms of giardiasis can cause some people to become dehydrated and malnourished.

How is giardiasis spread?

A person can get giardiasis by swallowing the Giardia parasite. This usually happens when a person drinks contaminated water or eats contaminated food that hasn't been cooked thoroughly.

People can also get infected after coming into direct contact with contaminated feces from an infected human or animal. While most people don't purposely eat feces, sometimes they might accidentally swallow the Giardia organism after coming into contact with a contaminated surface. For that reason, it makes sense to be very careful when cleaning diaper pails, changing tables, or bathroom surfaces. Be sure to either wear gloves or wash your hands thoroughly when you're doing chores that might put you into contact with infected fecal matter, especially if you're taking care of someone you know is already infected.

One other way giardiasis can be spread is through recreational contact with contaminated water. Say, for instance, you visit a lake and accidentally swallow some water. You can get infected with Giardia that way. You can even get sick after using a swimming pool or hot tub that hasn't been properly cleaned. That's why it pays to be careful not to swallow pool water or any unboiled or untreated water from natural sources like streams, lakes, or rivers.

Giardiasis cannot be spread through contact with blood.

How is giardiasis diagnosed and treated?

If you suspect you might have giardiasis, you should see your health care provider. He or she will likely ask for some stool samples, which will confirm the diagnosis. It may take several stool samples to definitively make the diagnosis.

Once your health care provider knows you have giardiasis, he or she will prescribe certain antibiotics to combat the infection. It's also important to drink a lot of fluids to help combat dehydration caused by diarrhea and vomiting. Be sure the fluids you drink are safe. Drink bottled water or water that has been boiled or treated or drink commercially prepared drinks.

How to avoid getting sick with giardiasis or spreading it to others

* Practice good hygiene. Wash your hands frequently, especially after using the toilet, handling pets, and before eating, especially if someone you live with is already infected with Giardia.

* Avoid contact with fecal matter. Wash your hands thoughly after changing diapers, washing diaper pails, cleaning changing tables, or engaging in sexual activity that might put you into contact with feces.

* Protect others from giardiasis by not swimming when you have diarrhea. Don't swim for at least a week after diarrhea stops. Keep kids in diapers out of public swimming areas.

* Take a shower before using recreational swimming areas. Make sure children are clean before they use pools.

* If you're in an area with questionable water sources, boil your tap water before drinking it or drink only bottled water. Don't use ice cubes unless you know they were made with uncontaminated water.

* Wash food with clean water that has either been boiled, bottled, or treated. If clean water isn't available, peel fruits and vegetables. Be careful about eating uncooked foods in countries where sanitation is questionable.

* If the local public health agency advises you not to drink the water straight from the tap, don't drink it! Unfortunately, I didn't know about the contaminated water in Armenia before it was too late because I didn't have access to the news. In the United States, most people don't have this problem.

* If your water comes from a well, consider having it tested for contamination, particularly if anyone in your household has trouble with diarrhea.

To treat water, use one of these methods

* Heat the water to a rolling boil and let it boil for at least one minute. If you're at an altitude of over 6,526 feet, boil it for at least three minutes.

* Filter the water with a filter that has a pore size of one micron or smaller, or one that has been rated for "cyst removal". Don't take any chances with filtering unless you know for certain that the filter meets one or both of these requirements.

* If you can't boil the water, you can treat it with chlorination or iodination. This is probably the least effective way to make your water safe, since there's a fine balance between the amount of chemicals needed to kill germs versus the amount that is safe for humans to drink.

Be safe-- don't be sorry!

Giardiasis is a very unpleasant condition that, with a little planning and forethought, is entirely preventable. If you practice good hygiene, good food safety, and exercise a little consideration, you probably won't have any trouble with this pesky little parasite. Keep these tips in mind when you're dealing with unknown water supplies and, above all, if you're warned not to drink the water, heed that warning!

Sources:

The Centers for Disease Control's fact sheet on giardiasis: http://www.cdc.gov/ncidod/dpd/parasites/giardiasis/factsht_giardia.htm

Web MD: http://www.webmd.com/a-to-z-guides/giardiasis-topic-overview

Personal experience