Giardiasis is an intestinal infection caused by the single celled organism Giardia. Expect some combination of diarrhea, bloating, vomiting and nausea. Also, sulphur smelling burps – this is one of the most commonly reported symptoms with giardiasis. Long-term infections can cause weight loss, malnutrition and loss of appetite. Giardiasis may be less alarming than other intestinal infections (like say, amoebic dysentery), but it is still a major intestinal infection that could end up being a complete nightmare.
As we mentioned in the travel health tips from West Africa article, giardiasis can also be asymptomatic. In other words, you won’t notice you have an infection. You will simply carry on living your life. At some point, evidence of the disease will surface, most likely in the form of anemia or fatigue. In some cases, the infection may go away on its own.
How do you get giardiasis? More importantly, how do you avoid it? And what do you do if you get it?
Prevention
Giardia is transmitted via feces. Not what you wanted to hear, I’m sure, but this is how almost all intestinal infections start, from bacterial based traveler’s diarrhea to amoebic dysentery. Some amount of fecal matter has worked its way into your food or drink and.. Oh, sorry. Did you not want to hear that?
When ingested, the giardia is in the form of a small cyst. Upon coming in contact with your stomach acid, the cyst (think of it as a hard shell) then releases trophozoites, which migrate to the small intestine where they take up residence along the intestinal wall. It is there that they multiply and form a colony.
The cyst form is how giardia enters your body, and it is this form to which you need to pay attention. The cyst is relatively indestructible. In fact, standard treatment amounts of chlorine are unable to destroy it. As we said in the 4 ways to treat water article, we prefer using a filter and the SteriPen UV treatment device. Check out our review of the SteriPen over here. Your other option is of course to buy bottled or pretreated water.
Giardia can also be found in food that has not been prepared in a hygienic matter. Make sure to eat food that has been well cooked/boiled, and if you are eating fruits and vegetables make sure they have not come in contact with contaminated water. Aim for fruits and vegetables that have either been peeled or boiled, or washed in potable water.
Treatment
You should get tested and treated at a clinic. You may be wondering how to tell if you have giardiasis, given that the symptoms are similar to regular traveler’s diarrhea, and there are no visible signs like blood in the stool. A couple things to look out for: sulphur burps and exceptionally foul smelling stools. Also, if you are taking a medication like cipro to try and treat the diarrhea and it is not having any effect, you may very well have giardiasis (UPDATE: we recently posted about cipro possibly being effective for giardia treatment. Take a look here
The most widely prescribed medication for giardiasis is metronidazole, commonly known as Flagyl. You will likely need to take a 250mg dose 3 times a day for 5 days. Alternate treatments include tinidazole (Fasigyn) and nitazoxanide. In any case, make sure that you have a proper diagnosis at a clinic. A thorough analysis will include both blood and stool samples.
As always, it is a good idea to visit a travel health clinic before traveling. Your doctor will likely discuss giardiasis as a possible infection you could encounter. He/she will reinforce your preparedness and review the treatment options. As we’ve also mentioned before, it is imperative to purchase travel insurance. In the unlikely but possible event you have to visit a clinic to treat giardiasis or any other intestinal infection, you do not want to foot the bill.
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