The Health/Medicine Archives contains a thread entitled: "Don't Drink the Water"-Dave Matthews Band dated March 07, 1999. This is not an effort to review that thread but to add to it for everyones health information.

Following a trip to Italy in Oct. 1995 I began noticing some changes in bowel habits (constipation), some food intolerances, and upper abdominal pain, mostly in the right upper quadrant mimicking gall bladder pain. An ultrasound of the abdomen indicated cholelithiasis or gall stones and so my gall bladder was removed in February 1997. There were no gallstones and following surgery the symptoms persisted. Thousands of dollars and many tests later the diagnosis is Giardiasis, probably contracted while traveling in Italy. (great souvenir!)

Human giardiasis may involve diarrhea within 1 week of ingestion of the cyst, which is the environmental survival form and the infective stage of the organism. Normally illness lasts for 1 or 2 weeks, but there are cases of chronic infections lasting months to years. Chronic cases are difficult to treat.

The disease is most frequently associated with the consumption of contaminated water but outbreaks have been traced to food contaminated by infected handlers or contaminated fruits and vegetables eaten raw. The organism is implicated in 25% of the cases of gastrointestinal disease and may be present asymptomatically. The incidence of infection in the USA is estimated at 2% of the population. (approximately 6,000,000 people, alot of protozoa floating around out there)

Lactose intolerance is frequently observed and chronic infections can lead to malabsorption syndrome and severe weight loss. The disease is difficult to diagnose and the present treatment is the antibiotic metronidazole (Flagyl) but chronic giardiasis can be refractive to this treatment. (recently a peptide antibiotic, bacitracin, stabilized with zinc, has been shown to have a high efficacy)

I have been an OR/PACU nurse for 31 years and knew very little about this disease. With the increasing risks to our water supply and especially with y2k it is MHO that we all know that the disease can become chronic, it is difficult to diagnose, and that treatment can fail. Also, it is highly contagious. There are several good Giardiasis web sites: http://vm.cfsan.fda.gov/~mow/chap22.html, http://www.emedicine.com/emerg/topic215.htm, http://www.niaid.nih.gov/factsheets/GIARDIA.htm

Also, the Great Smokies Diagnostic Laboratory in Asheville, North Carolina offers a Comprehensive Parasitology Profile that can be ordered by your physician via email. Their web site is: http://www.gsdl.com/index.html

Hope this information is helpful. Be diligent with your water storage, be sure to stringently obey any boil water advisories, don't even brush your teeth with it, use good hygienic practices, and wash/peel fresh fruits and vegetables. And above all stay healthy. Giardia is not fun even in the best of times.

-- Carol (jdufrene@laci.net), June 26, 1999

Answers

Carol,

Great information! This place could use a lot more input from a 31 year nurse...Thanks

-- BiGG (supersite@acronet.net), June 26, 1999.

From Giardias is:

AGENT: Giardia duodenalis - man, rodents, birds, & reptiles. This is the only zoonotic type. Dogs and NHP's represent the greatest public health risk. This is the most common intestinal parasite of people in the U.S. RESERVOIR AND INCIDENCE: Worldwide in distribution, occurs among all vertebrates and many lab animal species including dogs and NHP's. TRANSMISSION: Contamination of water by beavers, dogs, & humans. NHP's can also be a source. Infective cysts are ingested. Only a few cysts can cause severe disease. Asymptomatic hosts can shed organism intermittently. Shown in children to be transmitted via fecal contamination of fingers, toys, and the environment.

DISEASE IN ANIMALS: Usually asymptomatic although may produce diarrhea.

DISEASE IN MAN: Chronic intermittent diarrhea, steatorrhea, malaise, anorexia, and weight loss. The stool is frequently mucus laden, light colored and soft, not watery. More severe infections in young or immunocompromised.

DIAGNOSIS: FRESH feces (not more than 5 to 10 minutes old) to detect trophozoites or cysts. TREATMENT: Metronidazole (FLAGYL) PREVENTION/CONTROL: Fecals to screen dogs and NHP's. Water supplies monitored. Hygiene, protective clothing, when handling animals.

(NHP = non-human primate)

Filter all the water you use. Make sure the filter is rated to exclude giardia.

-- Tom Carey (tomcarey@mindspring.com), June 26, 1999.

Cascadia, home to beavers and too much water, has Giardia. We read somewhere that almost every stream, pond, etc. has Giardia. So much for frolicking in the woods and hand-bowl slurping out of the brooks. Thanks for the info, Carol.

-- Ashton & Leska in Cascadia (allaha@earthlink.net), June 26, 1999.

Yeah. People have nostalgic memories of boy scouts drinking right out of mountain streams. What they don't realize is that giardia is a fairly recent import to this country. In a survival situation it could easily kill you. Tom Brown caught a bad case one time and lost about forty pounds.

-- Shimrod (shimrod@lycosmail.com), June 26, 1999.