Think before you drink!

Giardiasis is a disease of the small intestine that is caused by a protozoon – a parasite – named Giardia intestinalis

zatrucie   Admit it; you immediately thought this was going to be another article devoted to the worldwide anti-alcohol campaign. Wrong! Disappointing though this may be – or relieving, for all it’s worth – this article aims at bringing to light a water-related, among other things, mishap that is unknown to most people: giardiasis. Giardiasis is a disease of the small intestine that is caused by a protozoon – a parasite – named Giardia intestinalis, previously known as Giardia lamblia. Believe it or not, this organism lives in as much as 80% of all raw water including lakes, ponds and streams and it can also be found in 15% of filtered water!. In fact, Giardiasis is the most common protozoal intestinal disease in the whole world1. This data most likely comes as a surprise to you, since most of you haven’t even heard the word giardiasis. You shouldn’t sweat it though, because to live is to learn and to learn is to live.

Aside from all the strictly medical stuff, which is bound to either unnecessarily perplex you or bore you, there are some points that are of extreme significance to the common individual. The most important of these are prevention strategies. To be able to implement them, however, you need to first learn the basics of the disease. To get sick, you need to swallow the parasite’s cysts, which can be found in the feces of infected individuals and in contaminated water, which means that you either have to eat food that has been handled by individuals with “dirty” hands, to touch infected feces or the anus of an infected person (venereal transmission) or to drink water infested with the cysts. Certain population groups run a higher risk of being infected, such as day-care and other inmate facility workers, active homosexual men, people suffering from immunodeficiency and those who travel to endemic areas with poor hygiene2. Although it may sound like a tropical or far-away disease, giardiasis outbreaks also happen in the western world, generally after consuming unfiltered water.

However beckoning a spring of crystal-clear, cold water, emerging from among wild, green ferns and moss covered rocks might seem to you, you should always keep in mind that natural surface water could very well be infested with all sorts of not so beautiful-looking organisms pathogenic to man. The areas, where giardia is most likely to be found, are western states of the USA, Eastern Europe and particular St. Petersburg, Russia, where tap water is the primary parasite carrier, New Zealand, Nepal, Bangladesh and Ethiopia. When travelling or hiking in these places, certain safety rules must always be adhered to: no unfiltered surface water should be consumed but if this cannot be avoided, the water should be carefully disinfected by boiling it, filtrating it properly or cleaning it with halogenating substances2. Always remember that infected water can also be ingested during showering and swimming or by adding infected ice-cubes to your drink.

Giardiasis doesn’t present itself like your typical traveler’s diarrhea, so don’t expect to feel anything out of the ordinary soon after you decide to take the plunge and drink that inviting yet fishy water. At the same time, you shouldn’t feel relieved and off the hook if nothing happens the first days after your hiking or traveling adventure comes to an end. The disease typically takes even up to 3 weeks to manifest itself with intestine-related and general symptoms like diarrhea, flatulence, bloating, abdominal pain and malaise or weight loss. In some cases it can be totally asymptomatic or the manifestations might go on for a long period of time, resulting in malabsorption of food nutrients and growth retardation of children. If any situation resembling the above occurs sometime after ingestion of questionable water or food, you should immediately contact your doctor. If a diagnosis of giardiasis is confirmed, you must be extra cautious not to spread the disease to those living around you, as is very often the case, by scrupulously implementing hygienic measures. In any case, though, you shouldn’t be overly worried because there is an available treatment that completely cures the disease.

Always keep in mind that prevention is better than cure and that you should always think about whether to drink or to eat whatever thirst-quenching and mouth-watering stands before you, or not. Moreover, don’t forget that good knowledge of the facts is always the first and most important step towards effectively protecting yourself against all the vices of this world, so here are some good sources that can help you in that direction: cdc.gov, emedicine.medscape.com and who.int. Enjoy!