GIARDIASIS: A GENERAL OVERVIEW

BY

JOSEPH JULIET
AST/2382290225

MICROBIOLOGY OPTION

FEBRUARY, 2024
Introduction
• Giardiasis, a gastrointestinal disease characterized by acute or chronic diarrhea, is caused by
protozoan parasites in the genus Giardia.

• Giardia duodenalis is the major species found in mammals, and the only species known to cause
illness in humans.

• This organism is carried in the intestinal tract of many animals and people, with clinical signs
developing in some individuals, but many others remaining asymptomatic.

• In addition to diarrhea, the presence of G. duodenalis can result in malabsorption; some studies
have implicated this organism in decreased growth in some infected children and possibly
decreased productivity in young livestock.

• Outbreaks are occasionally reported in people, as the result of mass exposure to contaminated
water or food, or direct contact with infected individuals (e.g., in child care centers) (2021).
 Life cycle of Giardia duodenalis
Cysts are resistant forms and are responsible for transmission of giardiasis. Both cysts and trophozoites can be
found in the feces (diagnostic stages)
1. The cysts are hardy and can survive several months in cold water. Infection occurs by the ingestion of cysts
in contaminated water, food, or by the fecal-oral route (hands or fomites)
2. In the small intestine, excystation releases trophozoites (each cyst produces two trophozoites)
3. Trophozoites multiply by longitudinal binary fission, remaining in the lumen of the proximal small bowel
where they can be free or attached to the mucosa by a ventral sucking disk
4. Encystation occurs as the parasites transit toward the colon. The cyst is the stage found most commonly in
nondiarrheal feces.
5. Because the cysts are infectious when passed in the stool or shortly afterward, person-to-person
transmission is possible. While animals are infected with Giardia, their importance as a reservoir is unclear.
Fig 1: Picture of Life Cycle of Giardia duodenalis
Prevalence of Giardiasis
• Giardiasis occurs global but is more prevalent in areas with insufficient sanitary conditions
(Betancourt, 2021).

• Whereas Giardiasis is also found among people living in developed countries where sanitation is
sufficient and water supplies are piped and purified (Farzan, 2018).

• The highest prevalence of giardiasis takes places in the tropics and subtropics. In the United
States, giardiasis is the most commonly reported pathogenic protozoan disease.
 Transmission of Giardia
• Giardia cysts are increase by the fecal-oral route.

• Cysts may be ingested with contaminated water or food, or acquired from unwashed hands.

• Giardia lamblia has been to be spread either from person to person, animal to person or from the environment
to person and via fecal-oral contamination with cysts or occasionally through food.

• These transmission modes are well favored by high temperatures and moist climatic conditions, poor personal
hygiene and unsanitary habits of individuals.

• G. lamblia infect infants in both industrialized and developing countries, making it one of the most common
causes of day-care center outbreaks of diarrhea. U.S. day-care centers have reported the prevalence of Giardia
to range from 17% - 90%. Infection often extends among the family members of infected children.
 Symptoms of Giardiasis
Some people can carry giardia parasites without experiencing any symptoms(asymptomatic). Symptoms of giardiasis generally show up one or two weeks

after exposure. Common symptoms include:

• Fatigue

• nausea

• diarrhea or greasy stools

• loss of appetite

• vomiting

• Bloating and abdominal cramps

• weight loss

• Excessive gas

• Headaches

• Abdominal pain
 Diagnosis
Giardiasis is diagnosed by the identification of cysts or trophozoites in the feces, using direct mounts as well as
concentration procedures. Cysts are typically seen in wet mount preparations, while trophozoites are seen in
permanent mounts (i.e. trichrome). Repeated samplings may be necessary. In addition, samples of duodenal fluid
(e.g., Enterotest) or duodenal biopsy may demonstrate trophozoites. Alternate methods for detection include
antigen detection tests by enzyme immunoassays, and detection of parasites by immunofluorescence. Both
methods are available in commercial kits.Direct Immunofluorescence Assay (DFA)Cysts of G. duodenalis
(lower right) and Cryptosporidium upper lert levered win commercially avalladie immunofluorescent antibodies.
A direct immunofluorescence assay (DFA) is available fordiagnosing Giardia duodenalis infections. Antibodies
tagged with fluorescent markers are added to stool and incubated. Visualization under a fluorescent microscope
shows the Giardia cysts as green, glowing ovoid objects. This test includes antibodies for Cryptosporidium and
both diseases can be tested for simultaneously
Fig 2: Picture of Diagnosis of Giardiasis
Treatment of Giardiasis
Prevention and Control of Giardiasis
• Washing hands carefully.

• Avoiding swallowing recreational water.

• Using caution when traveling.

• Avoiding drinking untreated water. Or treating water before drinking.

• Being careful when dealing with animals.

• Avoiding fecal exposure.

Conclusion
• Giardiasis spread is strongly known as due to unhygienic standards in our community and
potentially because of contaminated food and water.

• In order to prevent, one should apply good hygiene in retirement homes, day care centers, and at
home to avoid the infection.

• Another important implication, is to wash hands regularly with soap and also avoid contact with
the feces of an infected individual. Secondly, during traveling in areas where giardiasis is
common, infection with can be avoided by using only boil and bottled water and keep away from
consumption of raw fruits and vegetables.
Recommendation
• Help keep yourself and your loved ones healthy by washing your hands often with soap and water,
especially during key times when you are likely to spread germs.

• Since Giardia germs can be found in soil, wash hands with soap and water after field work,
landscaping, or gardening, even if you were wearing gloves

• Do not drink untreated water or use ice made with water from lakes, rivers, springs, ponds,
streams, or shallow wells.
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