P1254156689LniJh

1
Giardiasis
Michele Miller and Crista Tiboldo Ramapo College
MSET Infection June 21, 2007
2
What is giardiasis?

• Infection of the small intestine
• Caused by a parasite
• Symptoms
• Watery diarrhea
• Weight loss
• Bloating
• Abdominal cramping
• Sulfur-tasting burps
• Low grade fever
• Many people are asymptomatic
• Prognosis Unpleasant, but good!

3
PPT

• PERSON
• Anyone
• 3x more
• common in
• children
• Hikers

• PLACE
• Inadequate
• sanitation
• Inadequate
• water
• treatment
• Daycare
• centers

• TIME
• Late summer
• through
• autumn

4
History

• 1681 Anton von Leeuwenhoek describes
• Giardia intestinalis
• 1859 Vilem Lambl documents his observation of
• G. intestinalis
• - G. intestinalis is renamed G. lamblia
• 1950s Relationship between Giardia and illness
  is
• identified
• 1960s - G. lamblia is cultured for the first time
• 1970s - G. lamblia is confirmed as a pathogen

5
Prevalence

• Most common parasitic GI disease
• 2.5 million cases occur each year
• in US
• 20 of world population chronically
• infected
• Most common areas
• poor sanitary conditions
• insufficient water treatment
• Day care centers

6
Outbreak

• August November 2004
• Bergen, Norway
• 1,300 laboratory cases
• Source water supply
• Lake water is chlorinated,
• but not filtered
• 5 cysts per 10 L
• Persons affected
• Predominantly female
• 47 ages 20-29
• 1 children lt5 years

7
Personal Account

• Patient Lisa Stevenson
• Year 1990
• Age 11
• Location A New Hampshire camp
• Symptoms exhibited
• Flu-like
• Loss of appetite
• Diarrhea
• Vomitting
• 15 lb weight loss
• MD initial impression depression
• Length of illness one month
• Source of infection lake water on camp grounds

8
Pathogen

• Protozoan (animal-like protist)
• Giardia lamblia
• AKA
• Giardia intestinalis
• Giardia duodenalis
• Beaver fever
• Classification
• Kingdom Protista
• Phylum Sarcomastigophora
• Subphylum Mastigophora
• Class Zoomastigophora
• Order Diplomonadida
• Family Hexamitidae
• Genus Giardia
• Species lamblia

9
Pathogen Characteristics

• Eukaryotic
• Lack mitochondria
• Trophozoite
• 4 pairs of flagellum
• Convex dorsal surface
• Flat ventral surface
• Adhesive or sucking disk
• 2 nuclei
• Cyst
• 4 nuclei
• Smooth, oval shape

10
Life Cycle

• Two stages
• Trophozoite
• Active
• Does not
• spread infection
• Cyst
• Inactive
• Develops into
• trophozoid with
• stomach acid
• 10 cysts
• infection

11
Once giardia enters your body....

• It attaches to the small intestine
• Reproduces via binary fission
• Divides every 12 hours
• 1 becomes 1 million in 10 days
• 1 billion in 15 days
• Moves to colon
• Exits host through stool

12
Mechanism of infection

• Cysts are ingested
• Attaches to microvilli in SI
• Blocks absorption in
• digestive tract
• Diarrhea ensues

13
Method of transmission

• Ingestion of cysts
• Contaminated water
• Contaminated food
• Contact with contaminated
• feces

14
Onset of symptoms
Approx. 7 days post infection
Duration of illness
2 to 6 weeks
15
Treatment

• Prescriptive medication
• Furazolidone (Furoxone)
• Metronidazole (Flagyl)
• Tinidazole
• Rate of success
• 80-95 if full course is
• completed

16
Prevention

• Proper water treatment
• Good personal hygiene
• Avoid direct ingestion of potentially
• contaminated water
• Lakes
• Streams
• Disinfect surfaces in contact with
• feces
• Vaccine for dogs and cats

17
Giardia also affects....
Wild animals
Domestic animals
18
Background Information

• Protists
• Characteristics
• Protozoa
• Microscopy
• Communicable diseases
• Methods of transmission
• Prevention

19
Giardiasis In The Classroom

• http//www.bam.gov/teachers/activities/epi_3_giard
  ia.pdf
• Case study of giardiasis
• Objectives
• Define the host of disease
• Research giardiasis
• Describe characteristics, transmission, treatment
  
• and prevention of giardiasis
• Technology
• Guided internet research
• Role play
• Pediatricians diagnosing childrens illness to
• concerned parents

20
Cross-Curriculum

• Geography Identify locations of outbreaks
• worldwide on map
• Math Graph number of patients affected
• History Timeline of the study of giardiasis
• Language Arts Informational brochure