Giardia lamblia

Giardiasis, also called Lambliasis or Lamblia dysentery, is a gastrointestinal disease and is caused by the unicellular parasite Giardia lamblia, which lives in the intestines of humans, mammals and reptiles. The survival form is 4-nucleated cysts that are viable and infectious for several months in moist and cool environments (up to 3 months in water at 18°C), but only a few days in dry environments. Giardiasis is widespread worldwide. The countries of infection relevant for Germany are India, Turkey, Egypt, Spain and Italy. Children and persons between 20 and 40 years of age are most frequently affected by the disease. In dogs and cats, persistent intermittent diarrhea may occur, especially in the first year of life. Sometimes vomiting also occurs. In older animals, the infection is usually inconspicuous.

Transmission route

The cysts (encapsulated resting form) of Giardia lamblia are excreted in the stool of infected humans and animals. Infection of humans occurs primarily through fecally contaminated drinking water, raw vegetables contaminated with feces, or smear infection (fecal-oral) on towels, toys, etc. The cysts remain infectious in the environment for some time. The disease is most commonly acquired during travel to countries with low standards of hygiene.

Incubation period

The time that elapses between infection with Giardia lamblia and the appearance of the first symptoms (incubation period) is about 3 -25 days on average 7-10 days.

Symptoms

The disease usually begins suddenly with yellow watery and foamy diarrhea. Other signs of illness may include nausea, abdominal cramps, and weight loss. Most individuals experience only mild signs of illness, and often the disease progresses without symptoms. After 2 -3 weeks there is usually spontaneous improvement, but there are also chronic courses. Treatment of giardiasis consists in the administration of medication.

Duration of infectiousness

Patients are infectious as long as cysts of Giardia lamblia are shed. Because of the relatively high resistance of cysts to chlorine, swimming pools should not be visited until treatment is complete.

Hygiene measures

Giardia lamblia cysts are excreted in the stool and can be spread by tiny traces of stool on the hands (smear infection). Therefore, special emphasis should be placed on maintaining hand hygiene to prevent transmission to others. Wash hands thoroughly with your own soap or liquid soap after each visit to the toilet and before eating. This also applies after contact with suspected contaminated items (e.g., diapers), and before preparing meals. Everyone should use their own towel or disposable towels at home. Regularly clean toilets and use own toilet if possible as long as pathogen is excreted with stool. Laundry soiled with excretion should be washed at 70°C. Avoiding dubious drinking water and contaminated food (e.g. head-fertilized salads, unwashed fruit, etc.) especially when traveling to countries with low hygiene standards.

Legal regulations according to the Infection Protection Act

Detection of the pathogen must be reported to the Office for Health and Consumer Protection in accordance with the Infection Protection Act. The suspicion or the disease must be reported if the person concerned works in the food sector or 2 or more persons are affected by the disease and there is an epidemiological link. Children under 6 years of age who are ill with or suspected of having diarrhea caused by the pathogen Giardia lamblia may only re-enter the premises of kindergartens and other community facilities when, in the opinion of the attending physician, a further spread of the disease is no longer to be feared. Persons who have contracted giardiasis or who are suspected of having contracted the disease may not work in food establishments or in kitchens of restaurants and other facilities with or for communal catering in accordance with Section 42 of the Infection Protection Act. Re-permission to work in the food sector at the earliest 48 hours after clinical symptoms have subsided.