Giardiasis is a zoonosis, and cross-infectivity among beaver, cattle, dogs, rodents, and bighorn sheep ensures a constant reservoir. Because giardiasis frequently infects persons who spend a lot of time camping, backpacking, or hunting, it has gained the nicknames of “backpacker's diarrhea” and “beaver fever.” 11įood-borne transmission is rare but can occur with ingestion of raw or undercooked foods. The disease is commonly water-borne because Giardia is resistant to the chlorine levels in normal tap water and survives well in cold mountain streams. 10īecause giardiasis is spread by fecal-oral contamination, the prevalence is higher in populations with poor sanitation, close contact, and oral-anal sexual practices. 8, 9 Between 19, the Centers for Disease Control and Prevention (CDC) estimated that more than 2.5 million cases of giardiasis occur annually. Giardia is arguably the most common parasite infection of humans worldwide, and the second most common in the United States after pin-worm. lamblia is a pear-shaped, flagellated protozoan ( Figure 2) that causes a wide variety of gastrointestinal complaints. The “cellophane tape test” ( Figure 1) can serve as a quick way to clinch the diagnosis. Direct visualization of the adult worm or microscopic detection of eggs confirms the diagnosis, but only 5 percent of infected persons have eggs in their stool. Pinworm infection should be suspected in children who exhibit perianal pruritus and nocturnal restlessness. Rarely, more serious disease can result, including weight loss, urinary tract infection, and appendicitis. 3 The patient's constant itching in an attempt to relieve irritation can lead to potentially debilitating sleep disturbance. vermicularis is relatively innocuous, with egg deposition causing perineal, perianal, and vaginal irritation. In the absence of host autoinfection, infestation usually lasts only four to six weeks.ĭisease secondary to E. Fortunately, most eggs desiccate within 72 hours. Ingested eggs hatch in the duodenum, and larvae mature during their migration to the large intestine. Eggs on the host's perineum can spread to other persons in the house, possibly resulting in an entire family becoming infected. The eggs can be spread by the fecal-oral route to the original host and new hosts. The worms live primarily in the cecum of the large intestine, from which the gravid female migrates at night to lay up to 15,000 eggs on the perineum. 2Īdult worms are quite small the males measure 2 to 5 mm, and the females measure 8 to 13 mm. More than 30 percent of children worldwide are infected. Humans are the only known host, and about 209 million persons worldwide are infected. 1 It is the most prevalent nematode in the United States. vermicularis, commonly referred to as the pinworm or seatworm, is a nematode, or roundworm, with the largest geographic range of any helminth. Intestinal parasites that remain prevalent in the United States include Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica.Į. Intestinal parasites cause significant morbidity and mortality throughout the world, particularly in undeveloped countries and in persons with comorbidities. Careful sanitation and use of peeled foods and bottled water are preventive. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Preventive measures include wearing shoes and treating sewage. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. Stool ova and parasite studies are diagnostic. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Diagnosis can be made using the “cellophane tape test.” Treatment includes mebendazole and household sanitation. vermicularis, or pinworm, causes irritation and sleep disturbances. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. Intestinal parasites cause significant morbidity and mortality.
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