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Date Posted: 15:57:18 10/17/99 Sun
Author: clover
Subject: Re: purifying water...page 3
In reply to: clover 's message, "purifying water" on 18:14:46 10/15/99 Fri

OCR'ed memo from the Centers from Disease Control:

GIARDIASIS

GIARDIASIS: By Dennis D. Juranek, Chief, Epidemiology Activity Parasitic
Diseases Branch Division of Parasitic Diseases Centers for Disease Control

Transmission and Control

Introduction

During the past fifteen years giardiasis has been recognized as one of the
most frequently occurring waterborne diseases in the United States (1).
Giardia lamblia have been discovered in the United States in places as far
apart as Estes Park, Colorado (near the Continental Divide); Missoula,
Montana; Wilkes-Barre, Scranton, and Hazleton, Pennsylvania; and
Pittsfield and Lawrence, Massachusetts just to name a few. In light of
recent large outbreaks of waterborne giardiasis, it seem timely to present
reliable information on the way in which giardiasis is acquired, treated,
and prevented.

Giardiasis: Prevalence and Symptoms

Giardiasis is a disease caused by a one-celled parasite with the
scientific name Giardia lamblia. The disease is characterized by
intestinal symptoms that usually last one week or more and may be
accompanied by one or more of the following: diarrhea, abdominal cramps,
bloating, flatulence, fatigue, and weight loss (see Table 1). Although
vomiting and fever are listed in Table 1 as relatively frequent symptoms,
they have been uncommonly reported by people involved in waterborne
outbreaks of giardiasis in t he United States. Table 1 also suggests that
13 percent of patients with giardiasis may have blood in their stool.
Giardia, however, rarely causes intestinal bleeding. Therefore, blood in
the stool of a patient with giardiasis almost always indicates the
presence of a second disease.

While most Giardia infections persist only for one or two months, some
people undergo a more chronic phase, which can follow the acute phase or
may become manifest without an antecedent acute illness. The chronic phase
is characterized by loose stools, and increased abdominal gassiness with
cramping, flatulence and burping. Fever is not common, but malaise,
fatigue, and depression may ensue (2). For a small number of people, the
persistence of infection is associated with the development of marked
malabsorption and weight loss (3). Similarly, lactose (milk) intolerance
can be a problem for some people. This can develop coincidentally with the
infection or be aggravated by it, causing an increase in intestinal
symptoms after ingestion of milk products.

Some people may have several of these symptoms without evidence of
diarrhea or have only sporadic episodes of diarrhea every 3 or 4 days.
Still others may not have any symptoms at all. Therefore, the problem may
not be whether you are infected with the parasite or not, but how
harmoniously you both can live together, or how to get rid of the parasite
(either spontaneously or by treatment) when the harmony does not exist or
is lost.

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Replies:

Re: purifying water...page 4 -- clover, 16:01:11 10/17/99 Sun