Flagellate protozoan – lives in duodenum or jejunum.
Faecal-oral/ from pets or birds
(humans are main reservoir of infection)
Typically from drinking water contaminated with giardia cysts (killed by boiling but NOT chlorination)
Prevalence approx. 20-30% in developing countries
Also significant numbers of cases seen in USA
Trophozoite parasite multiplies in upper bowel by binary fissionàlarge areas of mucosa may be colonized in heavy infection
àDisrupts brush-border and affects enzyme activity.
àStimulates inflammatory cytokine response àsecretion of fluid and electrolytes and cell damage.
Trophozoites encyst as then pass through the intestine and become infective.
Most infections are asymptomatic.
symptoms are worse in immunodeficiency.
(Sometimes Explosive) watery diarrhea (NON-bloody)
mild abdominal pain
bloating and nausea
low grade fever
Chronic diarrhea with HIV
chronic inflammation can lead to increased risk of cancer
Culture of blood/ urine/stool/bone marrow/duodenal aspirates
Microscopy of stool for cysts and trophozoites.
Metronidazole or tinidazole
Good personal hygiene
Access to clean water.