Giardiasis

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Classification according to ICD-10
A07.1 Giardiasis
ICD-10 online (WHO version 2019)

The giardiasis (Syn .: giardiasis , Lamblienruhr ) is a by the flagellate protozoan Giardia intestinalis ( genotype caused A and B) disease in humans. Other mammals can also develop giardiosis, although other genotypes have been identified as triggers. The genotypes occurring in humans can also trigger an illness in dogs (→ giardiosis of the dog ) and cats.

Harmful Effects and Epidemiology

Life cycle of Giardia intestinalis

In contrast to Entamoeba histolytica , Giardia intestinalis is not invasive, the mucous membrane cells are not destroyed. However, their function is restricted and inflammation occurs . The symptoms of giardiasis (dysentery) are diarrhea , flatulence and rarely fever , and malnutrition occurs in severe cases. In Canada, the common name is beaver fever, because the pathogens supposedly enter the water through beaver droppings .

One problem is that there are people who carry Giardia in their intestines but do not show any pathological symptoms. These secrete cysts for months, which then infect other people if the hygiene is inadequate. However, the immune system usually manages to eliminate the trophozoites within a few weeks. The incubation period is one to about ten weeks.

Giardiasis develops around 200 million people each year and the disease can be a significant problem in developing countries. The number of deaths that can be attributed to Giardia intestinalis is completely insignificant compared to that of malaria. Giardia is a possible cause of traveler's diarrhea .

Giardia intestinalis has so far been found in over 140 countries and is therefore distributed worldwide. In temperate zones, it affects up to 25% of children and 10% of adults. One finds even higher contamination in the tropics. The unicellular organism causes infections very rarely in European countries, but the prevalence among returnees from the tropics is around 4%. Cattle and sheep are infected up to 30% depending on the area.

diagnosis

The detection of trophozoites or cysts can take place in the stool (after a gastric colonoscopy) from the small intestine secretion, possibly from biopsies of the mucosa of the duodenum. Furthermore, the detection of Giardia antigen in the stool is possible using ELISA and PCR . Several stool samples that are as fresh as possible must be examined to reliably rule out an infection.

treatment

Metronidazole is mainly used for treatment , alternatively albendazole , mebendazole , secnidazole , tinidazole , furazolidone or quinacrine can be used.

However, there are cases in which gastrointestinal problems can persist for months despite successful elimination of the pathogen. Giardiasis can presumably trigger persistent functional disorders such as lactose intolerance , irritable bowel syndrome and possibly even food intolerance.

Legal

In Germany there is an obligation to report an infection by Giardia intestinalis , but not in Austria and Switzerland.

Individual evidence

  1. ↑ D. Jaros, W. Zygner, S. Jaros, H. Wedrychowicz: Detection of Giardia intestinalis assemblages A, B and D in domestic cats from Warsaw, Poland. In: Polish journal of microbiology / Polskie Towarzystwo Mikrobiologów = The Polish Society of Microbiologists. Volume 60, Number 3, 2011, ISSN  1733-1331 , pp. 259-263. PMID 22184934 .
  2. ↑ P. Almirall, AA Escobedo, I. Ayala, M. Alfonso, Y. Salazar, R. Cañete, S. Cimerman, M. Galloso, I. Olivero, M. Robaina, K. Tornés: Mebendazole compared with secnidazole in the Treatment of adult giardiasis: a randomized, no-inferiority, open clinical trial. In: Journal of parasitology research. Volume 2011, 2011, p. 636857, ISSN  2090-0031 . doi : 10.1155 / 2011/636857 . PMID 22174992 . PMC 3228287 (free full text).
  3. ↑ N. Tejman-Yarden, L. Eckmann: New Approaches to the treatment of giardiasis. In: Current Opinion in Infectious Diseases . Volume 24, Number 5, October 2011, pp. 451-456, ISSN  1473-6527 . doi : 10.1097 / QCO.0b013e32834ad401 . PMID 21857510 . (Review).
  4. ↑ Wright JM, Dunn LA, Upcroft P., Upcroft JA: Efficacy of antigiardial drugs. In: Expert Opinion on Drug Safety . Volume 2, Number 6, November 2003, pp. 529-541, ISSN  1474-0338 . PMID 14585063 . (Review).
  5. ↑ Thomas Löscher, Gerd-Dieter Burchard (Ed.): Tropical medicine in clinic and practice . 4th, revised edition. GeorgThieme Verlag KG, Stuttgart 2010, ISBN 978-3-13-785804-1 , p. 652 ( online at Google Books ).
  6. ↑ K. Hanevik, V. Dizdar, N. Langeland, T. Hausken: Development of functional gastrointestinal disorders after Giardia lamblia infection. In: BMC gastroenterology. Volume 9, 2009, p. 27, ISSN  1471-230X . doi : 10.1186 / 1471-230X-9-27 . PMID 19383162 . PMC 2676300 (free full text).

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