Giardia Infection and Treatment, by Dr. Bob

Monday, Aug 29, 2011

Giardia is a regular fear during TEOTWAWKI due to sanitation and water purity issues when the Schumer hits the fan (WTSHTF).  Giardia lamblia, Giardia duodenalis, or Giardia intestinalis are the fancy names for good old-fashioned Giardia–everyone’s favorite parasite.  Giardia cysts can live in moist environments for prolonged periods of time, just waiting for some poor oaf to drink as little as 10 of them which can then cause infection.  The infection occurs when the cysts are ingested into your warm innards, most often through contaminated water.  Also can occur with direct person to person transmission (too gross to think about) and ingestion of contaminated food.  After ingestion, the “shell” of the cyst unfolds the nasty little trophozoite form which then swims around inside you, latching on to your intestine wall and starts making copies of itself by living off you like a penniless hippy.

For reasons that are actually poorly understood (whaaaat?  science doesn’t know everything?) diarrhea, malaise, flatulence, abdominal cramps, bloating, nausea, foul-smelling and fatty stools, and the weight loss from the diarrhea, etc. occurs in most people with acute giardia.  Less often, there is vomiting, and rarely fevers.  Symptoms usually last 2 to 4 weeks.  84 percent of folks in one study had self-limited disease, therefore the other 16 percent went on to develop chronic giardia.  Chronic giardia can have similar symptoms, usually without the diarrhea, and the manifestations of the infection can come and go for months.  Lactose intolerance often develops in those infected with chronic giardia, and drinking milk or eating dairy products too soon after infection can cause symptoms again for up to months.  The recommendation is to avoid dairy products altogether for one month.

Chronic exposure to giardia may give people immunity from infection; travelers have higher rates of infection than residents of giardia infested areas, as well as higher rates of infection in children in those areas compared to older people.  Immuno-compromised individuals appear to get infected at similar rates as those with no immune problems–although there are some conflicting reports in these populations.  Those that have cystic fibrosis and immunoglobulin deficiencies do get more severe symptoms and develop chronic disease more often, but not those with HIV.
Treatment is recommended in symptomatic patients with lab positive giardia in our modern world.  WTSHTF it is very likely to be difficult or impossible to get a “lab positive” confirmation and treatment itself will be difficult or impossible to get.  There are a variety of antibiotics that actually treat giardia readily available currently.  These include tinidazole (Tindamax), and metronidazole (Flagyl) as the drugs of choice, especially since they are dirt cheap.  Alternatives include nitazoxanide, albendazole and paromomycin; but these are very expensive.  Tinidazole dosing is 2 grams once for giardia and done.  Metronidazole dosing is 250 mg three times a day for 5 to 7 days.  You would still need to have it and know what you are using it for…both potential problems.

The tough thing about giardia is knowing that it is indeed the source of your infection.  (Reference my prior survivinghealthy.com post about water for details).  Prevention is the cure for giardia.   Never can enough be said about water purification and quality water sources at TEOTWAWKI.  Figure out practical solution now rather than waiting until trying to figure out what parasite you may have been infected with and then what you are going to do about trying to treat it.  If the labs and pharmacies are all open, easy solution.  When they are not…much more complicated problem.  This is not news to preppers, but for those of you that are surprised, you better get moving on your plans now.  Stay strong.


JWR Adds: Dr. Bob is is one of the few consulting physicians in the U.S. who dispenses antibiotics for disaster preparedness as part of his normal scope of practice. His web site is: SurvivingHealthy.com.


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