Question

CASE STUDY A 14-year-old girl comes to your office with symptoms of diarrhea, flatulence, greasy stools, stomach cramps, and nausea. In the past 2 weeks, the patient has lost 10 pounds. During the patient interview, you find out rom her mother that the family went camping about 3 weeks earlier. You also discover that the patient drank from a stream while on a hike. The patient shares with you that she saw beavers in the stream during the No other family members are exhibiting any symptoms. After several laboratory tests, the patient is diagnosed with giardiasis, a parasitic infection often carried by beavers. The incubation period for Giardia is 1 to 2 weeks; however, adults do not always show signs of the infection. Risk factors for infection with Giardia include children in child care settings, people in close contact with infected persons swim in contaminated water, and people who have contact with infected animals. The patient is placed on antimicrobial therapy As you read this chapter, consider the following questions: 1. What part of the cycle of infection caused the problem for the patient? 2. How could the patient have avoided this infection? 3. Why are the other family members not showing symptoms of the infection? 4. Should the patient's family members be tested for the infection?

Answer 1

Giardiasis

Giardia lamblia also known as Giardia intestinalis, or Giardia duodenalis is a protozoan flagellates. It is transmitted by faecal-oral route and causes the diarrheal illness called giardiasis (popularly known as beaver fever).

Life Cycle--

Contamination of water, food, or hands/fomites with infective cysts. Trophozoites are also passed in stool but they do not survive in the environment. = Infective Stage Diagnostic Stage Cyst 3 4 5 Cyst Trophozoites

• The trophozoite causes inflammation of the duodenal mucosa, leading to malabsorption of protein and fat.
  • Mild steatorrhoea (passage of yellowish greasy stools in which there is excess of fat)
• Approximately half of those who are infected are asymptomatic carriers who continue to excrete the cyst for years.

2. How to avoid the giardia infection-

Prevention

• Exclude people with Giardia infection from childcare, preschool, school and work until there has been no diarrhoea for 24 hours. If working as a food handler in a food business, the exclusion period should be until there has been no diarrhoea or vomiting for 48 hours.
• Infants, children and adults with giardia infection should not swim until there has been no diarrhoea for 24 hours.
• Follow good hand washing procedures.
• Water suspected of contamination should be boiled before drinking.
• Babies and small children without diarrhoea who are not toilet trained should wear tight fitting waterproof pants or swimming nappies in swimming pools and be changed regularly in the change room. When faecal accidents occur, swimming pools should be properly disinfected.
• Treatment of infected people reduces spread.

3. Other family members not showing symptoms because either they do not shaving infection or they have infection but symptoms not showing because incubation period is 1 to 2 weeks. After the period they can show symptoms.

Or the adult persons have high immunity power that's why they do not show always the symptoms.

The beaver has gained attention as a potential source of Giardia contamination of lakes, reservoirs, and streams.

4.

The patient's family members should be tested for infection because they do not showing symptoms but they can have the infective organism and they can further cause the infection again in other child of family. Means he can be a carrier of Guardia.

So members should be tested for infection.