Giardia

D

DanielL

Joined
Jan 13, 2000
Messages
168
We have had other threads about various ways of disinfecting and purifying water but I have a little bit different question.

Assume that the creek you just forded is loaded with giardia and you got your hands wet. Once your hands dry, how long before the little critters are dead? Do they die quickly once the water has dried? Or, do I need to disinfect my hands before I start to pick the beef jerky out of my teeth?
 
Clean your hands and chase down the jerky with a load of Corn Nuts - nature's tasty toothpick. lol

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It's not the pace of life that concerns me, It's the sudden stop at the end.
 
On a pack trip in the Sierra I once developed a serious intestinal problem from either hands or dishes that were washed in streamwater, then dried. All drinking water was carefully purified, but that was not sufficient.

The doctors gave me medication for both giardia and cryptosporidium. The told me that a dry environment MAY be sufficient to kill giardia after sufficient passage of time, but the cryto is far more resistant to dryness. It can survive for a long time and still nail you.

I would agree with the last opinion. You should wash your utensils and hands with purified water if at all possible,

DPD
 
Well, I've gone as far as to get water from streams and rivers I know to contain both giardia and crypto in my mouth on occasion - it happens. I've never gotten sick. I think that its a matter of luck and immune system. I've heard theories that giardia resides inside alot of people's intestines, but only becomes active when given the chance. Who knows? Regardless, there isn't a whole lot you can do about it (especially when say, white water rafting) unless you take along some form of disinfectant and are very very careful.
I think mostly your best bet is to purify the water you drink, and to let your hands dry thoroughly before using them to eat. The less actual bacteria you consume, the lower your chance of infection - your immune system will take care of at least some of them.
-- Rob
 
Rob makes an excellent point: Individuals react differently. I was once on a canoe trip down the Big Salmon River in the Yukon, with six other guys. Many of the group members were drinking untreated water from exactly the same sources, but only one developed giardia symptoms that required medical attention. Fortunately, it was not me that time!

DPD.
 
I never really considered the idea of "dry" Giardia. Good question. Sounds like we've gotten some good, factual info on the precautions we need to take.

I would say don't play with fire or you're gonna get burnt. If you are at the fringe of civilization, with help nearby, take the chance if you want to be brave, or if you feel the need to prove a point. If you are in a remote location, the last thing you want is a medical emergency on your hands.

Imagine getting the runs somewhere along the Pacific Crest trail, not to mention the associated dehydration and the worst intestinal cramps you've ever experienced. If treatment is not available Giardia can take your life.

I've also taken water directly from mountain streams, and I thank God that I didn't get sick; I've prayed many times that I would be protected from any pathogens in the water. I've mostly taken unfiltered water at times when I was without other resources, or before I even knew about the dangers of unfiltered water.

Of course, you always have to weigh the factors: are you without water completely and have no filtration system? How great is your need as compared to the risk involved? It is much better to drink impure water than to die of thirst.

I do think (IMHO) that it is possible to build an immunity, and I've often wondered if such isn't the case for myself. However, one should never recommend that somebody else not be careful. If we do so, and they suffer for our advice, then their blood is on our hands.

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Camine con tranquilidad, sirva con humildad, y viva en paz.
 
Another issue to consider with giardia is that symptoms usually occur 1-2 weeks after exposure. (Even up to six weeks later!)

I personally can't take that much time off of work - so I'm not overly worried about dying while out in the wilds of giardia.

Here's a pretty good informational link:
http://vm.cfsan.fda.gov/~mow/app2.html

On the other hand, cryptosporidiosis can occur in as little as 2 days. (2-25 days)
Look here:
http://www.hc-sc.gc.ca/ehp/ehd/catalogue/general/iyh/giardia.htm

Still, there's lots of stuff out there that can kill us. Your best bet is to be careful, purify all your water, and make sure you have dry hands before touching your mouth. Its plausible that you could still get infected, but hey - its plausible you could be bitten by a rabid bat/beaver/bunny in the wilderness too.
-- Rob

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Me fail english? That's unpossible!
 
The one time I was certain I got giardia (confirmed by the doctor's tests), it took only 2-3 days to show symptoms. Others are correct about the stomach pain. The first day it felt like someone had run a hot sword through my gut.

In an experience about 15 years later, I was not tested to determine whether the problem was giardia or crypto. Based on the circumstances and symptoms, they treated me for both. However, whatever it was took only 2-4 days to produce symptoms.

I got a physician friend to write me prescriptions for medication to use against both giardia and crypto. On long trips into remote areas, I carry both.

DPD.
 
Well, I'm just stating what I read online here. (Never had it myself, knock on wood). Crypto is supposed to blossom in as little as 2 days. I'm suprised at giardia in only 2. Guess I'll just stick weekend backpack trips.
smile.gif
Any ideas on how you got sick? Unfiltered water/water on the lip of your drinking container/etc? I'd be interested in knowing. Also, how much did it cost for the medicine? How long does the medicine last? Might be a good investment.
-- Rob

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Me fail english? That's unpossible!
 
Also consider that not everybody stays out for just a few days. Through hikers could easily get caught out-n-about, even with a six-week incubation.

A hot sword in the gut? No thanks - not even if I'm next door to a hospital.

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Camine con tranquilidad, sirva con humildad, y viva en paz.
 
The first episode (confirmed Giardia) was the result of sheer stupidity on my part. In the mid-80's I was backpacking in the Mineral King area of the Sierra and, at one point, thought I was high enough above likely contamination sources to drink directly out of a small stream. I was wrong.

Over a decade later, I was backpacking in the Domelands region of the Southern Sierra. I was carefully treating all drinking water, but was washing hands and dishes in the South Fork of the Kern. I let my hands and dishes air dry thoroughly and thought that would kill any parasites. A few days later I found out that my efforts had not been sufficient. I can't conclusively say that's how it (either giardia or crypto) got into me, but it was the most likely culprit. My partner and I were VERY careful about everything else.

By the way, not all people have as painful a reaction as I did. Some supposedly never develop symptoms and merely host giardia. Others have milder cramps. Wish I had.

The medication cost is unknown to me because under my health plan, I was required to make only a $10 copayment for each prescription.

I asked the longevity question to an elderly doctor who had done a lot of field work in Africa and Latin America. Off the record and not for attribution to him, he said the medication would likely last for 3-5 years after the one year expiration date on the bottle IF it was stored in a cool, dry, dark place. He specifically said not to put it in the medicine cabinet in a humid bathroom.

DPD.
 
The treatment of Traveler's Diarrhea is spelled out nicely at this site HERE

However, if what you have is Giardia, you need some metronidazole (Flagyl). This is an inexpensive antibacterial agent.

If you REALLY have Cryptosporidia (80% of the population test positive for having had it, so it is mostly a very mild, sometimes unnoticeable disease which usually cures itself), then you need a macrolide antibiotic. Azythromycin has been used as has paromomycin and Roxithromycin see HERE . These are all really expensive antibiotics. Unfortunately, there is no really good standard treatment for Crypto. This is not a problem for most people; as mentioned above, it is usually self limited. If you have AIDS or a depressed immune system for some other reason, however, it can be a problem.

Hope this helps,

Walt Welch MD
 
Rob,

I've been in several situations where friends have gotten giardia, and I have been OK, have been told by the medical people that I am a giardia carrier, have it in my system, but don't get the bad effects for some reason. They were also really concerned I be careful where I ****e in the backcountry if you take my meaning.

Not sure how this works, and if it means I'm immune to the buggy, I still act like I can get it and purify etc... but it may explain your resistance to it, another good reason to not pee in the canoeing pond for you.

Best

Todd (edgedance)
 
Walt - thanks for the links. Very useful information.

I have one question about a statement from the UCSF site. They stated "Treatment of Giardia involves medications that may have serious side effects." Can you give any details on the side effects of giardia treatments? I loaned out my PDR several years ago and never got it back.

Also, are there any holistic anti-parasitic treatments that are effective against giardia? For example, walnut tincture, wormwood, etc. This may not be within your area of expertise but any opinions are welcome.
Thanks.
 
<font face="Verdana, Arial" size="2">Originally posted by Walt Welch:
The treatment of Traveler's Diarrhea is spelled out nicely at this site HERE

However, if what you have is Giardia, you need some metronidazole (Flagyl). This is an inexpensive antibacterial agent.

If you REALLY have Cryptosporidia (80% of the population test positive for having had it, so it is mostly a very mild, sometimes unnoticeable disease which usually cures itself), then you need a macrolide antibiotic. Azythromycin has been used as has paromomycin and Roxithromycin see HERE . These are all really expensive antibiotics. Unfortunately, there is no really good standard treatment for Crypto. This is not a problem for most people; as mentioned above, it is usually self limited. If you have AIDS or a depressed immune system for some other reason, however, it can be a problem.

Hope this helps,

Walt Welch MD</font>
Click to expand...

Hi Walt,
Thanks for the info. I am wondering about flagyl. You say it is antibacterial but they use in on Giardia. Does it work on all organisms with flagella?

Also, I was wondering about Crypto. I saw a show on tv awhile back talking about an outbreak in, I think, Minnesota, where over 100 people died when it got in the city water. Do you know about this and if so, why was it so virulent when it is usually so benign? Does it kill mainly those whose immune systems are suppressed?


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Hoodoo

I get some pleasure from finding a relentlessly peaceful use for a combative looking knife.
JKM
 
DanielL; metronidazole (Flagyl) can cause an antabuse-like reaction (flushing and itching) in some people if they drink alcohol while on the drug. Some other minor side effects are nausea and a metallic taste in the mouth. This drug is commonly used and has few side effects in actual use.

Hoodoo; you heard an urban legend, it would seem. There was an outbreak in MN, in Sept. 1995, but here is what happened:

<font face="Verdana, Arial" size="2">Of the 26 persons who attended the function and who completed telephone interviews with MDH, 15 (58%) reported onset of diarrhea (three or more stools during a 24-hour period) within 14 days after attending the event (range: 1-9 days; median: 6 days). Symptoms included watery diarrhea (100%), abdominal cramps (93%), and chills (79%). The median length of illness was 4 days (range: 1--2 day-14 days). Three persons who sought medical care received outpatient treatment for acute gastroenteritis. Stool specimens obtained from two of these persons were negative for bacterial pathogens and for ova and parasites but were not tested for C. parvum. There were no other reports of cryptosporidiosis in the community at the time of this outbreak.</font>
Click to expand...

Get it?? Only THREE people were sick enough to go to the doctor, and were treated symptomatically as for stomach flu. As outpatients. No one hospitalized, no one died. If you would like to read it yourself, go HERE

Hope this helps, Walt
 
Wowzer! I saw this thing on TV, I think the discovery channel, but I'm not sure. I was only listening to it at first and then they started talking about a huge death rate, I kinda perked up. I thought it was kinda funny because with the death rate they were talking about, I was surprised I had never heard of it before. Anyway, it's a relief to know that crypto is not the big bad boogey man they were making it out to be. Thanks for the info.

BTW, I will try to find the source for my information and recheck it. I thought it was a Discovery show on parasites but again, I can't really remember.

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Hoodoo

I get some pleasure from finding a relentlessly peaceful use for a combative looking knife.
JKM
 
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