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Classification: Phylum: Metamonada Class: Trepomanadea Order: Giardida Family: Giardidae Genus: Giardia

This document provides classification, morphology, life cycle, transmission, pathogenesis, diagnosis and treatment information about Giardia lamblia (also known as G. duodenalis, G. intestinalis). It is a common cause of diarrhoea in humans and other mammals. The organism exists in two forms - trophozoite and cyst. It has a life cycle involving encystation in the intestine and excystation in the duodenum. Diagnosis involves detecting cysts or trophozoites in stool samples. Treatment includes metronidazole and other nitroimidazole derivatives. Control involves water treatment and sanitation measures.

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296 views21 pages

Classification: Phylum: Metamonada Class: Trepomanadea Order: Giardida Family: Giardidae Genus: Giardia

This document provides classification, morphology, life cycle, transmission, pathogenesis, diagnosis and treatment information about Giardia lamblia (also known as G. duodenalis, G. intestinalis). It is a common cause of diarrhoea in humans and other mammals. The organism exists in two forms - trophozoite and cyst. It has a life cycle involving encystation in the intestine and excystation in the duodenum. Diagnosis involves detecting cysts or trophozoites in stool samples. Treatment includes metronidazole and other nitroimidazole derivatives. Control involves water treatment and sanitation measures.

Uploaded by

Lohith MC
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Classification

Phylum: Metamonada
Class: Trepomanadea
Order: Giardida
Family: Giardidae
Genus: Giardia

(According to the new systematic based on genetic, structural and


biochemical data, Giardia, which was in the family Hexamatidae, family
Giardiidae)
FAMILY: GIARDIIDAE
• Giardia is a common cause of chronic diarrhoea in humans and
infection also occurs in wild and domestic animals.
• The organism is bilaterally symmetrical and possesses eight
flagella, six of which emerge as free flagella at intervals around the
body.
• Different names have been given based on host it was recorded
• >40 species of
• Only five are now considered valid
• G. duodenalis (= intestinalis;= lamblia) and G. muris from mammals
• G. ardeae and G. psittaci from birds
• G. agilis from amphibians
History:

•Giardia was initially described by Anton van


Leeuwenhoek ,who is the father of protozoology as he was
examining his own diarrhoeal stools under microscope in
1681.

•The organism was described later by Lambl in 1859,who


thought the organism was belong to the genus Cercomonas
and named as Cercomonas intestinalis.
G. duodenalis (= intestinalis;= lamblia)

• Host: man
• Location: duodenum and other parts of small intestine
occasionally found in colon
Common cause:
• Traveller’s diarrhoea
• Back- packers diarrhoea
• Beaver fever
Distribution:
• Cosmopolitan occurrence
• Occurs most commonly in warm climates
Morphology:

two forms, trophozoite and cyst.

Trophozoites
• Size: 12 µm -15 µm x 6 µm - 8 µm
• pyriform to elliptical (tear drop shaped) in outline
• Dorsoventrally flattened
• bilaterally symmetrical.
• The anterior end is broadly rounded and the posterior end is drawn
out and somewhat pointed.
• The dorsal side is convex and the ventral surface bears a concave
bilobed adhesive disc.
• Eight flagella are arranged in four pairs. A pair of ventral flagella and
three pairs of anterior flagella arise fro kinetosome located between
anterior margins of two nuceli
• There are two anterior nuclei, two slender median axostyle and one
pair of darkly staining bodies placed medially called median bodies .
• Adhesive disc along with the ventral flagella placed in the ventral
groove help in the attachment of organism to the host cell.
• No mitochondria, Golgi bodies, or lysosomes, and there is no smooth
endoplasmic reticulum
Cyst
• The cyst has 2 or 4 nuceli giving an appearance of double
spectacles
• Number of fibrillar remnants of the trophozoite organelles
such as median bodies and axostyle etc

Anterior flagella
Nucleus

Axostyle
Median bodies
Transmission
• Transmission is through contaminated food and water mostly
by cyst. At 4–10 ºC, the cysts may remain viable for several
months

• The cysts are relatively resistant to chlorination and to


disinfection by ultraviolet light.
Pathways of transmission
Life cycle
• The ingested cysts safely pass through the stomach and
undergo excystation in the duodenum
• Following this, the trophozoites are released which then
multiply by longitudinal binary fission. During multiplication,

Order of division
• Nuclei
• Locomotor apparatus
• Sucking disc
• Cytoplasm
• Large number of trophozoites are produced
• Trophozoites become encysted (cyst formation) when the
faeces enter into the colon because of an increased water
absorption in the large intestine
• The young cysts has 2nuceli but become 4 in number when it
matures
• The mature cysts are infective stages
• The trophozoites are found only water stools
Epidemiology
• Giardiasis is highly contagious
• If one person gets affected in the family others
would be infected in a few days
• Children's are more susceptible
Giardiasis can also be a zoonosis

• Numerous animals, including beavers, dogs, cats, and sheep, serve as reservoirs
• Calves, are infected, with prevalences ranging up to 100%.
• Two main genotype assemblages among zoonotic Giardia : A &B
• A-I: seen in both humans and other animal species, most potent for being
zoonoses
• A-II: isolated only from humans.
• Assemblage B is much more genetically diverse than A: includes isolates from
both human and nonhuman sources
• Assemblage C to G seen in other mammals.
Pathogenesis and clinical signs
• G. lamblia live in the duodenum, jejunum and upper ileum
with the help of adhesive disc they usually lie flat on the
surface of the epithelial cells
• Incubation period in humans: 10-20 days
• In many cases the infection may go unnoticed while in few
cases the infection causes clinical signs like marked mucus
production, diarrhoea, dehydration, intestinal pain,
fluctulance and weight loss
• In severe infection the free surface of the every cell may get
covered with trophozoites
• This may interfere with the absorption of fats so the stool is
fatty- Steatorrhea because of impaired fat absorption, fat
soluble vitamin deficiency may occur
Diagnosis:
1. Demonstration of cyst and trophozoite in the faecal sample.
Direct smears or fecal wet mounts can be used for
detecting trophozoites. Faecal sample is mixed with a drop of
lugol’s Iodine and examined. Samples should be taken from the
surface of the feces, where organisms are more common.
Trophozoites are usually detected only in very fresh samples from
animals with diarrhoea. Cysts can be concentrated by passive fecal
flotation or centrifugal fecal flotation. Zinc sulfate (33 per cent)
preserves the morphology better than sugar solutions.

2. Immunodiagnostic tests like IFAT, ELISA.


3. Molecular techniques like PCR
• ELISA to detect Giardia antigen in
faeces- sensitive as microscopy
• Fluorescent method using monoclonal
antibodies
• Immunochromatographic methods-
catridge format (Immunocard STAT) or
strip based format
• Triage parasite panel- Enzyme immune
assay-Giardia lamblia, Cryptosporidium
parvum, Entamoeba histolytica/ E.
dispar- requires fresh stool
Treatment
1 Quinacrine –100 mg/kg thrice for 7 days (side effects- headache, vomiting)
2 Metronidazole (Flagyl, a 5-nitroimidazole compound) - 250 mg/kg
• Complete cure within a few days
• Not recommended for pregnant women
• Side effects- vomiting , diarohoes, crapy abdominal pain,haed acheurticaria,
pruritus
• Metronidazole - strong warnings against concurrent consumption of
alcoholic beverages
3 Newer nitroimidazole derivatives have shown good antigiardial activity in
single doses and against strains resistant to metronidazole.
4 Tinidazole
5 Furazolidone is often used for treating children, paromomycin for pregnancy
Control
1. Public health
• A. Sewage treatment
• B. Adequate treatment of drinking water
• C. Proper location of intakes of surface water
• D. Chemotherapeutic treatment of infected persons
• E. Surveillance and treatment of food handlers

2. Personal
• A. Treatment of drinking water to remove or kill cysts
• B. Avoidance of contaminated water
• C. Sanitary procedures to avoid contact with cysts
• D. Surveillance and treatment of companion animals in household
Drinking water
• Use of Iodine as disinfectant for drinking water ( as iodine
tablets-kill cysts in 30 minutes at 15 degree celcius)
• UV irradiation- cysts ability to repair UV induced damage?
• Filtration systems- pore size not less than 4 µm -may get
clogged
• Boiling- Above 55 degree Celsius cysts are killed
• Rotifers ingests varying numbers of Giardia cysts

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