What is Giardia?
Giardia is a small parasite that when swallowed causes an illness called Giardiasis. It causes watery diarrhoea which is often very smelly with cramping stomach ache and wind. Other symptoms may include vomiting, headache, tiredness and fever. The illness may last for several weeks, and recovery back to normal can be slow over several more weeks.

The incubation period (the time taken from swallowing the parasite until the illness starts) can range from 5 to 25 days, but is usually around 7 days. 

How can you become ill with Giardia?
Giardia can be found in the guts of farm animals (especially lambs and calves), and occasionally in domestic pets and birds. Giardia can therefore be spread by direct or indirect contact with the faeces (also known as poo/motion/stool) of an infected animal.

Eating food or drinking water contaminated with Giardia is the most common way to become ill. This is more likely to happen when travelling abroad, and Giardia is therefore known as ‘travellers’ diarrhoea’. Mains drinking water is rarely a source of infection, however outbreaks have occurred where swimming pool water has been contaminated. It can also survive in rivers, streams, lakes and reservoirs that have been contaminated by infected animals.

A person who is already suffering from Giardia and does not wash their hands properly after using the toilet, will contaminate their hands with the germ. They can then spread it to other people, for example within families, or amongst children attending playgroups and nurseries who do not wash their hands properly after using the toilet or after changing a child’s nappy. Cases of Giardia infection have also been recorded amongst people, particularly children, following visits to zoos and animal petting farms where it is possible to handle animals such as lambs and calves.

To prevent infection:

• Do not drink untreated water from lakes, rivers, springs, ponds and streams. This includes accidental swallowing (e.g. when swimming in these waters) 
• When abroad in high-risk countries (e.g. Asia, Africa and Central/Southern America) or any location where water may not have been treated, use bottled water from a reputable source, or sterilise tap water before drinking (by boiling or using a sterilising tablet). Use this for drinking and for cleaning your teeth. Do not have ice in your drinks.
• Always wash your hands thoroughly after using the toilet and take extra care on visits to farms or other attractions where children are encouraged to handle animals.

Who can it affect?
Anyone. However, in the UK it is most common in children under 5 years old and young adults. The illness can be more severe and last longer in people who already have a poor immune system or are already suffering from other health problems.

How is it diagnosed?
The infection is diagnosed once a patient has provided a faecal sample (poo/motion/stool) to their Doctor or at a hospital, which is then tested at a laboratory. If Giardia cysts are found in the sample, then this proves that the patient is suffering from Giardiasis. A patient found to have this infection may be contacted by the Environmental Health Team to identify the most likely source of the infection and to offer hygiene advice.

What treatment is available?
If you are suffering from Giardia infection you should drink plenty of fluids as you can become dehydrated easily. You may also be prescribed antibiotics by your Doctor.

If you are worried or have an existing medical condition or weak immune system you should consult your Doctor.

How do you avoid spreading it?
Good general personal and domestic cleanliness is important in helping prevent the spread of infection.

Handwashing is the single most important way to stop the spread of infection. Make sure that you and all household members wash their hands thoroughly with warm running water and soap (ideally liquid anti-bacterial soap) and dry thoroughly with a clean towel, particularly;

• after using or cleaning the toilet
• before eating, preparing or serving food/drink
• after attending to another person who has diarrhoea/vomiting
• after changing a baby’s nappy
• after handling or washing soiled clothes and bedding
• when your hands have been contaminated with any bodily fluids

Make sure each person affected has an individual towel for drying their hands. Young children should be supervised when washing hands, or have their hands washed for them.

When washing soiled/dirty linen, follow this advice:

• For any items/clothes soiled with faeces (poo) or vomit, any ‘solids’ should be carefully put down the toilet and flushed away.
• Soiled linen should be washed separately in the washing machine using a pre-wash if possible and on the hottest temperature possible for the fabric.
• Use a biological washing powder whenever possible.
• Do not overload the washing machine.
• Wipe down the outside surface of the washing machine after loading with hot soapy water and a disposable cloth.
• You may wish to run an empty hot cycle to ‘wash through’ your machine if you have washed heavily soiled items.

After using the toilet, make sure that all surfaces are clean. Use a disinfectant to clean the toilet (including the bowl, seat, flush handle and lid), wash hand basin taps and the door handle. Wear rubber gloves to clean the toilet and keep them for this purpose only.

Pay particular attention to the toilet bowl and seat (surface and underneath) as well as taps, flush handles and surrounding area and surfaces that may have been contaminated by germs. If you are using a disinfectant, follow the manufacturer’s instructions.  Keep all chemical cleaning agents in a safe place away from children.

Where someone has vomited, all surfaces that may have been contaminated should be cleaned immediately. Any spillages on soft furnishings (e.g. carpet, sofas) should be cleaned straight away with a strong disinfectant.

DO NOT swim or use recreational waters (e.g. swimming pools, hot tubs, lakes or rivers) for at least two weeks after your diarrhoea has stopped. This is because you can still pass the Giardia cysts in your stool (poo/motion/faeces) for some time after your symptoms have ended. You do not even need to have an accident of diarrhoea in the water - simply being in the water may be enough for contamination to occur. This has resulted in outbreaks of the illness in large numbers of recreational water users.

When handling animals, including those at petting farms/zoos, supervise children to make sure that they do not put their hands in their mouths or eat and drink before they have thoroughly washed their hands.

If possible, you should not prepare food at home until you have been symptom free for 48 hours. When this is not possible, observe high standards of personal hygiene and make sure that you thoroughly wash your hands with hot water and soap before and after preparing food.

If symptoms persist you should seek further advice from your GP.

Do you need to stay off work, school or nursery if diagnosed with Giardia infection?
Yes,until you have been completely free from any diarrhoea symptoms for 48 hours. If you work in a food business, or a caring environment (e.g. in a residential home, nursery, or a hospital) you have a legal duty to tell your employer that you are suffering from Giardia infection. This is because it is likely that you could pass the illness on to others.

Children should be kept away from school, playgroup or nursery until they have been free from symptoms for at least 48 hours. Similarly, if you work as a childminder and are suffering from Giardia infection you should not look after children until you have been symptom-free for 48 hours.

You should not go swimming until two weeks after your first normal stool/poo/motion.

For further information contact the Health Protection Team at Shropshire Council:

• Telephone: 03456789067 
• Email: food@shropshire.gov.uk