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Subject:
From:
MARY BLACK <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 17 Jun 1999 14:55:02 +1000
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From Lisa Mooney:
"I am a Navy Nurse getting ready for Kosovo. We have some  life
experienced Infectious Disease Docs giving us lectures on such matters as
Gastrointestinal Infections. Giardia is a protozoan that can be endemic in
certain areas of the US, UK and Mexico. ....."

Dear Lisa 
So you are going to Kosovo - well good luck and take care. I worked through the active war stages in Bosnia, I hope you do not get put under fire and get home safely

Some extra points about Giardia

Giardia is endemic in a lot more countries than the ones you name (which focuses just on the Americas). Include all developing countries, some rural areas in developed countries. You will certainly find it in Kosovo. I see it a lot in returned hikers from Nepal and other adventurous out of the way spots. 

We have plenty in Cairns and get quite blase about it ( we have quite a poor water purification system in Port Douglas where Bill Clinton stopped of on his last Oz trip, please do not report me to the Australian tourist board for telling you this!). The local GPs don't even bother to test anymore, they just treat. I had it while breastfeeding my last, toddler he got it too, source probably the water supply. 

The usual symptoms apart form alternate diarrhea and constipation are the most awful farts which smell like rotten eggs, the malabsorption you mention occurs when the little leaf shaped Giardia parasites cover the lining of the intestine in large numbers. 

I do not think the drugs you mention (Quinacrine or furazolidine ) would be considered first choice in either the US or UK. We use either metronidazole, single bolus dose, or else tinidazole, two stat doses and both work just fine.

Kind regards

Mary E Black

Professor of Public Health
University of Queensland

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