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Amebiasis - Causes and Symptoms

Other Names: Amebic Dysentery, Intestinal Amebiasis

Definition of Amebiasis

Amoebiasis is infection of the intestine (bowel) caused by a protozoan, typically Entamoeba histolytica. It is usually contracted by ingesting water or food contaminated by amoebic cysts . Is usually included between the waterborne diseases . Amoebiasis most commonly affects young to middle-aged adults. It is mainly characterized by frequent, loose stools flecked with blood and mucus.

Symptoms of Amebiasis

People exposed to Entamoeba histolytica parasite may experience mild or severe symptoms and in some cases - no symptoms at all. Fortunately, most exposed people do not become seriously ill. The symptoms start 2-4 weeks or even months after infection with a cyst.

Emaciation and anemia can occur in people with chronic infection. Sometimes a large lump (ameboma) forms and blocks the intestine. Occasionally, the trophozoites perforate the intestinal wall and enter the abdominal cavity, causing severe abdominal pain and an abdominal infection (peritonitis) that requires immediate medical attention.

The mild form of amebiasis includes

  • Intermittent Diarrhea.
    • Passage of 3 to 8 semiformed stools per day.
    • Passage of soft stools with mucus and occasional blood.
  • Nausea.
  • Increased gas (flatulence).
  • Loose stools.
  • Cramping abdominal pain.
  • Weight loss.

Rarely, the parasite will invade the body beyond the intestines and cause a more serious infection, such as a liver abscess. The other symptoms in serious cases of amebiasis are:

  • Abdomen is tender when touched
  • Anorexia
  • Stool may contain mucus and blood.
  • Jaundice
  • Fever may also be there accompanied with chills
  • Nervousness.
  • Fatigue.

Causes of Amebiasis

Infected people are the main source of causing the infection as they are the carrier of entamoeba histolytica parasite. Fecal material from infected people may contaminate water or food and may serve as a vehicle to infect others. In some parts of the world, flies may serve to transfer cysts from human stool to fruits and vegetables and then from them, directly to human beings. The cysts survive the acid in the stomach and get transported to the small intestine. The walls of the cysts are then broken open, releasing the trophozoites. These travel to the large intestine where they multiply, eventually forming new cysts that can be excreted in the stool.

Anyone can get amebiasis, but it is more common in people arriving from tropical or subtropical areas, individuals living in institutions, and men who have sex with men.

Treatment for Amebiasis

Diagnosis is done by examining a stool sample under a microscope for the presence of the parasite or its cysts.

There are many prescription drugs prescribed by doctor to treat amebiasis. Some of them are given below:

Nitroimidazole Drugs - This type of drugs are very good in killing amoebas in the blood, in the wall of the intestine and in liver abscesses. These drugs include metronidazole (Flagyl) and tinidazole (not available in the United States). Metronidazole usually is given for 10 days, either by mouth or directly into the veins (intravenously).

Luminal Drugs - Three types of Luminal Drugs are known to kill amoebas and cysts confined to the intestine, these include - iodoquinol (Diquinol and others), paromomycin (Humatin) and diloxanide furoate (Furamide). In people who pass amoebas in their stools without having symptoms of amebiasis, the luminal drugs alone can clear the amoebas from the bowel.

It is not usually necessary to isolate an infected person, since casual contact at work or school is not likely to transmit the disease. Special precautions may be needed by food handlers or children enrolled in day care.

Preventing Amebiasis from occuring

  • Wash hands thoroughly with soap and hot running water for at least 10 seconds after using the toilet or changing a baby's diaper.
  • Bottled water may be used for drinking when traveling to endemic areas.
  • Clean bathrooms and toilets often. Pay particular attention to toilet seats and taps.
  • Avoid sharing towels or face washers.
  • Improved sanitation and clean water supply decrease incidence of amebiasis. The amount of chlorine normally used to purify water is inadequate in killing the cysts.
  • Eating only cooked food or self-peeled fruits in endemic areas minimizes risk. Avoid eating raw fruits and salads, which are difficult to sterilize.
  • Drinking water can be rendered safe by boiling, 0.22 µm filtration, or iodination with tetraglycine hydroperiodide.
  • Disease transmission can be reduced by early treatment of carriers in nonendemic areas.
  • Vaccination for amebiasis currently is being investigated. One potential vaccine candidate is the galactose-inhibitable adherence lectin of E histolytica .
  • Children who attend day care centers should be kept at home if they have diarrhea. If household members or other contacts develop symptoms, they should be tested for amebiasis also.
  • Foodhandlers who are infected should not work until after the treatment is finished.

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