Introduction to Giardia duodenalis: The Parasite and the Disease

  • Lucy J. Robertson
Part of the SpringerBriefs in Food, Health, and Nutrition book series (BRIEFSFOOD)


Giardia duodenalis is the most common intestinal protozoan parasite of humans globally. A range of other mammals can also be hosts to this parasite, although the zoonotic potential is currently unresolved and parasites that are infectious to humans are not necessarily infective to other mammals and vice versa. The life cycle of G. duodenalis is simple, and contains two morphologically distinct forms: the vegetative trophozoites that inhabit the host intestine and replicate largely asexually by binary fission, sometimes resulting in the mucosal surface of the intestine being covered, and the transmission stage, the environmentally robust cysts that are excreted in the faeces of the infective host. This chapter provides an overview of the parasite, establishment of infection and details of the life cycle, and also describes the disease, giardiasis, that is associated with infection, with focus on symptoms, diagnosis and treatment.


Cyst Wall Lactase Deficiency Binary Fission Giardia Cyst Giardia Infection 
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  1. Adak G, Long S, O’Brien S (2002) Trends in indigenous foodborne disease and deaths, England and Wales: 1992 to 2000. Gut 51:832–841PubMedCrossRefGoogle Scholar
  2. Beck R, Sprong H, Bata I, Lucinger S, Pozio E, Caccio SM (2011) Prevalence and molecular typing of Giardia spp. in captive mammals at the zoo of Zagreb, Croatia. Vet Parasitol 175:40–46. doi: 10.1016/j.vetpar.2010.09.026 PubMedCrossRefGoogle Scholar
  3. Bénéré E, Van Assche T, Cos P, Maes L (2011) Variation in growth and drug susceptibility among Giardia duodenalis assemblages A, B and E in axenic in vitro culture and in the gerbil model. Parasitology 138(11):1354–1361. doi: 10.1017/S0031182011001223 PubMedCrossRefGoogle Scholar
  4. Berkman DS, Lescano AG, Gilman RH, Lopez SL, Black MM (2002) Effects of stunting, diarrhoeal disease, and parasitic infection during infancy on cognition in late childhood: a follow-up study. Lancet 59(9306):564–571CrossRefGoogle Scholar
  5. Birky CW Jr (2010) Giardia sex? Yes, but how and how much? Trends Parasitol 26:70–74. doi: 10.1016/ PubMedCrossRefGoogle Scholar
  6. Buret AG, Cotton J (2011) Pathophysiological processes and clinical manifestations of giardiasis. In: Luján HD, Svärd S (eds) Giardia: a model organism. Springer, New York. ISBN 978-3-7091-0197-1Google Scholar
  7. Cacciò SM, Sprong H (2011) Epidemiology of giardiasis in humans. In: Svärd S, Luján HD (eds) Giardia: a model organism. Springer, New York. ISBN 978-3-7091-0197-1Google Scholar
  8. Cantey PT, Roy S, Lee B, Cronquist A, Smith K, Liang J, Beach MJ (2011) Study of non-outbreak giardiasis: novel findings and implications for research. Am J Med 124(12):1175.e1–1175.e8. doi: 10.1016/j.amjmed.2011.06.012 CrossRefGoogle Scholar
  9. Cook N, Lim YAL (2012) Giardia duodenalis: contamination of fresh produce. In: Robertson LJ, Smith HV (eds) Foodborne protozoan parasite. Nova Publishers, Hauppauge, NYGoogle Scholar
  10. Dib HH, Lu SQ, Wen SF (2008) Prevalence of Giardia lamblia with or without diarrhea in South East, South East Asia and the Far East. Parasitol Res 103(2):239–251. doi: 10.1007/s00436-008-0968-6 PubMedCrossRefGoogle Scholar
  11. Escobedo AA, Almirall P, Robertson LJ, Franco RM, Hanevik K, Mørch K, Cimerman S (2010) Giardiasis: the ever-present threat of a neglected disease. Infect Disord Drug Targets 10(5):329–348PubMedCrossRefGoogle Scholar
  12. Frenzen PD (2004) Deaths due to unknown foodborne agents. Emerg Infect Dis 10:1536–1543PubMedCrossRefGoogle Scholar
  13. Gerwig GJ, van Kuik JA, Leeflang BR, Kamerling JP, Vliegenthart JF, Karr CD, Jarroll EL (2002) The Giardia intestinalis filamentous cyst wall contains a novel beta(1–3)-N-acetyl-d-galactosamine polymer: a structural and conformational study. Glycobiology 12(8): 499–505PubMedCrossRefGoogle Scholar
  14. Geurden T, Olsen M (2011) Giardia in pets and farm animals, and their zoonotic potential. In: Svärd S, Luján HD (eds) Giardia: a model organism. Springer, New York. ISBN 978-3-7091-0197-1Google Scholar
  15. Hanevik K, Hausken T, Morken MH, Strand EA, Mørch K, Coll P, Helgeland L, Langeland N (2007) Persisting symptoms and duodenal inflammation related to Giardia duodenalis infection. J Infect 55(6):524–530PubMedCrossRefGoogle Scholar
  16. Koh W, Geurden T, Paget T, O’Handley R, Steuart R, Thompson A, Buret AG (2013) Giardia duodenalis assemblage-specific induction of apoptosis and tight junction disruption in human intestinal epithelial cells: effects of mixed infections. J Parasitol 99(2):353–358. doi: 10.1645/GE-3021.1 PubMedCrossRefGoogle Scholar
  17. Lane S, Lloyd D (2002) Current trends in research into the waterborne parasite Giardia. Crit Rev Microbiol 28(2):123–147PubMedCrossRefGoogle Scholar
  18. Lasek-Nesselquist E, Welch DM, Sogin ML (2010) The identification of a new Giardia duodenalis assemblage in marine vertebrates and a preliminary analysis of G. duodenalis population biology in marine systems. Int J Parasitol 40(9):1063–1074. doi: 10.1016/j.ijpara.2010.02.015 PubMedCrossRefGoogle Scholar
  19. Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM, Tauxe RV (1999) Food-related illness and death in the United States. Emerg Infect Dis 5:607–625PubMedCrossRefGoogle Scholar
  20. Monis PT, Cacciò SM, Thompson RC (2009) Variation in Giardia: towards a taxonomic revision of the genus. Trends Parasitol 25:93–100. doi: 10.1016/ PubMedCrossRefGoogle Scholar
  21. Mørch K, Hanevik K, Robertson LJ, Strand EA, Langeland N (2008) Treatment-ladder and genetic characterisation of parasites in refractory giardiasis after an outbreak in Norway. J Infect 56(4):268–273. doi: 10.1016/j.jinf.2008.01.013 PubMedCrossRefGoogle Scholar
  22. Nash TE (2011) Antigenic variation in Giardia. In: Svärd S, Luján HD (eds) Giardia: a model organism. Springer, New York. ISBN 978-3-7091-0197-1Google Scholar
  23. Nash TE, Herrington DA, Losonsky GA, Levine MM (1987) Experimental human infections with Giardia lamblia. J Infect Dis 156:974–984PubMedCrossRefGoogle Scholar
  24. Rendtorff RC (1954) The experimental transmission of human intestinal protozoan parasites. II. Giardia lamblia cysts given in capsules. Am J Hyg 59(2):209–220PubMedGoogle Scholar
  25. Robertson LJ, Hanevik K, Escobedo AA, Mørch K, Langeland N (2010) Giardiasis—why do the symptoms sometimes never stop? Trends Parasitol 26:75–82. doi: 10.1016/ PubMedCrossRefGoogle Scholar
  26. Savioli L, Smith H, Thompson A (2006) Giardia and Cryptosporidium join the ‘Neglected Diseases Initiative’. Trends Parasitol 22(5):203–208PubMedCrossRefGoogle Scholar
  27. Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM (2011) Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 17:7–15. doi: 10.3201/eid1701.091101p1 PubMedGoogle Scholar
  28. Singer SM (2011) Immunology of giardiasis. In: Svärd S, Luján HD (eds) Giardia: a model organism. Springer, New York. ISBN 978-3-7091-0197-1Google Scholar
  29. Smith HV, Mank TG (2011) Diagnosis of human giardiasis. In: Svärd S, Luján HD (eds) Giardia: a model organism. Springer, New York. ISBN 978-3-7091-0197-1Google Scholar
  30. Smith HV, Robertson LJ, Ongerth JE (1995) Cryptosporidiosis and giardiasis: the impact of waterborne transmission. J Water SRT-Aqua 44(6):258–274Google Scholar
  31. Sprong H, Cacciò SM, van der Giessen JW, ZOOPNET network and partners (2009) Identification of zoonotic genotypes of Giardia duodenalis. PLoS Negl Trop Dis 3:e558. doi: 10.1371/journal.pntd.0000558 PubMedCrossRefGoogle Scholar
  32. Stensvold CR, Lebbad M, Verweij JJ (2011) The impact of genetic diversity in protozoa on molecular diagnostics. Trends Parasitol 27(2):53–58. doi: 10.1016/ PubMedCrossRefGoogle Scholar
  33. Strand EA, Robertson LJ, Hanevik K, Alvsvåg JO, Mørch K, Langeland N (2008) Sensitivity of a Giardia antigen test in persistent giardiasis following an extensive outbreak. Clin Microbiol Infect 14(11):1069–1071. doi: 10.1111/j.1469-0691.2008.02078.x PubMedCrossRefGoogle Scholar
  34. Wielinga C, Ryan U, Andrew Thompson RC, Monis P (2011) Multi-locus analysis of Giardia duodenalis intra-Assemblage B substitution patterns in cloned culture isolates suggests sub-Assemblage B analyses will require multi-locus genotyping with conserved and variable genes. Int J Parasitol 41(5):495–503. doi: 10.1016/j.ijpara.2010.11.007 PubMedCrossRefGoogle Scholar

Copyright information

© Lucy J. Robertson 2013

Authors and Affiliations

  • Lucy J. Robertson
    • 1
  1. 1.Institute for Food Safety & Infection BiologyNorwegian School of Veterinary ScienceOsloNorway

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