Amebiasis

The disease is caused by ingestion of amoeba infected food or water. The infection is mainly transmitted by feco-oral route. This means contamination of food or water by feces of infected person. It may be transmitted by dirty hands and objects or also by anal oral contact.

This condition can be seen anywhere in the world, but it is most common in tropical areas with crowded living conditions and poor sanitation. Africa, Mexico, parts of South America, and India has significant health problems associated with this disease.

There are approximately 70,000 deaths every year due to amebic dysentery. Traveler’s diarrhea is generally due to bacterial or viral infection and not due to amoebic infection.

Pregnancy, old age, malnutrition, malignancy and use of steroids are risk factors for amoebic dysentery.

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Signs and symptoms

Almost 90 percent people infected by amoebae remain asymptomatic.

In the remaining population when the disease develops, the symptoms of mild diarrhea to dysentery (diarrhea with blood and mucus in the stool) are with or without abdominal pain. The number of motions may be 3-8 with semi formed stools, with or without blood mucus and intestinal gas. There may be rectal pain during dysentery.

There may be fatigue and weight loss. The severity of symptoms depends upon the strain of infecting amoeba, presence of associated bacteria and viruses and immune response of the host.

In severe cases, there may be 10-20 passages of stool in a day with streak of blood in it, accompanied by fever, vomiting and tender abdomen. The disease normally lasts up to two weeks. But it may reoccur again and again.

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Tests and tools

Amoebic cysts in the stool may be seen under microscope after staining. Serological tests may be done to find out the presence of antibodies against amoeba. Antibodies can be detected in serum only after two weeks of infection and they persist in blood for years after the cure of the infection. An Ova and Parasite (O and P) test is the perfect test for the diagnosis if intestinal amoeba infection.

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Treatment

Amoebic infection (amebiasis) is treated using amebicides. Some drugs are rapidly absorbed in the blood and no drug is available in the intestine to kill intestinal amoebae. Therefore, amebiasis is generally treated using two drugs, a drug which is absorbed in the tissue and the other drug which acts on amoebae present in the lumen.

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Expectations (Prognosis)

The symptoms disappear by treatment but the amoebae may remain present in the intestine for longer time and may cause repeat episodes of illness.

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Complications

In most of the cases the amoebae remain present in the intestine of the patient for longer periods. In severe cases there may be an ulceration of the mucosal surfaces of the intestinal tract. In severe cases, approximately 10 percent, the amoebae enter the blood stream by invading the intestinal lining and reach to various organs in the body, mainly liver (since blood from intestine reaches liver first). The organism reaches to liver and cause amebic liver abscess. They can reach to any organ in the body. Infection may be there without symptoms for a period of up to year. In rare cases the amoebae form masses that can cause intestinal obstruction.

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Calling your health care provider

If the diarrhea or dysentery is severe accompanied by fever and other symptoms then it is better to call the health care provider.

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Prevention

Boiling the drinking water and treating it with iodine is a safe practice to prevent amoebic infection. Avoiding raw vegetables in the areas where the amebiasis is prevalent as the human feces might be used as fertilizer.

Towels, soaps or face washers should not be shared. Washing hands thoroughly after toilet and after changing diapers of babies is important. Cleaning bathrooms and toilets particularly toilet seats and taps is important.

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