Signs and Symptoms
Most people who are infected with E. histolytica have no symptoms at all - on the average, about 1 in 10 infected people become sick from the infection.
A child with intestinal amebiasis may complain of abdominal pain that begins gradually, with frequent loose or watery bowel movements. There may be cramps, nausea, and loss of appetite. The child may feel generally well, with fever occurring in only one third of cases.
However, intestinal amebiasis can also be more severe, with fever, chills, and diarrhea that contains blood or mucus. This is known as dysentery, and can lead to complications such as dehydration (abnormally low levels of body water).
In rare instances, children may develop a chronic form of amoebic intestinal infection, with symptoms such as abdominal pain and episodes of diarrhea occurring over a long period of time (weeks to years). These children may also develop an ameboma, which is a mass of inflamed tissue in the bowel wall.
When amoebas spread through the bloodstream to other parts of the body, they can cause pockets of infection (abscesses) in many different organs. One of the organs most commonly affected when this occurs is the liver - this condition is called hepatic amebiasis. Signs and symptoms of hepatic amebiasis include fever, abdominal pain, an abnormally distended abdomen, and tenderness in the area of the liver (below the ribs on the right side). This condition is rare in children, and is seen in less than 1% of those infected with E. histolytica.
Although most cases of amebiasis in the United States are mild, some people are prone to more severe disease. These include: pregnant women, young children, the elderly, the malnourished, and people with weakened immune systems (such as patients with cancer or AIDS, or people on medications that suppress the immune system).
Contagiousness
Amebiasis is contagious. Someone who carries amoebas in his or her intestines can pass the infection to others through the stool. When infected stool contaminates food or water supplies, amebiasis can spread quickly to many people at once. This is especially true in developing countries where drinking water may be contaminated, and where human stool is used as fertilizer.
Although the primary mode of transmission of amebiasis is via contaminated food and water, it can also be spread by person-to-person contact. It can be transmitted by direct contact with contaminated hands or objects, as well as by sexual contact. Family members can pass the infection to one another, and food- handlers can pass amoebas to their customers. People who live in institutions such as mental hospitals, orphanages, or prisons are also at higher risk for contracting the infection due to crowding and poor sanitation.
Generally, wherever living conditions are unsanitary and hygiene is poor, there is a better chance that the infection will pass from person to person.
Prevention
There is no vaccine for amebiasis.
Because amoebas often contaminate food and water, you can prevent amebiasis by watching what you eat and drink, especially if you travel to high-risk tropical countries. Wherever there is a chance that amoebas may contaminate drinking water, reduce your risk of infection by boiling the water for at least 5 minutes or by drinking bottled water. Because amoebas may also contaminate the outside skins of fresh fruits and vegetables, never eat these foods without peeling them first. In high-risk areas, avoid food that can't be cooked or peeled.
Another effective way to prevent the spread of amoebas is by frequent and careful hand washing with soap, which is important for all age groups. Children should be reminded to wash their hands, especially after they use the toilet and before they eat. This is particularly important in day-care settings.
Incubation
For some people, symptoms of amebiasis can begin within days to weeks of swallowing food or water contaminated by amoebas, with 2 to 4 weeks being the most common. For other people, symptoms of amebiasis either take months to appear or never appear at all.
Duration
In those who are infected but asymptomatic, the amoebas can live in the intestines for months or even years without causing any problems. Often the asymptomatic infection resolves spontaneously within 12 months.
When invasive amoebas cause intestinal amebiasis, symptoms can last from a few days to several weeks. Rarely, a chronic form of the disease develops, in which episodes of abdominal pain and bloody diarrhea recur over the course of several years.
Professional Treatment
If your doctor suspects that your child has amebiasis, you may be asked to collect samples of your child's stool to be checked for amoebas in a laboratory.
Amebiasis can usually be cured with an antimicrobial medication. All children with E. histolytica in their stools should be treated with oral antimicrobial medications prescribed by a doctor, whether they have symptoms or not. After finishing treatment for amebiasis, your child may need to give periodic stool samples for several months to make sure that no more medications are needed.
Hospitalization might be needed for children who become moderately or severely dehydrated or for those with problems in organs other than the digestive tract, such as the liver. While in the hospital they can be monitored and receive necessary treatment such as intravenous fluid (IV) therapy or antimicrobial medications.
Home Treatment
If your child is found to have amebiasis, give the antimicrobial medication as prescribed by your child's doctor for as long as directed. This will help the child get better faster and decrease the risk of amoebas passing to other members of your family. Remind your child to wash his or her hands thoroughly before eating and after using the toilet.
To prevent dehydration, follow your doctor's guidance about what your child should eat and drink. Your doctor may suggest that you give your child a special drink (called an oral rehydration solution, or ORS) to replace lost body fluids, especially if the diarrhea has been going on for longer than 2 or 3 days.
In general, children with mild diarrhea who aren't dehydrated should continue to eat normally but should receive more fluids. (Fruit juices and soft drinks can make diarrhea worse and should be avoided.) Children who have mild to moderate dehydration should be given an oral rehydration solution in small, frequent amounts for several hours to correct the dehydration and then should go back to eating normally. Children who are breastfed should be breastfed throughout. A child who's vomiting will need to eat smaller amounts more frequently.
To reduce fever and make the child more comfortable, acetaminophen (such as Tylenol) can be given.
When to Call Your Child's Doctor
Call your child's doctor if your child has signs or symptoms of amebiasis, including: diarrhea with blood or mucus, abdominal pain, fever, distended abdomen, pain or tenderness in the area of the liver (below the ribs on the right side). This is especially important if you have recently traveled to a tropical part of the world where amebiasis is common.
Your child should also be examined if he or she has persistent diarrhea without any other symptoms.
Children with diarrhea can become dehydrated, which can lead to serious complications. Signs of dehydration include:
- thirst
- irritability
- lethargy
- dry mouth, tongue, and lips
- sunken eyes
- a dry diaper for several hours in infants or fewer trips to the bathroom to urinate in older children
If you see any of these signs, call your child's doctor right away. |
