Giardia is a small microscopic parasite that can be brought home in the stool from many countries. Children may have symptoms of diarrhea, bloating or flatulence, or they may be asymptomatic carriers. Frequent hand-washing, especially whiles changing diapers will help decrease transmission to other family members. We test all children newly home for parasites with 3 stools vials, collected every other day (since it can shed intermittently). Treatment is generally with an antibiotic (Flagyl) for 10 days. This is usually sufficient, but rarely we will see resistant strains that need a second round of antibiotics.
Pinworms are small worms that infect the stool. They are frequently described as having an appearance of a "grain of rice" or "white thread". Infected people should bathe in the morning; bathing removes a large proportion of eggs. Frequently changing the infected person's underclothes, bedclothes, and bedsheets can decrease the egg contamination of the local environment and decrease risk of reinfection. Also it is helpful to keep fingernails short, avoid nail biting, and do lots of hand washing. All family members should be treated as a group in situations in which multiple or repeated symptomatic infections occur.
Drugs to treat pinworms are mebendazole (vermox), pyrantel pamoate (available over the counter), and albendazole. Each is given in a single dose and repeated in 2 weeks. Reinfection with pinworms occurs easily.