12 countries in 12 years

Saturday, January 9, 2016

The War on Parasites When Living in Developing Countries

It’s no laughing matter, moving to a developing country comes with some annoyances such as the presence of ugly bugs that contaminate the food, the water and the occasional (hope it is the occasional) food handler and server that prepares your food and has filthy hands. Ugh! 

Amazing Garlic

Now, certainly anyone can contract parasites living anywhere in the world but it is much more prevalent in certain areas of the world that are in the development stages…especially if eating from street vendors and eating out a lot. The more you eat out and not take precautions your chances are much greater for getting a parasitic infection or disease.

It started with our youngest son who began complaining of aches and pains in different parts of his body. Sometimes he would have jabbing pains in his liver and sometimes he complained of stomach aches with sharp pains in different areas of his intestines.  He has never been ill like this in his life. He took a stool sample down to the lab here in Cuenca and it came back positive for parasites. 

Then just to be on the safe side we all got checked and sure enough it was confirmed we all had the same parasites! EEK! Our son had a more pronounced stage (stage 2) said the lab technician and why he was having more intestinal issues. The rest of us had some cramping (stage 1) but didn't put two and two together. There are 4 stages; stage 3 is serious and 4 is fatal. We eat a lot of raw garlic, raw yogurt and sauerkraut and is probably why the parasitic infection did not reach a more advanced stage. Thank goodness. 

This parasite we had is not your ordinary Giardia parasite that stays confined to your intestines. It’s a parasite that mutates if it breaches the intestines into a totally different creature, it normally lives in your intestines but in some people, (we think in constipated people) it travels through your blood stream to other parts of your body and makes home in your organs and that is when it begins to make bigger trouble.  Rarely does this nasty parasite migrate to the lungs and brain but in severe cases, if left unchecked it can and does.

Entamoeba Histolytica is very common in South America.  It is the third most dangerous parasite in the world and kills 70,000 people per year.  In ten percent of the population it can become serious where the protozoans migrate out of the intestines and into other organs in the body where cysts feed off cells and tissues, causing ulcers and a myriad of other complications to its host.  Yuck! And because we had it, we felt compelled to find out all we could about this disgusting parasitic attacker.

Facts about Entamoeba Histolytica

1. These parasites are very prevalent in rural Ecuador - 57.1% of the Quichua Highland children of Ecuador that were tested for E. Histolytica had it.

2. When the parasites migrate out of the intestines and into the organs it is called Amoebiasis Disease, and if left untreated it can be fatal.

3. Most people, about 90% live with these parasites without issue; however, 10% to 20% percent of people with it, contract Amoebiasis Disease where the cysts make homes in the organs, particularly the intestines and to the liver where they eat away at the tissues and cells.

3. E. Histolytica is rather easy to contract, either from fecal contaminated food and water, or from a food prep worker or server with dirty hands, or, the cysts can be transferred from objects you touch and then accidentally touch your mouth and you’ve got it; and amazingly enough, even flies can transfer the cysts from their furry little legs onto your food.

4. E. Histolytica infection (Amoebiasis) is the third leading cause of death from parasitic diseases worldwide, with its greatest impact on the people of developing countries; it is mostly seen in Asia and South American countries.

5. The infectious cyst form of the E. Histolytica Parasite is relatively resistant to chlorine.

6. Parasitic infections are the most prevalent infections of humans in developing countries.

7. World Health Organization (WHO) estimates that approximately 50 million people worldwide suffer from invasive amoebic infection each year, resulting in 40-100 thousand deaths annually

8. 203 stool samples were taken from children in rural Ecuador and the results showed that 85.7 percent of them had at least one type of intestinal parasite and 57% of those children had E. Histolytica.

Source: Journal of Health, Population and Nutrition - Human Intestinal Parasites Rashidul Haque, Scientist and Head of Parasitology Laboratory

9. In the U.S the most dramatic incidence of E. Histolytica was the Chicago World's Fair outbreak in 1933 caused by contaminated drinking water; defective plumbing permitted sewage to contaminate the drinking water. There were 1,000 cases (with 58 deaths). In recent times, food handlers are suspected of causing many scattered infections, but there has been no single large outbreak in the U.S.

NOTE: It is safe to say that something like this could have happened in Cuenca Ecuador as well. If it can happen in the U.S it can happen in South America.


10. Ecuadorians routinely get checked and rid themselves of parasites at least once a year, says the lab technician in Cuenca Ecuador. That tells us a lot!

Update November 2016 - We since learned that many Ecuadorians treat with antibiotics every 6 months!

Is Tap Water in Cuenca Ecuador Safe to Drink?

As our long time followers know we quit drinking the tap water several years ago, not because we think the tap water in Cuenca is dirty but because we wanted to filter out chlorine, heavy metals and fluoride.  Overall, we feel the tap water in Cuenca is perfectly safe to drink and actually is cleaner than some parts of the U.S. 

UPDATE 2016: No, the tap water is NOT SAFE to drink. We have expats that have reported to us they got the same parasite we did in Cuenca called Entamoeba Histolytica!  Several expats have also goteen Giardia in Cuenca Ecuador. As much as we would like to tell people something is safe and healthy we no longer recommend anyone drink the water in Cuenca, Ecuador ever.

When the Tap Water in Cuenca Is UNSAFE to Drink

There are exceptions to every rule, however, and in this instance it’s when the water has been turned off.  This has happened in Cuenca more times than we would like to admit, especially now since they have been working on the light rail. If the water has been turned off, the first rushes of water that runs through your pipes would be contaminated.

The other exception is drinking water from an old house with old pipes or washing fruits and vegetables with contaminated water or brushing your teeth with contaminated water by not letting it run long enough before using the water. After water has been shut off, running the water through the pipes for at least 5 minutes is a good rule of thumb. But now we will not use the water the first day after a shut off just to be safe.  This calls for having a back up water plan.

How Did We Get Entamoeba Histolytica?

The lab technician kept telling us it was from dirty water, but we drink from Berkey filters that filter out 99.98% of parasites and amoebas (we checked) and so it is unlikely it that it was from the 0.2 percent chance. But we eat out and drink the juice drinks that come with the Almuerzo and we drink tap water when given to us from people we know.

NOTE: If the lab technicians that check people's stools samples day in and day out for parasites (it's their job, what they do for a living) say parasites are from the water in Cuenca, then they would know something that we're not privy to. Now we're privy to it and we're sharing it with you...you can do what you will with this information.

We think we got Entamoeba Histolytica from eating out and eating contaminated food or water, or perhaps the food prep worker had dirty hands, or we used the tap water too soon after the water was shut off to wash our fruits and vegetables with...or our Berkey failed us, which it has in the past...so there ya go. 

We recommend buying bottled water if you're just visiting; why take chances with your health. You do not want this parasite!

Who Should Be Checked for Parasites?

Anyone living in or traveling in a developing country should be checked for parasites. In Cuenca Ecuador you can take a stool sample to any lab for a couple of bucks. You probably have to go there first and let them know that you think you might have parasites and they will give you the container for your sample.

Guidelines to Stay Healthy When Living in
Developing Countries

  • Only eat from restaurants that you know are safe (we have only a few restaurants we go to now, since both of us got food poisoning eating out in Cuenca)

  •  Cook at home and avoid illness altogether. 

  • Run the water through tap for at least 5-minutes if water has been shut off before drinking, brushing teeth or washing your vegetables.

  •  Be careful and do not touch your face with your hands after riding public buses and taxis, after touching fruits and vegetables that may have been washed with contaminated water.

  •  When eating from street vendors never eat anything that did not just come off the grill. Anything sitting around is suspect and should not be eaten.

  • Make sure street vendors wear gloves or use napkins when handling your food.

  • Don’t allow flies in the home; flies are carriers of many germs and diseases and they are filthy creatures. Make sure all foods sitting out in the open are covered.

  • If the water is not clean to drink then not a good idea to brush your teeth with it either. We used to  brush our teeth with the water on the Ecuador coast but now, after getting this parasite, we’re going to quit doing that too.

To make a long story short, we are happy to say after we took Nitazoxanide, an anti-parasite medicine for 6 days, we took stool samples back to the lab and it came back negative for E. Histolytica.  And we are so happy!

big update!!! We are not parasite free. the medicine only kills the dangerous trophozoites not the cysts, and well, they hatched again and we're having stomach issues again. E. histolytica is difficult to get rid of.  Saying this parasite creates a vicious cycle in your gut, is an understatement!

Instead of making the stupid mistkae we did, of taking the medicine three times in a row, just a few months apart from each other, here's what you need to do. You MUST have good eating habits and bowel movements and eat papaya seeds (1 large tablespoons) every single day to get rid of the cysts!! 

How it works is the seeds paralyze the cysts and they can no longer hang on to the wall of your intestines and hide in the crevices of your intestines and eventually you end up just flushing them out with bowel movements but it takes several weeks to maybe months, depending on how heavily infected you are!!

WE know because we've been dealing with this parasite for two years now!!!!

Update: three weeks later - We are parasite (trophozoite) free but the pharmaceutical medicine changed our intestinal flora and made us constipated. Doing research we find that this anti-parasite medicine is routinely given for people with parasites and dysentery, which none of us had dysentery!! We are working on building up our intestinal flora through natural ways and preventing parasites from making home in our intestines again, while living in South America, because the medicine really put our bodies out of whack. 

Update November 2016 - Actually, we thought we were parasite free but we were not.  This is what you are NOT told by anyone in the labs. The cysts are not killed off by the antibiotics; it's hard to kill those buggers because they hide in the crevices of your colon. Eventually, when not in an endemic area, the best way to rid the cysts is through good flora, and papaya seed drinks for several weeks in  a row which overtime, hopefully (but still not sure), flush out the cysts.

UPDATE: If living in an endemic area, the best way to stay free of parasites is to stay very healthy and eat and drink fermented foods and papaya seeds DAILY to PREVENT infection.

We’re good to go for now   (NOT) and hope that by following these guidelines we will not get parasites again, but as you know sometimes that’s hard to do unless you lock yourself up in your house all day and never do anything. 

Another BIG Update 2018 - Living in rural Ecuador we're getting Giardia now! Just letting you know, Ecuador does not have clean water anywhere and all it takes is a simple squirt of water from the shower or brushing your teeth with th water. Even Cuenca does not have clean water all the time!!

Until we write again…

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We're an Expat Family of Five, Living Frugal, Healthy and Happy Abroad. We live in Cuenca, Ecuador and travel the Ecuador coast whenever we get a chance. We just adventured throughout the country of Panama for five weeks! Come along and enjoy some of our experiences with us!

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