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Here we discuss Giardia cyst contamination in drinking water and we review alternative treatment, sterilization, or giardia removal methods used to make drinking water safe from giardia contamination. This article series outlines methods to purify or sanitize drinking water in an emergency following a disaster such as an earthquake, flood, or hurricane. Some of the water treatment or water purification methods discussed are also used for regular non-emergency water sterilization as well. A companion article, DRINKING WATER - EMERGENCY SOURCES,describes possible sources of drinking water that may be useful in emergency conditions.

For explanation of the types of contaminants found in water and how they are removed in residential water systems, see WATER TESTS, CONTAMINANTS, TREATMENT.

© Copyright 2009 Daniel Friedman, All Rights Reserved. Information Accuracy & Bias Pledge is at below-left. Use links at the left of each page to navigate this document or to view other topics at this website. Green links show where you are in our document or website.

How to Treat or Purify Giardia-contaminated Water to Sanitize it For Drinking

• Chemical contaminants: If your water supply has become contaminated by pesticides, heavy metals, or other chemicals, disinfecting the water will not correct those unsafe conditions.
• Protozoan contaminants: Chlorine and iodine are good disinfectants against bacterial contamination (probably among the most common water contaminants) but studies have shown that these are not effective against certain contaminants in water such as toxic chemicals, Cryptosporidia (Cryptosporidium parvum) , and Giardia.
• Filtration and boiling are additional steps that can address these microorganisms. Activated charcoal can remove some chemical contaminants but has limited life and capacity. See Filters for Drinking Water Purification for details of various water filter options.

Advice for Dealing with Giardia cysts in Drinking Water - working draft

InspectAPedia.com reader Sharon Ross is a New York City resident, a Riverkeeper member and a MENSA member, who for health reasons has collected references and treatment information about dealing with Giardia cyst contamination in drinking water. This article is in draft form and is incomplete. Contact Us with corrections or suggestions.

Giardia cysts also survives the amounts of chlorine in municipal water treatment. Dr. Herman Bueno, a Parasitologist I conferred with reported in 1994 that people with AIDS were dying of Giardia in hospitals because of their weakened immune systems. We would not recommend that anyone with a compromised immune system eat raw vegetables without sufficient sterilization to kill parasite cysts.

Ceramic Filters for Giardia cyst & Cryptosporidium Removal from Drinking Water

There are ceramic giardia and cryptosporidium filters that can be used to filter tap water so that cysts will not be ingested by drinking it. The company that I have bought my ceramic filter from is Duff company, though there are other companies that also carry them. The ceramic filters are "absolute" and if used properly, remove the cysts 100 percent.

Well water, or even municipal water when it delivered inside of some buildings, contains high levels of sediment that causes water filters to clog quickly. Thus water filters may need cleaning as often as every few days, making filtration to remove giardia a labor intensive solution. But it beats being exposed to cysts which may be present in some drinking water supplies.

Eventually ceramic water filters wear down from the constant scrubbing and they have to be replaced. Even with the work involved, we recommend them for anyone with a compromised immune system. See Filters for Drinking Water Purification for details of various water filter options.

Charcoal Water Filters for Giardia cyst & Cryptosporidium Removal from Drinking Water

Granulated charcoal filters do not work. Environmental activist, Robert F Kennedy Jr. has been aware of Giardia contamination of our water and we think that he was trying to get a filtration system that would remove cysts built for NYC. The problem was the cost - by some estimates over a billion dollars.

Whole House Filtration Systems for Giardia cyst & Cryptosporidium Removal from Drinking Water

There are now both point of use reverse osmois systems (photo at left) and whole house filters or RO systems that remove parasite cysts. A sample proposal for a whole house reverse osmosis (RO) water treatment system is provided at Example of an Equipment Design for Water Filtration for Giardia. A reverse osmosis whole house filter system including a large storage tank can be installed if you own your own home and have a place to put it.

Also available is a filter attachment to remove nitrates as well, since nitrates can be a problem in some areas. I am sending you is an attachment with a link. Sato Iwasa of Pure Water Express was very helpful and knowledgeable in discussing whole house water treatment options. Duff Company provides ceramic giardia cyst filters.

OPINION: Our beaches are no longer safe for the immune compromised and maybe not for others as well. Billions of tons of raw sewage are being dumped into Long Island Sound because we do not have the sewage treatment plants to handle it. This can be confirmed by another New York environmental organization, "Riverkeeper".

That means that waste from third world immigrants who are carriers of parasites from India, the middle east, China, and Latin America and other countries where parasites are endemic is being carried by the currents to the ocean beaches that New Yorkers swim in. According to Dr. Bueno, cysts take at least three days to die in ocean water so they can be still viable and be ingested.

Examples of U.S. Sources of Giardia Infection

You do not have to travel to a foreign country to be exposed to Giardia cysts, though it has been our experience that many physicians still believe that you do, and if you complain of parasite related symptoms they still ask you if you have left the country.

Giardia Contamination Around New York City

In New York there are huge storm drain runoff pipes that run into Little Neck Bay. Some of them are near Alley Pond Environmental center and you can speak to the director of the center about them. I had taken a wrong turn on a trail in Alley Pond park leading from the center when encountered a terrible stink and I came one of "storm" drains which are storm drains no longer and there is a constant flow of sewage from them. There was a hoard of seagulls circling overhead and the filth was pouring into the waters leading to the sound. When we (Ross) asked the director about why this was happening, since it was a sunny dry day with no rain in sight, he told me that the storm drains are in operation constantly because we do not have the facilities to handle all of the raw sewage.

On the opposite side of the storm drains running into Little Neck Bay are Westchester beaches, though few doctors would make the connection if someone complains of exhaustion weakness, diarrhea, MS like symptoms and abdominal pain.

Dr. Tennenbaum, an infectious disease specialist reported that they now treat empirically for Giardia if the person has been in endemic areas in our country i.e.: vacationing in Maine, and is exhibiting symptoms. because Giardia is so difficult to find. We do not know if New York City is considered an endemic area for Giardia.

Eating out in some restaurants can also cause problems. Giardia is endemic to the USA and can be carried and spread from anyone born here who has been infected. Further, restaurant workers who have lived-in countries where parasites like entameoba histolytica are common may be a potential source of parasites.

Some people who suffer from a compromised immune system no longer eat out in restaurants.

Safe foods? According to Dr. Amin, parasite cysts cannot withstand the freeze/thaw cycle, so am safe with ice cream (I am not considering bacteria that can withstand freezing) and food taken out from a restaurant that is frozen, thawed and then re-heated.

Ross recommends that anyone wash their hands thoroughly when they come home and turn public faucets on and off with clean paper towels.

Difficulty in Diagnosing & Treating Giardia Infection

When a person first becomes infected with Giardia, stress and irritable bowel may be suggested by more than one physician.

Parasite cysts are often difficult to spot under the microscope and tests for them can manifest negative results when a person is really infected. Dr. Bueno reported that the US army tests GI's 8 times if they complain of parasite type symptoms and the results are negative. Dr. Amin also said that two stool samples might not be sufficient to determine if a person is infected.

Use of UV light, Vinegar, or Chlorine for Giardia cysts ?

As for vinegar as a method of killing giardia cysts, it is highly acidic and it breaks down the walls of the giardia cysts, if it is used full strength. Dr. Omar Amin, of "Parasitology Center " in Tempe, Az confirmed this. [WARNING: authoritative sources confirming the safety of this approach have not been obtained.] Here is a representative reader comment: "I have battled an immune disorder and I had been very ill with intractable Giardia because of my condition. I do not eat raw produce now unless I sterilize it. Right now, I use distilled white vinegar. I submerge vegetables in pure vinegar for 25 minutes but more porous vegetables have a vinegar taste when I am done. I have ceramic giardia filters on my tap water now and I was thinking that if I could use a peroxide solution, and then rinse off the peroxide in fresh, giardia free water, I would not have to deal with a vinegar taste."

UV doesn't kill cysts, according to Dr. Amin and I have seen websites that advertise it to kill giardia which is very misleading. it will kill Giardia trophozoites but the real concern for drinking water is the cysts, since it is the cysts from stool that appear there. Chlorine does kill cysts in high enough amounts, the amount that one would find in a swimming pool, amounts not suitable for drinking and I was told by another parasitologist that I have conferred with, that the cysts would take about 20 minutes to die in a chlorinated swimming pool. UV light combined with chlorine treatment has been used for treatment of Giardia infected water.

Example of an Equipment Design for Water Filtration for Giardia, Equipment Costs

Pre-filter Water Filter for Sediment Removal

Optional: install a plastic sediment filter 1-1/2" model to remove sediment, $289 includes shipping, ref: www.purewaterexpress.com/wholehouse.htm#3a removes dirt before the water supply enters the reverse osmosis component, providing insurance protection of the RO filter against water main work upstream (or a private well water source containing sediment) sending massive debris into the water treastment system.

Reverse Osmosis RO Treatment Unit Cost

Compact II-2: special high flow membrane, daily production 250 gallons minimum, $1,548 plus shipping from Perris, CA, reference: www.purewaterexpress.com/wholehouse.htm#9. See REVERSE OSMOSIS WATER TREATMENT for details of reverse osmosis water purification systems and alternative RO products. Other reverse osmosis, filter, ceramic filter and water treatment products are listed at the end of this article.

Post Reverse-Osmosis RO Water Treatment Processing Equipment Options

1. 165 gallon storage tank, float switch,1 HP re-pressurization pump, low pressure cutoff safety switch, $2,122 plus shipping from MN
2. 1-1/2 cubic foot reverse flow acid neutralizer, $342, 1 cubic foot calcite $60, plus shipping from MN, restores pH of RO water close to neutral, ref: www.purewaterexpress.com/wholehouse.htm#7
3. Post RO polishing carbon +UV 20” Big Blue $1,049 includes shipping, ref: www.purewaterexpress.com/wholehouse.htm#5 Carbon makes delicious tasting water, UV protects against potential bacterial growth over time in the storage tank

List of Principal Methods Used to Purify Contaminated Drinking Water when Camping or in an Emergency

• Boil the water to make it suitable for drinking.
• Bleach: Use chlorine (bleach, sodium hypochlorite) to purify the water. (see warnings just above). Permanent well water chlorination systems are discussed at CHLORINATORS & CHARCOAL FILTERS.
• Chlorination: where electrical power and water pressure are present and the equipment is already installed, a chlorinator or water chlorine injection treatment system, usually combined with a charcoal filter for water treatment may be functional. See CHLORINATORS & CHARCOAL FILTERS for details.
• Giardia in Drinking Water - a review of the health hazards & typical equipment costs for portable and whole house water treatment to remove Giardia cysts from drinking water
• Iodine: Use Iodine tablets or a liquid tincture of iodine to purify the water for emergency use (see warnings just above)
• Hydrogen peroxide may be used (maybe) to purify water for emergency drinking use. [The concentration and exposure time data are still needed for this application.]
• Water purifying filters: Use a filter designed for water purification, particularly ceramic filters and silver-ceramic filters. See WATER FILTERS for a separate discussion of home water filters used for sediment, odors, etc.
• Use a water purifying pump such as models sold by camping equipment suppliers to purify the water - typically these pumps use a ceramic or other filter
• Use a water distiller such as a home or portable distillation unit (our photo just above/left shows a Sears® Kenmore home water distiller) (You'll need electrical power or a source of heat to distill water). This device processes about one gallon of water per cycle. We have been using this Sears Kenmore water distiller, model 5000 for more than fifteen years without a hitch. A disposable charcoal post-distillation filter is available for use in the drip spout of the unit - a potential source of contamination if it is not changed occasionally.
• Reverse osmosis: use a Reverse osmosis water filtration system if water pressure is available or if a portable R.O. system is available. See REVERSE OSMOSIS WATER TREATMENT for details. RO treatment systems may work where there is no electrical power provided that you have water pressure, such as in some municipal water situations.
• UV Lights - ultra violet light used for water sterilization - see UV -ULTRAVIOLET LIGHT TREATMENT
• Vinegar is sometimes used as a vegetable wash and may be effective against some microorganisms in water - we have not yet found authoritative data on this application.
• Mixed oxidants electrochemically generated from brine have been used for water disinfection
• Halogenated resins have been used for water disinfection
• Home Made & Expedient Water Sterilization Methods: Matthew Stein describes a variety of home-made, expedient, and partly effective water filters and water treatment methods in When Technology Fails. With plastic and a few sticks you can build a solar water sterilizer (solar water disinfection or SODIS systems).
  
  Stein also explains that slow sand filters have been used for partially cleaning and treating water for a very long time. A crude home made charcoal filter will remove some odors, bad tastes, organic toxic chemicals, and radioactive fallout. Mr. Stein also describes sari water filters used in Bangladesh after flooding, but includes a critical warning that filtering water through cloth is by no means really safe.
  
  Our favorite of his suggestions is using a plant to form a water collector and filter system, an idea which reminds us of native Americans who knew how to obtain water from desert barrel cactus. We enjoyed this book and provide this purchase link for it.

Basic water purification procedures that can be used in an emergency are described just below. If community or private wells are back in operating and providing water, do not assume that the water is sanitary and ok to drink until responsible authorities have said so. Even then, local water pipes in a building may be unsanitary and additional cleaning or disinfection may be needed. See WELL CHLORINATION SHOCKING PROCEDURE and See WATER TESTS, CONTAMINANTS, TREATMENT for advice on using a private well for drinking water.

Links provided just below continue with details about various methods to disinfect or purify emergency drinking water.

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ENVIRONMENTAL HAZARDS - INSPECT, TEST, REMEDY
FLOODS & MOLD CLEAN/PREVENT A Guide to Dealing with Flood Damage & Mold Prevention &r Cleanup of Flooded Homes
  FIRST PRIORITIES When Responding to a Flooded Building
  BUILDING ENTRY PROCEDURE How to Enter a Building After a Building Flood
  DRINKING WATER - EMERGENCY PURIFICATION How to purify emergency drinking water, how to remove odors
    How to Purify Water
    Boiling Water for Drinking
    Iodine Tablets or Iodine Disinfectant
    Bleach as a Disinfectant for Drinking Water
    Vegetable Disinfection Washes
    Hydrogen Peroxide for Water Disinfection
    Vinegar & Other Disinfectants
    How Much Disinfectant to Use
    Wait Time & Water Temperature
    Filters for Drinking Water Purification
    Giardia in Drinking Water
  DRINKING WATER - EMERGENCY SOURCES Where to find drinking water in an emergency
  ELECTRICAL SAFETY for Flood Damage Inspectors
  FLOOD DAMAGE TO FOUNDATIONS
  FLOOD RESPONSE CHECKLIST Checklist of Key Steps to Minimize Mold Damage After a Building Flood
  INEFFECTIVE MOLD PRODUCTS Ineffective Mold Products and Procedures to Avoid in Mold Cleanup/Prevention
  FURTHER STEPS PREVENT MOLD Further Steps to Avoid Mold Damage After a Building Flood
  WHEN TO STOP LOOKING FOR MOLD after Flooding: When is a Mold Cleanup Job Complete?
  GENERAL MOLD PREVENTION Preventing Future Mold After a Flooded Building Cleanup
  FLOOD DAMAGE RFERENCES References on Mold Prevention and Flood Damage
  FLOOD VENTS How to Use Flood Vents for Structural Protection from Flooding - Flood Venting in Foundations and Enclosures Below Design Flood Elevation
  SEPTIC SYSTEMS & FLOODS What to Do after a Flood - Septic Flood Response, Safety, Health, Maintenance, Repair Advice
  SEWAGE CONTAMINATION IN BUILDINGS how to detect and respond to sewage backups
  SEWAGE PATHOGENS in SEPTIC SLUDGE what are the contaminants in sewage
  Wind Damage to Roofs how to assess and identify wind damage to roofs
PLUMBING TOPICS
WATER TREATMENT EQUIPMENT CHOICES
WELL CHLORINATION SHOCKING PROCEDURE

• Dr. Omar Amin, of the Tempe AZ Parasitology Center, corresponded with Sharon Ross (citation below), one of our readers asking about peroxide: "You can use hydrogen peroxide if you want to but we do not have a track record of percentage dilution". Dr. Amin has done research for the US military and for the CDC.
• Aquamira™ chlorine dioxide water purification kits - see www.aquamira.com/
  "Aquamira Water Treatment Drops were introduced to the Outdoor market in 1999 and have been a favorite of top outdoor guides and instructors ever since. Whether you are camping, traveling in a foreign country or faced with a disaster, our goal is to provide you with safe, pure and good tasting drinking water. Our complete line of water treatment products include leading edge purification and filtration technologies developed and tested in the lab and proven in the field. We offer systems and products that will provide water for a single individual or a village and almost anything in between."
• "Bacteria in Drinking Water" - "Chlorine," Karen Mancl, water quality specialist, Agricultural Engineering, Ohio State University Extension. Mancl explains factors affecting the effectiveness of chlorine in water as a means to destroy bacteria and other microorganisms. OSU reports as follows:

  Chlorine kills bacteria, including disease-causing organisms and the nuisance organism, iron bacteria. However, low levels of chlorine, normally used to disinfect water, are not an effective treatment for giardia cysts. A chlorine level of over 10 mg/1 must be maintained for at least 30 minutes to kill giardia cysts. -- http://ohioline.osu.edu/b795/index.html is the front page of this bulletin.

• Crystal Clear Supply provides portable ceramic water filter purifiers and portable reverse osmosis water treatment equipment - see http://www.crystalclearsupply.com/category_s/7.htm
• Mark Cramer Inspection Services Mark Cramer, Tampa Florida, Mr. Cramer is a past president of ASHI, the American Society of Home Inspectors and is a Florida home inspector and home inspection educator. (727) 595-4211 mark@BestTampaInspector.com 11/06
• "Do Iodine Water Purification Tablets Provide an Effective Barrier against Cryptosporidium parvum?", Starke, Jeffrey A., Bowman, Dwight D., Labare, Michael, Fogarty, Elizabeth A., and others, Military Medicine, 25 October 2001 [possibly a later version of this article appeared in 2005 -DF]www.amsus.org/military medicine/milmed.htm
• "Drinking Water Safety in Emergencies", University of Minnesota extension, extension.umn.edu/info-u/nutrition/BJ646.html
• Duff Company provides ceramic filters: 610 275-4453.
• EPA: www.epa.gov/ogwdw/mdbp/pdf/alter/chapt_2.pdf provides an article on use of disinfectants for water treatment
• FDA Warning about drinking hydrogen peroxide: www.truthorfiction.com/rumors/h/hydrogen-peroxide.htm This article cites a 2003 entry in Journal of Food and Science on using Hy.Perox to sterilize vegetables, referring to E.coli - NOT to Giardia.
• Giardia exposure limits for drinking water: see www.mass.gov/dep/water/drinking/standards/giardia.htm is the current regulatory exposure limit (your minimum target for sterilization)
• Hankey and Brown home inspectors, Eden Prairie, MN, technical review by Roger Hankey, prior chairman, Standards Committee, American Society of Home Inspectors - ASHI. 952 829-0044 - hankeyandbrown.com 11/06
• Potable Aqua® emergency drinking water germicidal tablets are produced by the Wisconsin Pharmacal Co., Jackson WI 53037. 800-558-6614 pharmacalway.com
• Pure Water Express, Sato Iwasa, has U.S. facilities located in Harvard, MA 01451, 888-928-3794 sales@purewaterexpress.com or website: www.purewaterexpress.com/ There are "Big Blue" filters that pure water express carries that aren't ceramic but that also effective in removing cysts.
• Riverkeeper, is located at 828 South Broadway, Tarrytown, NY 10591 - 800-21-RIVER - info@riverkeeper.org
  To Report a Polluter: 800-21-RIVER ext 242 - Email: watchdog@riverkeeper.org
  Riverkeeper Press Liaison: Andrea Kott, 914-478-4501 ext. 239 - Email: akott@riverkeeper.org riverkeeper.org.
  Riverkeeper’s mission is to protect the ecological integrity of the Hudson River and its tributaries, and to safeguard the drinking water supply of New York City and the lower Hudson Valley.
  For more than 40 years Riverkeeper has been New York’s #1 clean water advocate. We have helped to establish globally recognized standards for waterway and watershed protection and serve as the model and mentor for the growing Waterkeeper movement that includes more than more than 180 Keeper programs across the country and around the globe.
• Sharon Ross is a New York City resident, a Riverkeeper member and a MENSA member, who for health reasons has collected references and treatment information about dealing with Giardia cyst contamination in drinking water.
  
• Katadyn™, a Swiss corporation provides water filters, desalinization equipment, and their Micropur chlorine dioxide water purification - see www.katadyn.com/usen/
  "Katadyn offers a wide variety of water filtration and purification products suitable for any need. This allows outdoor enthusiasts and travelers to take along products for making their own drinking water when preparing their trips."
• Patent: This patent application for UV light sterilization www.patentstorm.us/patents/6565803.html Lists good references on water purification for Giardia et als
• Princeton University - www.princeton.edu
• Arlene Puentes, a licensed home inspector, educator, and building failures researcher in Kingston, NY. 11/29/06
• Wikipedia on history of use of hydrogen peroxide: Information on Hydrogen peroxide as a sterilant is in Wikipedia at en.wikipedia.org/wiki/Sterilization_(microbiology) HO2 has been used for a long time, including by vaporization for sterilizing freeze dryers.
• Wilderness Medical Society has advice about boiling water for consumption

Books & Articles on Building & Environmental Inspection, Testing, Diagnosis, & Repair

• Our recommended books about building design, inspection, and repair, and about indoor environment testing, diagnosis, and cleanup are at the InspectAPedia Bookstore.
• Potable Aqua® emergency drinking water germicidal tablets are produced by the Wisconsin Pharmacal Co., Jackson WI 53037. 800-558-6614 pharmacalway.com
• Principles and Practice of Disinfection, Preservation and Sterilization (Hardcover)
  by A. D. Russell (Editor), W. B. Hugo (Editor), G. A. J. Ayliffe (Editor), Blackwell Science, 2004. ISBN-10: 1405101997, ISBN-13: 978-1405101998.
  "This superb book is the best of its kind available and one that will undoubtedly be useful, if not essential, to workers in a variety of industries. Thirty-one distinguished specialists deal comprehensively with the subject matter indicated by the title ... The book is produced with care, is very readable with useful selected references at the end of each chapter and an excellent index. It is an essential source book for everyone interested in this field. For pharmacy undergraduates, it will complement the excellent text on pharmaceutical microbiology by two of the present editors."
  The Pharmaceutical Journal: "This is an excellent book. It deals comprehensively and authoritatively with its subject with contributions from 31 distinguished specialists. There is a great deal to interest all those involved in hospital infection ... This book is exceptionally well laid out. There are well chosen references for each chapter and an excellent index. It is highly recommended." The Journal of Hospital Infection.: "The editors and authors must be congratulated for this excellent treatise on nonantibiotic antimicrobial measures in hospitals and industry ... The publication is highly recommended to hospital and research personnel, especially to clinical microbiologists, infection-control and environmental-safety specialists, pharmacists, and dieticians."
  New England Journal of Medicine: City Hospital, Birmingham, UK. Covers the many methods of the elimination or prevention of microbial growth. Provides an historical overview, descriptions of the types of antimicrobial agents, factors affecting efficacy, evaluation methods, and types of resistance. Features sterilization methods, and more. Previous edition: c1999. DNLM: Sterilization--methods.
• Handbook of Disinfectants and Antiseptics, Joseph M. Ascenzi (Editor), CRC, 1995, ISBN-10: 0824795245 ISBN-13: 978-0824795245 "The evaluation of chemical germicides predates the golden age of microbiology..." -
  This well-focused, up-to-date reference details the current medical uses of antiseptics and disinfectants -- particularly in the control of hospital-acquired infections -- presenting methods for evaluating products to obtain regulatory approval and examining chemical, physical, and microbiological properties as well as the toxicology of the most widely used commercial chemicals.
• When Technology Fails, Matthew Stein, Chelsea Green Publisher, 2008,493 pages. ISBN-10: 1933392452 ISBN-13: 978-1933392455, "... how to find and sterilize water in the face of utility failure, as well as practical information for dealing with water-quality issues even when the public tap water is still flowing". Mr. Stein's website is www.whentechfails.com/

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