Giardia - symptoms and treatment of parasites in children. Therefore, most often doctors resort to the simplest method of diagnosing - the study of feces.

Flies are another source of infection., which carry cysts on themselves, as well as pets, especially those that walk on the street.

Giardia in children: symptoms and treatment

Giardiasis in children can occur in acute and chronic form. There are cases when there is an asymptomatic course of the disease. In most cases, an acute form of the course of the disease is noted in childhood.

Symptoms of giardiasis in children:

All of the above symptoms are usually regarded as symptoms of dysbacteriosis, as well as other disorders of the digestive tract. Therefore, it is recommended to take the initiative in your own hands and ask the pediatrician for referrals for appropriate examinations.

Advanced forms of the disease are extremely difficult to treat. If the diagnosis was detected in the early stages of the development of the disease, then the fight against it is more effective. Diagnosis of giardiasis includes the following types of studies:

Giardia in children: treatment

Comprehensive treatment of giardiasis in children consists of three main stages:

Preparatory stage

The essence of this stage is the implementation of activities that reduce toxicity in the body. To do this, it is necessary to take choleretic drugs, and enzyme and enterosorbent drugs are also indicated for use, thanks to which it is possible to normalize digestion processes and eliminate stagnation from the biliary tract, and inflammatory processes in the body are inhibited. In parallel with them, antispasmodic drugs and drugs that help strengthen the child's immunity are included in the scheme.

A special role is given following a special diet. The diet to be followed during the preparatory phase includes the rejection of simple carbohydrates. The number of prohibitions includes whole milk, confectionery flour products, sweets. It is strongly recommended to give preference to gray cereals (wheat, buckwheat and oatmeal). The diet must contain drinks from sour berries, salads with vegetable oil, fresh vegetables and fruits rich in fiber. At this stage, it is useful to use Essentuki No. 4 and Slavyanskaya mineral waters.

In total, the preparatory stage takes about two to three weeks.

This stage of treatment is the most basic. The attending physician, taking into account the individual characteristics of the child and the course of the disease, should develop an individual regimen for taking the drugs, determine the duration of the therapeutic course and describe the dosage and administration of the drugs. For the treatment of giardiasis in children, in most cases, the following is prescribed:

Anthelmintic treatment should be carried out in two courses. The second course should be carried out with an interval of 7-10 days after the first.

Usually on the fifth day of treatment the child's health begins to deteriorate sharply. This is due to the fact that the drugs destroy Giardia, which, during their death, release toxic substances into the blood of the child. At this stage of treatment, it is advisable to give the child laxatives and antihistamines, which will help to quickly remove decay products from the body, as well as reduce intoxication.

Recovery stage of treatment

The main goal of this stage is in increasing the defenses of a young organism and eliminating disorders that were caused by the vital activity of pathogens. For this purpose, drugs are indicated for use that improve intestinal motility; enzyme medications that promote good digestion; medicines to eliminate dysbacteriosis. At this time, it is extremely important to provide the child with proper nutrition and establish a daily routine.

The diet at the recovery stage of treatment involves the inclusion in the diet of fermented milk products (cottage cheese, yogurt and kefir), low-fat fish or lean boiled meat. Vegetable purees, fresh fruits and vegetables, oatmeal, rice and buckwheat are useful. Foods containing carbohydrates, flour products and sugar should be excluded from the diet. At this stage, the child should lead an enhanced drinking regimen in order to replenish the water balance in the body and remove the remnants of toxins. It will not be superfluous to give the child dried fruit compotes, green tea with lemon, sour fruit drinks and mineral water.

To consolidate the result, it is necessary to give your child decoctions of medicinal herbs, which are characterized by choleretic, regenerating and anti-inflammatory properties. In addition, the doctor will prescribe vitamin and mineral complexes and drugs aimed at strengthening the immune system. If the disease occurred in the summer, then it is recommended to take sun and air baths, as well as swimming in the sea.

Prevention

After complete recovery, the child should be under the strict supervision of a pediatrician for at least six months. Together with him, all family members should undergo a therapeutic course, since this will significantly reduce the likelihood of relapses. Remission of the disease can be achieved in more than 90% of cases.

Preventive measures, compliance with which will prevent repeated relapses:

About the disease

Giardiasis is a disease caused by the simplest microorganisms - Giardia. They resemble a jellyfish, have flagella and a suction disc, with which they can attach to the walls of the small intestine. It is this section of the digestive tract that is a favorite place for Giardia to stay, where they feel quite comfortable.

The World Health Organization claims that up to 200 million people are infected with Giardia annually in the world, and more than 70% of them are children under 14 years of age.

Giardia cysts

In the large intestine, the conditions for the existence of Giardia are assessed as extreme, completely unsuitable for themselves, and therefore quickly turn back into immobile cysts and, in this form, come out with feces. In a dormant state, Giardia can exist in the soil for more than three weeks, and even longer in water - about 5 weeks.

With water, vegetables and fruits, with unwashed hands, cysts enter the body of another person, begin to multiply, come out in the form of cysts, and the circle closes.

At risk - children from one year to 4-5 years. It is at this age that the world is known not only by sight, sound and smell, but also by taste, and therefore the spread of lamblia in the children's team is just a matter of time, and a small segment of it. Giardia most negatively affects children with stomach diseases, especially with ailments accompanied by low acidity. At risk and children are vegetarians who are deficient in protein foods.

Myths and truth about lamblia

It is all the more incomprehensible why there are so many myths around giardia and giardiasis, which, by the way, are actively supported by medical workers themselves:

Symptoms

• discomfort in the navel, in the upper abdomen, moderate pulling pains that are not sharp or pronounced, the sensations are not permanent;
• loss or disturbance of appetite, change in taste preferences, feeling of slight nausea;
• the child's tummy is often swollen, after eating you can hear a rumbling;

• stool instability - diarrhea is replaced by constipation and vice versa;
• prolonged diarrhea (several days);
• feces are yellow or yellowish in color and uneven in texture, in some places there are blotches of mucus;
• general weakness, irritability, capriciousness of the child;
• if the baby was previously diagnosed with atopic dermatitis, an exacerbation may begin;
• body temperature is usually normal, very rarely it rises to subfebrile values ​​(37.0 - 37.9 degrees).

The most common symptom is weight loss. As we have already found out, Giardia suck out many useful substances from the small intestine that get there with food. And if you consider that the child already has a reduced appetite, then the weight will really begin to change downwards. Babies will experience delayed weight gain or the weight will stay in one place.

In acute giardiasis, if a very large number of cysts immediately enter the child's body, the temperature may rise to 38.0 degrees, and all of the above symptoms will be quite pronounced. They may be accompanied by vomiting and severe headaches.

Diagnostics

It is possible to establish the presence of Giardia cysts in the body of a child only by the results of stool tests, the so-called coprological analysis. However, cysts are not always found in the material, since they do not always end up in the portion of feces that the parents took to be sent to the laboratory. To get to the bottom of the truth (if you really want to get to the bottom of it) you need to bring a fecal analysis to the clinic once a week for at least a month. Only then will laboratory assistants be able to answer the question with a probability of up to 90% if the child has lamblia.

Often pediatricians write out a referral for a serological blood test. To do it, the child must be raised early, not fed, and prepared for his protests, since blood is taken exclusively from a vein. To take this analysis or not, it's up to the parents, because it is not considered informative in terms of the development of giardiasis. A certain amount of specific antibodies to Giardia in the blood during a serological analysis can, in principle, be detected, but only 3-4 weeks after infection. And since it is impossible to identify the fact of infection in time, serological analysis cannot be considered a reliable diagnosis.

A rather unpleasant diagnostic method is duodenal examination. It can be assigned to a child who is already 10 years old. During probing, the child will need to swallow a one and a half meter probe, which will take bile samples. The method was previously widespread, since medicine sincerely considered Giardia to be the culprit of problems with the gallbladder and duodenum.

Numerous recent studies have shown the failure of such a relationship, and therefore parents have the right to refuse painful diagnostic probing as uninformative, even if the doctor insists on it. Surely the doctor is an adherent of the old fundamental medical school.

A simpler and more revealing method is enterotest.

The child is given a gelatin capsule to drink. Inside the capsule is a nylon thread. It will be released after the capsule dissolves in the stomach. The thread will pass through the small intestine, Giardia will definitely stick to it, if any, after which it will come out with feces through the large intestine. Emptying is provoked by taking a laxative 2 hours after swallowing the capsule.

Treatment

The World Health Organization gives very specific instructions for this case - it is necessary to start treating giardiasis with medicines only when the diarrhea has not stopped for 7-10 days. In this case, Giardia must be detected and confirmed.

In more complex cases, when prolonged diarrhea is not the only symptom, the doctor may prescribe a three-stage treatment regimen.

Elimination of intoxication and help immunity

To remove possible skin manifestations, antihistamines are prescribed in an age dosage. The best remedy for a very young child - 1 year, 2 years - " Suprastin". It is recommended to take it in tablets. Choleretic drugs and enterosorbents can be prescribed as adjuvant therapy. As a cholagogue, children from 5 years old are often prescribed a herbal preparation " Hofitol».

A combination drug that contains both metronidazole and furazolidone is very popular - "Emigil-F". For children over 5 years old, it is given in tablets, and for babies up to a year old - in suspension. Quite often, children with acute giardiasis are prescribed the drug "Nemozol". It is available only in tablets. The doctor calculates the age dose based on the weight of the child. The average course of treatment is from 5 to 7 days.

Some other well-known antihelminthic drugs, for example, Pirantel, are ineffective for giardiasis, since they have a rather limited spectrum of action that does not apply to protozoan microorganisms.

These funds are prescribed courses in tablets. If the situation is close to critical, and the child’s diarrhea against the background of giardiasis has lasted for more than 10 days, then “heavy artillery” can be used - drugs that need to be taken once, for example, Tinidazole.

Consolidation of results

The third stage largely repeats the first, since it is aimed at creating such conditions in the body under which Giardia will be extremely uncomfortable to settle in it again. Of course, it is impossible to reduce such a risk to zero, because Giardia is widespread, but at least you can try. For a month, the child must adhere to a special

Giardia can also settle in the small intestine, causing the onset and development of a disease called giardiasis.

What is lamblia?

Treatment regimen

Treatment of Giardia in children involves the use of a number of stages:

Treatment of lamblia in children according to Komarovsky

Dr. Komarovsky's approach to the treatment of this disease is somewhat different.

Furazolidone drug: how to take it?

Komarovsky believes that this drug should be given preference. The tool is quite old, reliable and proven. It is used not only in the treatment of giardiasis, but also in many other intestinal disorders.

According to the doctor, it is necessary to prescribe pills based on the body weight of the child. For every kilogram of weight, there should be 10 mg of this substance in active form. The course of taking the drug is 10 days. The multiplicity of reception is three times a day.

Children may not get sick, but be healthy carriers. Some experts believe that the treatment of carriage is possible with the help of diet.

In general, food should be fractional. Eat often, but little by little. Water with gas and sweet juices are completely excluded from the diet. According to Dr. Komarovsky, during treatment, the child must consume a large amount of fluid.

Treatment should begin immediately! Protect yourself and your loved ones!

Folk remedies for the treatment of giardiasis

Folk remedies against giardiasis:

• It will help with the disease of burnet in the form of a decoction. Grass roots are taken in the amount of two spoons and boiled water is poured in the amount of two glasses. After that, the mixture is aged on low heat with an exposure of 1/3 hour. Within 60 minutes, the composition is infused. The entire volume is divided into 4 parts and drunk during the day.
• Dandelion roots are a good remedy. They are also used as a decoction. A spoonful of medicinal raw materials is poured with boiling water in the amount of one glass and placed for a third of an hour in a water bath. The remedy is taken in equal parts during the day.
• In the same way, a decoction is prepared, where leaves and bark of an aspen tree act as medicinal raw materials. Take a decoction before meals.
• An excellent remedy is plantain in the form of leaves on honey. The proportions for cooking are the same. Reception is long, within a month. It is enough to take a teaspoon before meals.
• An old proven remedy is pumpkin seeds. They must be taken in an amount of 100 g and grind. To them you need to add honey and water, 25 ml each. The mixture is taken in full within an hour.

We have 2 dogs and a cat at home, we regularly carry out preventive measures against infection with helminths. We really like the remedy, because it is completely natural, and this is important for prevention."

How to accurately determine whether a child is infected with Giardia?

The research material is:

• blood;

Detection of Giardia in feces

The study of feces involves the use of the following methods:

After 2 weeks from the moment of infection, it is possible to detect antibodies in the child's blood. The accuracy of the method depends on how the laboratory is equipped and what qualifications its employees have.

It is possible to confirm the diagnosis with an accuracy of 100% by examining the gastric contents obtained by duodenal sounding. However, due to the complexity of the procedure in technical terms, for children, this method is not practiced.

A very effective diagnostic method is PCR, in which Giardia DNA is detected in biological substrates.

throat swab

Often, the disease can cause a child to develop a painful cough. The reason for it is an allergic reaction that occurs due to infection with Giardia.

Or from flagellated protozoa, it can last 3 months or even longer. It is always accompanied by sputum production.

Infection: step by step

Transfer factors can be:

• water from reservoirs and from the tap;
• use of shared toys;
• vegetables, fruits, greens in assortment;
• pets;
• sandbox play;
• having a bad habit of putting your hands in your mouth.

Once in the body, Giardia reach the small intestine, finding there comfortable conditions for their existence and development.

Failure to comply with elementary hygiene standards and rules contributes to infection with them.

The entry of protozoa into the body does not mean the mandatory development of the disease. If the body's defenses are at a fairly high level, it simply will not allow them to develop. The amount of lamblia that has entered the body also matters.

1. The child is lethargic and loses weight.
2. Severe diarrhea that is prolonged. The stool has an extremely unpleasant odor. Due to the large amount of undigested fats, it is very poorly washed off.
3. The temperature can rise up to 38 degrees.
4. Pain in the umbilical region.
5. Skin itching.
6. Dyspeptic phenomena in the form of nausea and vomiting.

giardiasis, giardiasis, giardiasis

For the first time, the causative agent of giardiasis - Lamblia intestinalis - was described by the professor of Kharkov University D.F. Lyamble in 1859. Only in Russia and the former countries of the USSR, the disease was called giardiasis - in honor of the discoverer. All over the world it is called differently - giardiasis, giardiasis. Giardia have two forms: the lamblia itself is live, active, and the cyst is a fixed form. Infection most often occurs when cysts enter the body.

Why is giardiasis so common in Russia

Giardiasis is a disease of low sanitary culture. This does not mean that Russians wash their hands worse or less often than the British or Germans. It's just that in Russia and the countries of the former USSR Giardia in the external environment is much larger. According to the degree of infection, Russia is considered an endemic country, that is, the probability of getting Giardia here is very high. Why?

• Poor water disinfection. Water is the main source of Giardia infection. Chlorination does not kill these protozoa. And other methods of disinfection in Russia do not work. Studies have shown that Giardia die during ozonation, but not all.
• Dog excrement on the street. Abroad, dog owners clean their pets' feces in bags; this “cultural tradition” has not yet taken root in our country. Giardia cysts live in the feces of animals and "come" into our homes along with dirty shoes. Also, excrement is washed away by rains, gets into groundwater, then into water bodies.
• Non-compliance with sanitary standards in the villages. Pit latrines predominate in rural areas. Feces penetrate into groundwater, are washed away by rains, and with melt water enter the reservoirs that feed large cities.
• Fecal drains. Illegal diversion of fecal effluents and dumping of feces into water bodies leads to infection with Giardia and their wide distribution.

Now it becomes clear why foreigners in Russia often have "traveler's diarrhea". In most cases, it is provoked precisely by the abundance of Giardia in our environment. It becomes clear why children are so often infected. This is due not only to age-related physiology, but also to the method of infection - through dirty hands. After all, it is not always possible to control the behavior of children on the street. Many people have a habit of putting their hands in their mouths, biting their nails, licking their fingers, digging in sandboxes with dubious sanitary standards, etc.

Survey

Diagnosis of giardiasis in children in modern medicine can be carried out by several methods.

Neither blood, nor the now popular computer diagnostics, nor all kinds of swabs from the throat provide reliable and accurate information. Therefore, the most reliable and effective diagnostic method in children of different ages is a repeated analysis of feces.

Is it necessary to treat

The opinions of doctors on this matter were divided. And in the end, parents have to take responsibility for choosing a doctor with a specific point of view on this disease and principles of treatment.

• Do not treat. Some doctors do not consider giardiasis a disease and say that the body itself can cope with the protozoa that have settled in the small intestine. True, there is no permanent immunity to this disease. If the baby has had the disease, and even been treated, there is no guarantee that the cysts will not enter the gastrointestinal tract (GIT) in an hour, a day or a week again. By the way, the treatment of giardiasis in Europe and the United States is prescribed much less frequently than in Russia.
• Treat always and in a variety of ways. Other doctors insist on immediate treatment. Some of the methods act like a placebo. It has been proven that the treatment of giardiasis with ultrasound or dietary supplements is ineffective. But people believe it.
• Treat only if there are symptoms. According to the World Health Organization (WHO), giardiasis should be treated when there are symptoms. Alas, in Russia this is not always taken into account: they treat with positive tests.

Symptoms of the disease

Symptoms of giardiasis in children can manifest themselves in different ways, some of them may be absent altogether:

• pain in the abdomen;
• digestive disorders: diarrhea is more common, sometimes diarrhea is replaced by constipation;
• constant nausea;
• bloating;
• poor appetite;
• irritability, restless sleep, weakness;
• weight loss.

The main symptom of giardiasis is prolonged (more than 10 days) diarrhea. At the same time, there are no typical symptoms of AII - no vomiting, no temperature, and giardia was found in the analysis of feces. In this case, treatment is required. If the diarrhea went away after three days, this means that the child's body coped with the problem on its own. In this case, no treatment is needed.

Treatment of giardiasis

The goal of treatment is to eliminate Giardia from the small intestine. In general, children tolerate giardiasis more easily. The prognosis of the disease is favorable, but long-term treatment. However, the risk of reinfection is high. The treatment regimen for giardiasis in children includes three stages.

Anti-lamblia drugs are prescribed by a doctor. The following important points are taken into account: effectiveness, safety (the medicine is suitable for the child by age), good tolerance by the child's body, the presence of concomitant diseases. In case of any side effects, you should immediately consult a doctor. With severe sensitivity to the drug, the doctor will prescribe another medicine.

Separately about antigiardia drugs

Some doctors believe that no schemes, stages, stages of treatment are needed. It is enough to use an anti-infective medicine that will destroy Giardia and cysts.

Table - Overview of drugs used in the treatment of Giardia in children

Unfortunately, due to the frequent use of antimicrobial drugs, lamblia become "addicted" to drugs. You have to change the drug several times in order for it to work. In chronic forms of giardiasis, several courses of drug therapy are prescribed.

Myths and legends about Giardia

In modern medicine, many accurate, informative research methods and scientific discoveries have appeared. Therefore, some diagnoses and hypotheses associated with Giardia were not confirmed in any way, remained at the level of myths and legends.

• Giardia in the liver in children. Back in the middle of the twentieth century, it was proved that Giardia die from bile. Despite this fact, the myth of their presence in the liver and gallbladder is firmly established in the minds of people. Therefore, the "terrible" diagnosis - Giardia in the liver - should not be taken seriously. These protozoa can only live in the small intestine.
• Giardia is the cause of atopic dermatitis. Infants and children under 4 years of age are often diagnosed with atopic dermatitis. It is associated with the immaturity of the digestive system, often hereditary. Giardia can increase the manifestation of dermatitis, but cannot be the cause of it.
• Cough with giardiasis in children. In some sources, you can find a statement: the appearance of a cough is due to an allergy to Giardia. Allergic cough and shortness of breath - a protective mechanism of the body, a reaction to the presence of lamblia in the small intestine. This view is more of a hypothesis. Often, with a prolonged cough, the cause of which is difficult to establish, the doctor prescribes a variety of examinations, including an analysis for Giardia. The latter are often found in the stool of a child. And it turns out that Giardia is to blame for everything, even for coughing.

On the Internet you can find a huge number of articles on the topic "giardia in a child." There is no need to rush to diagnose them. It is important to find a doctor you trust much more than online materials.

How nutrition can help: 9 requirements

A diet for giardiasis in children helps to alleviate the condition or even get rid of the disease. A properly selected menu will not only help stop diarrhea, reduce flatulence, remove inflammation of the gastrointestinal tract, but will also be aimed at combating the pathogens themselves - Giardia.

It is possible to cure giardiasis in children with a diet, but it takes a long time, patience and consistency. You can’t ban sweets today, give them tomorrow, and start all over again from Monday. The diet can last up to 3 months.

Giardia treatment in children is required only when there are symptoms. The main signs are prolonged diarrhea without signs of AII, weight loss, abdominal pain. During examination, cysts can be detected in the feces, but the baby will be healthy. This means that he is a carrier of the disease. According to the order of the Ministry of Health of the Russian Federation, such children should not be allowed into the children's team, even without symptoms they must be treated.

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Giardia cysts, getting into the intestines of the child, are released from the membranes and begin to actively multiply. For growth and development, they need nutrients, which they begin to receive by sticking to the walls of the intestine. As a result, the child's body does not receive the right amount of nutrients, vitamins, minerals and amino acids, which negatively affects the health and well-being of the baby.

The processes of absorption and assimilation of the necessary substances are disrupted, as a result of which beriberi develops and there is a lag in growth and overall development. In the process of vital activity, lyablia release toxins into the blood of the child, which suppress the immune system and provoke severe allergic reactions. Children infected with Giardia suffer from manifestations of atopic dermatitis, bronchial asthma, chronic bronchitis and colds.

In addition, babies have symptoms of damage to the gastrointestinal tract and the autonomic nervous system. Intoxication with giardiasis leads to an increase in lymph nodes and the appearance of such neurological syndromes as grinding teeth in a dream, tics, hand trembling. The child quickly gets tired, often complains of inexplicable weakness, suffers from mood swings and a decrease in emotional tone. What symptoms should alert parents and serve as a reason for going to the doctor?

Symptoms

Labliosis in children can occur in both acute and chronic forms. In some cases, there is an asymptomatic course of the disease. In childhood, the disease often occurs in an acute form, which is characterized by the presence of the following symptoms:

• Prolonged rise in temperature to subfebrile values ​​(37.2 - 37.5 ° C).
• Nausea, diarrhea. Liquid, foamy stools can be up to 10 times a day.
• Bloating, flatulence.
• Pain syndrome without a clear localization. The pain is aggravated by palpation.
• Decreased vitality, tearfulness, anxiety.
• Sleep disturbances, teeth grinding in sleep.
• Enlarged lymph nodes.

Diagnostics

Treatment

In the treatment of giardiasis in children, a scheme consisting of three stages is used:

The preparatory stage consists in measures that reduce the intoxication of the body. To do this, choleretic agents are used, enterosorbents and enzyme preparations are prescribed, which normalize digestion processes, eliminate congestion from the biliary tract and reduce inflammation. Along with these drugs, antispasmodic drugs and drugs that help strengthen the immune system are included in the treatment regimen. An important role is given to the observance of a special diet.

involves avoiding simple carbohydrates. Banned sweets, flour and confectionery products, whole milk. The basis of the diet is gray cereals (oatmeal, buckwheat, wheat). It is recommended to give the child baked apples, fresh vegetables and fruits rich in fiber, make salads with vegetable oil, make drinks from sour berries (cranberries, lingonberries). It is useful to use mineral water (Slavyanskaya, Essentuki No. 4). The preparatory stage takes 2-3 weeks, it is necessary to prevent complications and increase the effectiveness of subsequent therapy.

Anthelmintic therapy is carried out in two courses. The second course is carried out 7-10 days after the first.

provides for the use of lean boiled meat, low-fat fish, dairy products (kefir, yogurt, cottage cheese). Rice, buckwheat, oatmeal, fresh vegetables and fruits, vegetable purees are useful. Sugar, flour products, sweets and other products containing carbohydrates are excluded from the menu. The child should be provided with an enhanced drinking regimen in order to make up for the lack of fluid in the body and remove the remnants of toxins. Give your baby mineral water, sour fruit drinks, green tea with lemon, dried fruit compote.

To consolidate a positive result, the child is given decoctions of medicinal herbs that have anti-inflammatory, regenerating, choleretic effects. In addition, the doctor will prescribe vitamin complexes and drugs to strengthen the immune system. In the summer season, sea bathing, air and sunbathing will be useful.

Proven folk recipes for the treatment of giardiasis help to improve the child's condition and reduce the risk of possible complications. Before using folk remedies, be sure to consult with your doctor and get his approval for the procedure.

Prevention

The following preventive measures will help prevent relapses:

• Teaching hygiene habits to children
• Use only boiled water for drinking
• Thoroughly wash and boil vegetables and fruits
• Keep your baby away from pets
• Avoid swimming in open, polluted waters

Following simple recommendations will significantly reduce the risk of re-infection. But the likelihood of infection will remain, therefore, if any unfavorable signs appear, you should immediately contact a specialist for an anti-relapse course of treatment.