Materiały źródłowe

• #1 Giardia duodenalis – Wikipedia

  https://en.wikipedia.org/wiki/Giardia_duodenalis

  G. duodenalis causes an infection called giardiasis. This disease is the cause of both endemic and epidemic disease worldwide and is the most frequently identified intestinal parasite in the United States and Canada. An infected individual can excrete between 1 million and 1 billion cysts daily, and the infectious dose can be as low as 10 cysts. This makes Giardia extremely infectious. […] It is estimated to infect over 280 million people world every year resulting in over 500,000 deaths. The most affected demographic is children 0 to 4 years of age. Globally G. duodenalis is the most commonly identified protozoal intestinal parasite. […] Giardia has common seasonal patterns in the distribution of infection rates with highest peaks in the late summer to early fall.

• #2 Giardiasis – Wikipedia

  https://en.wikipedia.org/wiki/Giardiasis

  Giardiasis occurs worldwide. […] It is one of the most common parasitic human diseases. […] Infection rates are as high as 7% in the developed world and 30% in the developing world. […] In 2013, there were approximately 280 million people worldwide with symptomatic cases of giardiasis. […] The World Health Organization classifies giardiasis as a neglected disease. […] The number of reported cases in the United States in 2018 was 15,584. […] All states that classify giardiasis as a notifiable disease had cases of giardiasis. […] There are seasonal trends associated with giardiasis. […] July, August, and September are the months with the highest incidence of giardiasis in the United States. […] In the ECDC’s (European Centre for Disease Prevention and Control) annual epidemiological report containing 2014 data, 17,278 confirmed giardiasis cases were reported by 23 of the 31 countries that are members of the EU/EEA.

• #3

  https://journals.lww.com/jfmpc/fulltext/2023/12100/trends_and_clinico_epidemiological_profile_of.42.aspx

  Awareness and knowledge amongst the primary healthcare professionals and family physicians will help in early diagnosis and treatment of Giardiasis. […] Fecal antigen detection should be done along with microscopy for detection of Giardiasis. […] Globally, about 280 million people suffer from symptomatic Giardia infection annually. […] Although distributed worldwide, the prevalence of Giardiasis ranges from 20% to 30% in developing countries compared to 2% to 5% in developed countries. […] In India, the prevalence of Giardia varies from 3.8 to 23.5%. […] Giardiasis commonly presents as acute or chronic diarrhea, weight loss, abdominal cramp, and malabsorption. […] Early identification of Giardiasis will help in its treatment simply with antigiardial drugs and thus minimize postinfectious and long-term sequelae.

• #4 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Giardiasis is the most prevalent enteric protozoal infection globally, affecting nearly 2% of adults and 8% of children in developed countries. About 33% of individuals in developing countries have been infected with giardiasis. Giardiasis spans temperate and tropical regions, with prevalence rates between 4% and 42%. In industrialized countries, prevalence rates are 2% to 5%. Giardiasis constitutes a significant cause of epidemic diarrhea among children in the developing world, with prevalence rates reaching 15% to 20% in those under 10 years. Giardia is among the most common gut parasites in the United Kingdom, with particularly high infection rates in Eastern Europe. […] The estimated prevalence of giardiasis in the US is approximately 1.2 million cases, although most of these cases go unnoticed because carriers remain asymptomatic. According to data from the Centers for Disease Control and Prevention (CDC), 15,223 cases were reported in 2012. Children aged 0 to 4 years were the most affected demographic group, with the largest percentage of cases being reported from the northwest US. Notably, Yoder et al observed that the prevalence in northern states could be associated with variations in state-level surveillance systems and may not reflect a higher incidence. Giardiasis exhibits peak incidence during late summer and early fall, correlating with increased outdoor water activities.

• #5 Giardiasis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/giardiasis

  Giardiasis has a worldwide distribution. Children are infected more frequently than adults. Prevalence is higher in areas of poor sanitation and in institutions with children who are not toilet trained, especially child care centers. It infects nearly 2% of adults and 6% to 8% of children in developed countries worldwide. Nearly 33% of people in developing countries have had giardiasis. In the United States, Giardia infection is the most common intestinal parasitic disease affecting humans. Surveys conducted in the United States have demonstrated prevalence rates of Giardia in stool specimens that range from 1% to 30%, depending on location and age. Cases occur more commonly in the summer and fall months. […] The Council of State and Territorial Epidemiologists (CSTE) surveillance case definitions should not affect the investigation or reporting of a case that fulfills the criteria in this chapter. (CSTE case definitions are used by the state health department and the CDC to maintain uniform standards for national reporting.)

• #6 Giardiasis: Epidemiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/giardiasis-epidemiology-clinical-manifestations-and-diagnosis/print

  Giardiasis is an important cause of waterborne and foodborne disease, daycare center outbreaks, and illness in international travelers. […] G. duodenalis infection occurs worldwide. High-risk groups include infants, young children, international adoptees, travelers, immunocompromised individuals, and patients with cystic fibrosis. […] Giardiasis is especially common in areas with poor sanitary conditions and limited water-treatment facilities. Children <10 years have higher rates of giardiasis than older individuals. In some areas with poor sanitation, the prevalence of giardiasis has been reported to be as high as 20 to 40 percent; in such settings, the rate of infection is highest among children <5 years. Worldwide, G. lamblia is a common agent of diarrheal disease in children <5 (after rotavirus and Cryptosporidium spp); >300 million cases are reported annually. Peaks in cases are often observed during spring and summer months with warm, humid climatic conditions.

• #7 Giardia duodenalis – Wikipedia

  https://en.wikipedia.org/wiki/Giardia_duodenalis

  In addition to waterborne sources, Giardia infections are more commonly found in children compared to adults, this is believed to be due to fecal-oral transmission of the cysts. For example, in developed countries it affects approximately 2% of adults and 8% of children. In developing countries the prevalence rates reach 15% to 20% in children under 10 years old. Thus, there is a significant variation in infection rates based on geographical area. […] G. duodenalis is the most widespread intestinal parasite affecting humans. The parasite Giardia duodenalis can be found all over the world, in both developing and industrialized nations. However, human infections are most common in tropical and subtropical climates. […] Giardiasis is more prevalent in developing countries, where the sanitation and overall hygiene is poorer compared to developed countries. In developed nations, giardiasis has a prevalence of 25%, whereas in developing nations it is significantly higher, ranging from 20% to 30%.

• #8 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Giardiasis is the most prevalent enteric protozoal infection globally, affecting nearly 2% of adults and 8% of children in developed countries. About 33% of individuals in developing countries have been infected with giardiasis. Giardiasis spans temperate and tropical regions, with prevalence rates between 4% and 42%. In industrialized countries, prevalence rates are 2% to 5%. Giardiasis constitutes a significant cause of epidemic diarrhea among children in the developing world, with prevalence rates reaching 15% to 20% in those under 10 years. Giardia is among the most common gut parasites in the United Kingdom, with particularly high infection rates in Eastern Europe. […] The estimated prevalence of giardiasis in the US is approximately 1.2 million cases, although most of these cases go unnoticed because carriers remain asymptomatic. According to data from the Centers for Disease Control and Prevention (CDC), 15,223 cases were reported in 2012. Children aged 0 to 4 years were the most affected demographic group, with the largest percentage of cases being reported from the northwest US. Notably, Yoder et al observed that the prevalence in northern states could be associated with variations in state-level surveillance systems and may not reflect a higher incidence. Giardiasis exhibits peak incidence during late summer and early fall, correlating with increased outdoor water activities.

• #9 Giardia duodenalis – Wikipedia

  https://en.wikipedia.org/wiki/Giardia_duodenalis

  In addition to waterborne sources, Giardia infections are more commonly found in children compared to adults, this is believed to be due to fecal-oral transmission of the cysts. For example, in developed countries it affects approximately 2% of adults and 8% of children. In developing countries the prevalence rates reach 15% to 20% in children under 10 years old. Thus, there is a significant variation in infection rates based on geographical area. […] G. duodenalis is the most widespread intestinal parasite affecting humans. The parasite Giardia duodenalis can be found all over the world, in both developing and industrialized nations. However, human infections are most common in tropical and subtropical climates. […] Giardiasis is more prevalent in developing countries, where the sanitation and overall hygiene is poorer compared to developed countries. In developed nations, giardiasis has a prevalence of 25%, whereas in developing nations it is significantly higher, ranging from 20% to 30%.

• #10 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Giardiasis is the most prevalent enteric protozoal infection globally, affecting nearly 2% of adults and 8% of children in developed countries. About 33% of individuals in developing countries have been infected with giardiasis. Giardiasis spans temperate and tropical regions, with prevalence rates between 4% and 42%. In industrialized countries, prevalence rates are 2% to 5%. Giardiasis constitutes a significant cause of epidemic diarrhea among children in the developing world, with prevalence rates reaching 15% to 20% in those under 10 years. Giardia is among the most common gut parasites in the United Kingdom, with particularly high infection rates in Eastern Europe. […] The estimated prevalence of giardiasis in the US is approximately 1.2 million cases, although most of these cases go unnoticed because carriers remain asymptomatic. According to data from the Centers for Disease Control and Prevention (CDC), 15,223 cases were reported in 2012. Children aged 0 to 4 years were the most affected demographic group, with the largest percentage of cases being reported from the northwest US. Notably, Yoder et al observed that the prevalence in northern states could be associated with variations in state-level surveillance systems and may not reflect a higher incidence. Giardiasis exhibits peak incidence during late summer and early fall, correlating with increased outdoor water activities.

• #11 Giardiasis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/176718-overview

  Giardiasis is a major diarrheal disease found throughout the world. The flagellate protozoan Giardia intestinalis (previously known as G lamblia or G duodenalis), its causative agent, is the most commonly identified intestinal parasite in the United States and the most common protozoal intestinal parasite isolated worldwide. Infection is more common in children than in adults. […] Giardia species are endemic in areas of the world that have poor sanitation. In developing countries, the disease is an important cause of morbidity. Water-borne and food-borne outbreaks are common. […] High-risk groups for giardiasis include travelers to highly endemic areas, immunocompromised individuals, and sexually active homosexual men. […] Giardia remains the parasite most commonly identified in stool specimens, causing about 1.2 million annual episodes of illness. From 1964 to 1984, G lamblia caused at least 90 water-borne outbreaks of diarrhea, affecting more than 23,000 people. More recently, between 2012 to 2017 there were 111 outbreaks.

• #12 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Giardiasis is the most prevalent enteric protozoal infection globally, affecting nearly 2% of adults and 8% of children in developed countries. About 33% of individuals in developing countries have been infected with giardiasis. Giardiasis spans temperate and tropical regions, with prevalence rates between 4% and 42%. In industrialized countries, prevalence rates are 2% to 5%. Giardiasis constitutes a significant cause of epidemic diarrhea among children in the developing world, with prevalence rates reaching 15% to 20% in those under 10 years. Giardia is among the most common gut parasites in the United Kingdom, with particularly high infection rates in Eastern Europe. […] The estimated prevalence of giardiasis in the US is approximately 1.2 million cases, although most of these cases go unnoticed because carriers remain asymptomatic. According to data from the Centers for Disease Control and Prevention (CDC), 15,223 cases were reported in 2012. Children aged 0 to 4 years were the most affected demographic group, with the largest percentage of cases being reported from the northwest US. Notably, Yoder et al observed that the prevalence in northern states could be associated with variations in state-level surveillance systems and may not reflect a higher incidence. Giardiasis exhibits peak incidence during late summer and early fall, correlating with increased outdoor water activities.

• #13 Giardiasis – Wikipedia

  https://en.wikipedia.org/wiki/Giardiasis

  Giardiasis occurs worldwide. […] It is one of the most common parasitic human diseases. […] Infection rates are as high as 7% in the developed world and 30% in the developing world. […] In 2013, there were approximately 280 million people worldwide with symptomatic cases of giardiasis. […] The World Health Organization classifies giardiasis as a neglected disease. […] The number of reported cases in the United States in 2018 was 15,584. […] All states that classify giardiasis as a notifiable disease had cases of giardiasis. […] There are seasonal trends associated with giardiasis. […] July, August, and September are the months with the highest incidence of giardiasis in the United States. […] In the ECDC’s (European Centre for Disease Prevention and Control) annual epidemiological report containing 2014 data, 17,278 confirmed giardiasis cases were reported by 23 of the 31 countries that are members of the EU/EEA.

• #14 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  Giardiasis is the most common intestinal parasitic disease of humans identified in the United States (US) and an important waterborne disease. In the United States, giardiasis has been variably reportable since 1992 and was made a nationally notifiable disease in 2002. Our objective was to describe the epidemiology of US giardiasis cases from 1995 through 2016 using National Notifiable Diseases Surveillance System data. […] During 1995-2016, the average number of reported cases was 19,781 per year (range, 14,623-27,778 cases). The annual incidence of reported giardiasis in the United States decreased across all age groups. This decrease differs by age group and sex and may reflect either changes in surveillance methods (eg, changes to case definitions or reporting practices) or changes in exposure. Incidence rates in males and older age groups did not decrease to the same extent as rates in females and children.

• #15 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  We describe significant declines in the rates of reported giardiasis in the United States during 1995-2016. We observed considerable variations in the incidence of reported giardiasis cases between age groups and sex and among US states and jurisdictions. […] Giardiasis has declined significantly in the United States, and the age and sex groups at highest risk have changed. Our findings should be used by federal, state, and local public health agencies to guide and implement targeted evidence-based disease prevention strategies and research priorities for giardiasis. Further investigation is needed to explain the apparent plateau in rates between 2012 and 2015, if the increase in 2016 continues thereafter; higher and increasing reporting in males, especially among certain age groups; variability in geographical distribution; and how the increasing use of molecular diagnostics will influence the future notification and surveillance of giardiasis in the United States.

• #16 Giardiasis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/176718-overview

  Giardiasis is a major diarrheal disease found throughout the world. The flagellate protozoan Giardia intestinalis (previously known as G lamblia or G duodenalis), its causative agent, is the most commonly identified intestinal parasite in the United States and the most common protozoal intestinal parasite isolated worldwide. Infection is more common in children than in adults. […] Giardia species are endemic in areas of the world that have poor sanitation. In developing countries, the disease is an important cause of morbidity. Water-borne and food-borne outbreaks are common. […] High-risk groups for giardiasis include travelers to highly endemic areas, immunocompromised individuals, and sexually active homosexual men. […] Giardia remains the parasite most commonly identified in stool specimens, causing about 1.2 million annual episodes of illness. From 1964 to 1984, G lamblia caused at least 90 water-borne outbreaks of diarrhea, affecting more than 23,000 people. More recently, between 2012 to 2017 there were 111 outbreaks.

• #17 Giardiasis: Epidemiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/giardiasis-epidemiology-clinical-manifestations-and-diagnosis/print

  Giardiasis is an important cause of waterborne and foodborne disease, daycare center outbreaks, and illness in international travelers. […] G. duodenalis infection occurs worldwide. High-risk groups include infants, young children, international adoptees, travelers, immunocompromised individuals, and patients with cystic fibrosis. […] Giardiasis is especially common in areas with poor sanitary conditions and limited water-treatment facilities. Children <10 years have higher rates of giardiasis than older individuals. In some areas with poor sanitation, the prevalence of giardiasis has been reported to be as high as 20 to 40 percent; in such settings, the rate of infection is highest among children <5 years. Worldwide, G. lamblia is a common agent of diarrheal disease in children <5 (after rotavirus and Cryptosporidium spp); >300 million cases are reported annually. Peaks in cases are often observed during spring and summer months with warm, humid climatic conditions.

• #18 Giardiasis – Wikipedia

  https://en.wikipedia.org/wiki/Giardiasis

  Giardiasis occurs worldwide. […] It is one of the most common parasitic human diseases. […] Infection rates are as high as 7% in the developed world and 30% in the developing world. […] In 2013, there were approximately 280 million people worldwide with symptomatic cases of giardiasis. […] The World Health Organization classifies giardiasis as a neglected disease. […] The number of reported cases in the United States in 2018 was 15,584. […] All states that classify giardiasis as a notifiable disease had cases of giardiasis. […] There are seasonal trends associated with giardiasis. […] July, August, and September are the months with the highest incidence of giardiasis in the United States. […] In the ECDC’s (European Centre for Disease Prevention and Control) annual epidemiological report containing 2014 data, 17,278 confirmed giardiasis cases were reported by 23 of the 31 countries that are members of the EU/EEA.

• #19

  https://journals.lww.com/jfmpc/fulltext/2023/12100/trends_and_clinico_epidemiological_profile_of.42.aspx

  Giardiasis is an important cause of diarrheal disease and is associated with morbidity in children and adults worldwide. […] We aimed to study the prevalence of Giardiasis, its clinical presentations, seasonal trends in detection, and coinfection with other intestinal parasites along with comparison of fecal antigen and microscopy for the detection of Giardiasis. […] Of 8364 patients, 432 (5.2%) had Giardiasis by microscopy and/or ELISA. […] Giardiasis was more common in males compared to females (318/5613 [5.6%] vs. 114/2751 [4.1%]; P = 0.003) and among those 10 y compared to older individuals (102/560 [18.2%] vs. 330/7804 [4.2%]; P 0.0001). […] Most cases were detected in the month of May to October. […] The most common clinical presentation was diarrhea (80.1%) and abdominal pain (72.9%) followed by malnutrition (60.2%) and loss of appetite (46.8%).

• #20 Giardiasis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/176718-overview

  Giardiasis is slightly more common in males than in females. A Canadian population study demonstrated infection rates of 21.2 per 100,000 per year versus 17.9 per 100,000 per year for males and females, respectively. […] Giardiasis affects people of all ages. Infection is rare during the first 6 months of life in breastfed infants, but infants and young children have an increased susceptibility to giardiasis. Age-specific prevalence of giardiasis continues to rise through infancy and childhood and begins to decline only in adolescence. […] According to 2003-2005 data from the Centers for Disease Control and Prevention, the greatest number of reported cases occurred among children aged 1-4 and 5-9 years and adults aged 35-44 years.

• #21 Giardiasis: Pediatric OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-pediatric-opportunistic-infections/giardiasis

  Giardia duodenalis (also known as Giardia lamblia or Giardia intestinalis) has a worldwide distribution, and giardiasis due to G. duodenalis is the most common nationally reportable intestinal parasitic disease identified by public health laboratories in the United States. Giardiasis surveillance data show a bimodal age distribution, with the greatest number of reported cases occurring in children aged 1 to 9 years and adults aged 35 to 44 years. […] In the United States, most cases are reported between early summer and early fall and are associated with recreational water activities (e.g., swimming) and camping. […] Humans are the principal reservoir of G. duodenalis. The parasite is found in many animals species, although the role of zoonotic transmission is still being unraveled. […] Infection with Giardia can occur directly by the fecal-oral route or indirectly via ingestion of contaminated water or food, but water contaminated with Giardia cysts appears to be the major reservoir and vehicle for spread of the parasite.

• #22 Giardiasis: Pediatric OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-pediatric-opportunistic-infections/giardiasis

  Most waterborne giardiasis outbreaks have been related to ingestion of untreated or improperly treated surface water. […] G. duodenalis infection is more common in certain high-risk groups, including children, employees and attendees of child care centers, patients and staff of institutions for people with developmental disabilities, men who have sex with men, people who ingest contaminated drinking water or recreational water (e.g., water from lakes, rivers, or inadequately treated swimming pools), travelers to disease-endemic areas of the world, close contacts of people with Giardia, people taking antibiotics, and people exposed to Giardia-infected domestic and wild animals (e.g., dogs, cats, cattle, deer, and beavers). […] There is little information on giardiasis in children with HIV infection, although Giardia has been associated with diarrhea in children with HIV infection and AIDS.

• #23 Giardiasis – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/giardiasis/

  Giardiasis is a diarrheal illness caused by a microscopic parasite called Giardia duodenalis (Giardia for short). It is a fairly common cause of diarrhea throughout the United States and the world. […] Anyone can get giardiasis, but children are more likely to get sick than adults. It tends to occur more often in people in childcare centers, international travelers, and persons who drink improperly treated surface water (such as hikers drinking from a stream or people swallowing water while swimming in a river or lake). […] The Giardia parasite can be found in the feces (stool) of infected people and animals (such as cats, dogs, deer, cattle, and beavers), and their feces can contaminate surfaces, food, or water. […] Symptoms can appear from 3 to 25 days after exposure, but usually appear within 7 to 10 days after exposure.

• #24 Giardiasis Epidemiology | IntechOpen

  https://www.intechopen.com/chapters/56706

  In developed countries, giardiasis represents the leading cause of travelers diarrhea and is frequently reported among citizens that traveled to developing countries and expose themselves to untreated water from lakes, streams, and swimming pools. […] The high prevalence of Giardia among children raised a major concern about their long-term impacts, which currently have been well documented and reported as more worrisome due to the association between persistent Giardia and children’s growth. […] Giardia infections can be detected repetitively in over 40% of children suggesting that persistent infections are common and associated with a damage of the intestinal permeability, which independently of diarrhea can lead to stunted growth. […] Giardiasis prevalence rates have been reported consistently as high among young children from developing countries, with high rates of repeated infection even within the first year of life.

• #25 Giardiasis – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/giardiasis/

  Giardiasis is a diarrheal illness caused by a microscopic parasite called Giardia duodenalis (Giardia for short). It is a fairly common cause of diarrhea throughout the United States and the world. […] Anyone can get giardiasis, but children are more likely to get sick than adults. It tends to occur more often in people in childcare centers, international travelers, and persons who drink improperly treated surface water (such as hikers drinking from a stream or people swallowing water while swimming in a river or lake). […] The Giardia parasite can be found in the feces (stool) of infected people and animals (such as cats, dogs, deer, cattle, and beavers), and their feces can contaminate surfaces, food, or water. […] Symptoms can appear from 3 to 25 days after exposure, but usually appear within 7 to 10 days after exposure.

• #26 Prevalence of Giardia infection in households of Giardia cases and risk factors for household transmission | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2586-3

  The prevalence of additional Giardia infection was measured by dividing the number of households that had at least one case of Giardia infection in addition to an index case by the total number of households included in the study. […] At least one additional case of Giardia infection was detected in 27 households, giving a household prevalence of 30% (27/91). […] The highest association with additional household Giardia infection was with having a child under 5 years old in the household. […] In the multivariable analysis two risk factors remained significantly associated with additional Giardia infection in the household; having children under 5 years in the household and having anyone with gastrointestinal symptoms in the household in the 3 weeks before the index case. […] Our finding of a high household prevalence of asymptomatic infection has raised the public health question of whether treatment of asymptomatic household contacts may be justified in preventing Giardia re-infection of the index case or in preventing household clusters.

• #27 Giardiasis Epidemiology | IntechOpen

  https://www.intechopen.com/chapters/56706

  However, many developed countries have many regions with endemic giardiasis or regular outbreaks. […] At these countries giardiasis outbreaks are particularly common during the summer months (likely due to recreational swimming exposure) or throughout the year around day-cares and nurseries, infecting children under 5 years old and their caregivers the most. […] Surveillance data cases have shown that giardiasis infects populations with a bimodal age distribution, peaking at ages 0-9 years and 45-49 years, without gender preferences. […] Waterborne transmission is recognized as the most common transmission, with numerously documented outbreaks throughout the world. […] Fecal-oral transmission is also a significant mechanism of transmission and is the one responsible for the outbreaks in day-cares and nurseries. […] Sexual transmission of Giardia is now a very well described form of oral-anal transmission and fecal-oral transmission among men who have sex with men. […] Overall, every immunocompromised group, like AIDS patients, is recognized as more susceptible to the development of chronic giardiasis.

• #28 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #29 Giardiasis: Pediatric OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-pediatric-opportunistic-infections/giardiasis

  A recent study in Kenya described the association of enteric pathogens with HIV infection and HIV exposure in children. Giardia was the second most frequently associated pathogen, but the prevalence of Giardia was similar between the children with HIV and those exposed to HIV. […] Symptoms of giardiasis in individuals with HIV infection appear to be no more severe than in individuals who are HIV negative, and giardiasis is not typically considered a major cause of enteritis in patients with HIV. […] However, with progressive immunosuppression and reduced CD4 T-lymphocyte (CD4) cell counts, the risk of symptomatic Giardia infections increases. […] Studies in adults have demonstrated that enteritis due to G. duodenalis is a frequent event among patients with AIDS, especially in the most advanced stage of disease. […] Given the evidence, it is reasonable to recommend initiation of ART and immune reconstitution as a primary mode of Giardia prevention, which is consistent with standard practice to treat all children with HIV infection in the United States.

• #30 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #31 Prevalence of Giardia infection in households of Giardia cases and risk factors for household transmission | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2586-3

  The prevalence of additional Giardia infection was measured by dividing the number of households that had at least one case of Giardia infection in addition to an index case by the total number of households included in the study. […] At least one additional case of Giardia infection was detected in 27 households, giving a household prevalence of 30% (27/91). […] The highest association with additional household Giardia infection was with having a child under 5 years old in the household. […] In the multivariable analysis two risk factors remained significantly associated with additional Giardia infection in the household; having children under 5 years in the household and having anyone with gastrointestinal symptoms in the household in the 3 weeks before the index case. […] Our finding of a high household prevalence of asymptomatic infection has raised the public health question of whether treatment of asymptomatic household contacts may be justified in preventing Giardia re-infection of the index case or in preventing household clusters.

• #32 Giardiasis Epidemiology | IntechOpen

  https://www.intechopen.com/chapters/56706

  However, many developed countries have many regions with endemic giardiasis or regular outbreaks. […] At these countries giardiasis outbreaks are particularly common during the summer months (likely due to recreational swimming exposure) or throughout the year around day-cares and nurseries, infecting children under 5 years old and their caregivers the most. […] Surveillance data cases have shown that giardiasis infects populations with a bimodal age distribution, peaking at ages 0-9 years and 45-49 years, without gender preferences. […] Waterborne transmission is recognized as the most common transmission, with numerously documented outbreaks throughout the world. […] Fecal-oral transmission is also a significant mechanism of transmission and is the one responsible for the outbreaks in day-cares and nurseries. […] Sexual transmission of Giardia is now a very well described form of oral-anal transmission and fecal-oral transmission among men who have sex with men. […] Overall, every immunocompromised group, like AIDS patients, is recognized as more susceptible to the development of chronic giardiasis.

• #33 Giardiasis: Pediatric OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-pediatric-opportunistic-infections/giardiasis

  Giardia duodenalis (also known as Giardia lamblia or Giardia intestinalis) has a worldwide distribution, and giardiasis due to G. duodenalis is the most common nationally reportable intestinal parasitic disease identified by public health laboratories in the United States. Giardiasis surveillance data show a bimodal age distribution, with the greatest number of reported cases occurring in children aged 1 to 9 years and adults aged 35 to 44 years. […] In the United States, most cases are reported between early summer and early fall and are associated with recreational water activities (e.g., swimming) and camping. […] Humans are the principal reservoir of G. duodenalis. The parasite is found in many animals species, although the role of zoonotic transmission is still being unraveled. […] Infection with Giardia can occur directly by the fecal-oral route or indirectly via ingestion of contaminated water or food, but water contaminated with Giardia cysts appears to be the major reservoir and vehicle for spread of the parasite.

• #34 Giardiasis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/176718-overview

  Giardiasis is slightly more common in males than in females. A Canadian population study demonstrated infection rates of 21.2 per 100,000 per year versus 17.9 per 100,000 per year for males and females, respectively. […] Giardiasis affects people of all ages. Infection is rare during the first 6 months of life in breastfed infants, but infants and young children have an increased susceptibility to giardiasis. Age-specific prevalence of giardiasis continues to rise through infancy and childhood and begins to decline only in adolescence. […] According to 2003-2005 data from the Centers for Disease Control and Prevention, the greatest number of reported cases occurred among children aged 1-4 and 5-9 years and adults aged 35-44 years.

• #35

  https://journals.lww.com/jfmpc/fulltext/2023/12100/trends_and_clinico_epidemiological_profile_of.42.aspx

  Giardiasis is an important cause of diarrheal disease and is associated with morbidity in children and adults worldwide. […] We aimed to study the prevalence of Giardiasis, its clinical presentations, seasonal trends in detection, and coinfection with other intestinal parasites along with comparison of fecal antigen and microscopy for the detection of Giardiasis. […] Of 8364 patients, 432 (5.2%) had Giardiasis by microscopy and/or ELISA. […] Giardiasis was more common in males compared to females (318/5613 [5.6%] vs. 114/2751 [4.1%]; P = 0.003) and among those 10 y compared to older individuals (102/560 [18.2%] vs. 330/7804 [4.2%]; P 0.0001). […] Most cases were detected in the month of May to October. […] The most common clinical presentation was diarrhea (80.1%) and abdominal pain (72.9%) followed by malnutrition (60.2%) and loss of appetite (46.8%).

• #36 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Protozoa are transmitted via the fecal-oral route, primarily through consuming contaminated water or food. Person-to-person transmission is also standard, while animal-to-person transmission occurs less frequently. An infected individual can shed 1 million to 1 billion cysts daily, while the infectious dose can be as low as 10. People with subclinical disease can act as carriers, potentially infecting others. Within the US, populations at risk include international travelers, wilderness enthusiasts, daycare workers, certain men who have sex with men, and professionals who have contact with human waste.

• #37 Giardia duodenalis – Wikipedia

  https://en.wikipedia.org/wiki/Giardia_duodenalis

  G. duodenalis causes an infection called giardiasis. This disease is the cause of both endemic and epidemic disease worldwide and is the most frequently identified intestinal parasite in the United States and Canada. An infected individual can excrete between 1 million and 1 billion cysts daily, and the infectious dose can be as low as 10 cysts. This makes Giardia extremely infectious. […] It is estimated to infect over 280 million people world every year resulting in over 500,000 deaths. The most affected demographic is children 0 to 4 years of age. Globally G. duodenalis is the most commonly identified protozoal intestinal parasite. […] Giardia has common seasonal patterns in the distribution of infection rates with highest peaks in the late summer to early fall.

• #38 Giardiasis Epidemiology | IntechOpen

  https://www.intechopen.com/chapters/56706

  However, many developed countries have many regions with endemic giardiasis or regular outbreaks. […] At these countries giardiasis outbreaks are particularly common during the summer months (likely due to recreational swimming exposure) or throughout the year around day-cares and nurseries, infecting children under 5 years old and their caregivers the most. […] Surveillance data cases have shown that giardiasis infects populations with a bimodal age distribution, peaking at ages 0-9 years and 45-49 years, without gender preferences. […] Waterborne transmission is recognized as the most common transmission, with numerously documented outbreaks throughout the world. […] Fecal-oral transmission is also a significant mechanism of transmission and is the one responsible for the outbreaks in day-cares and nurseries. […] Sexual transmission of Giardia is now a very well described form of oral-anal transmission and fecal-oral transmission among men who have sex with men. […] Overall, every immunocompromised group, like AIDS patients, is recognized as more susceptible to the development of chronic giardiasis.

• #39 Giardiasis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/176718-overview

  Giardiasis is a major diarrheal disease found throughout the world. The flagellate protozoan Giardia intestinalis (previously known as G lamblia or G duodenalis), its causative agent, is the most commonly identified intestinal parasite in the United States and the most common protozoal intestinal parasite isolated worldwide. Infection is more common in children than in adults. […] Giardia species are endemic in areas of the world that have poor sanitation. In developing countries, the disease is an important cause of morbidity. Water-borne and food-borne outbreaks are common. […] High-risk groups for giardiasis include travelers to highly endemic areas, immunocompromised individuals, and sexually active homosexual men. […] Giardia remains the parasite most commonly identified in stool specimens, causing about 1.2 million annual episodes of illness. From 1964 to 1984, G lamblia caused at least 90 water-borne outbreaks of diarrhea, affecting more than 23,000 people. More recently, between 2012 to 2017 there were 111 outbreaks.

• #40 Giardiasis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/176718-overview

  Most water-borne outbreaks in the United States have occurred in western mountain regions (eg, Rocky Mountains, Sierra Nevada, Cascades) where giardiasis is considered endemic. The incidence of giardiasis is high among individuals who camp and backpack in mountainous Western states. […] Giardia has a worldwide distribution, occurring in both temperate and tropical regions. It continues to be the most frequently identified human protozoal enteropathogen. Prevalence rates vary from 4% to 42%. In the industrialized world, overall prevalence rates are 2-5%. In the developing world, G intestinalis infects infants early in life and is a major cause of epidemic childhood diarrhea. Prevalence rates of 15-20% in children younger than 10 years are common. […] Giardiasis does not have any race predilection. Native American populations residing on reservations can have high carrier rates.

• #41 Giardiasis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/giardiasis.html

  Giardiasis occurs worldwide. In the United States, G. lamblia is the parasite most commonly identified in stool specimens submitted to state laboratories for parasitologic examination. Other surveys conducted in the United States have demonstrated G. lamblia prevalence rates ranging from 1 percent to 30 percent, depending on the location and ages studied. […] Most transmission occurs sporadically by direct person-to-person contact in households where a case has occurred and among neighborhood contacts with infected children. Epidemics resulting from person-to-person transmission most often occur in daycare centers for preschool-age children and institutions for the developmentally disabled. […] Infections also occur among backpackers and campers who drink untreated stream water. Less commonly, community epidemics caused by contaminated drinking water occur. In such outbreaks, approximately 11 percent of the residents have become infected.

• #42 Prevalence of Giardia infection in households of Giardia cases and risk factors for household transmission | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2586-3

  The prevalence of additional Giardia infection was measured by dividing the number of households that had at least one case of Giardia infection in addition to an index case by the total number of households included in the study. […] At least one additional case of Giardia infection was detected in 27 households, giving a household prevalence of 30% (27/91). […] The highest association with additional household Giardia infection was with having a child under 5 years old in the household. […] In the multivariable analysis two risk factors remained significantly associated with additional Giardia infection in the household; having children under 5 years in the household and having anyone with gastrointestinal symptoms in the household in the 3 weeks before the index case. […] Our finding of a high household prevalence of asymptomatic infection has raised the public health question of whether treatment of asymptomatic household contacts may be justified in preventing Giardia re-infection of the index case or in preventing household clusters.

• #43 Giardia | Mass.gov

  https://www.mass.gov/info-details/giardia

  Giardia is germ (a parasite) that causes an infectious disease (called “giardiasis”) that affects the stomach and bowels. Giardia germ is a common cause of diarrhea in the United States. […] Giardiasis is often spread when people do not wash their hands with soap and water after using the toilet or changing a diaper. […] Giardiasis can also be spread this way in a household setting. […] Yes. Giardia parasites have been found in the stools of many animals, including rodents, dogs, cats, cattle, and wild animals. […] Because giardiasis is a disease that can easily spread to other people, health care providers are required by law to report cases to the local board of health.

• #44 Giardiasis in Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/giardiasis-giardia/giardiasis-in-animals

  Giardiasis is an intestinal infection with the protozoan parasite Giardia spp. Giardia infection occurs worldwide in most domestic and wild mammals and many birds. […] Surveys conducted in different parts of the world have reported point prevalence estimates of Giardia infection of around 10%30% for dogs and somewhat lower for cats, with higher rates of infection in younger animals. […] In general, very young animals (neonates) are less likely to be infected, although animals Giardia infection in some animals. […] In pigs, the occurrence of Giardia tends to be lower, at around 15%, but is age related, with low infection rates (around 5%) recorded from piglets and sows and higher rates reported from starter pigs and fatteners (15%30%). […] Although zoonotic transmission of Giardia to humans is generally rare, it may be more likely to occur from infections in chinchillas.

• #45 SciELO Brazil – Epidemiology of Giardia duodenalis assemblages in Brazil: there is still a long way to go Epidemiology of Giardia duodenalis assemblages in Brazil: there is still a long way to go

  https://www.scielo.br/j/mioc/a/PdK4pSGq9pVXNsTrbBkFQxC/?lang=en

  In Brazil, assemblages A, B, C and E have already been identified in isolates from human faeces samples distributed in 21 studies carried out in the nine states. […] Domestic animals have great relevance in G. duodenalis zoonotic transmission, mainly anthropozoonotic. […] In Brazil, all assemblages (A, B, C, D, E and F) were identified in domestic animals, demonstrating the epidemiological importance of pets in maintaining cysts in the environment. […] Despite these data, given that few areas of the country were studied and also that few hosts were investigated, knowledge about the real epidemiology of G. duodenalis assemblages in Brazil is still a long way to go.

• #46 Giardia Infection: Data and Publications | Giardia | CDC

  https://www.cdc.gov/giardia/publications/index.html

  CDC collects and publishes data about illnesses and outbreaks caused by Giardia. This information helps public health officials better understand how Giardia spreads and prevent future illnesses. […] Giardiasis (illness caused by Giardia) is a nationally notifiable disease. This means that healthcare providers and laboratories that diagnose laboratory-confirmed giardiasis are required to report those cases to their health department. […] State health departments voluntarily report outbreaks of giardiasis affecting multiple people to CDC. Health departments can report giardiasis outbreaks spread through water, food, or from person to person to CDC’s National Outbreak Reporting System (NORS). […] It is important for healthcare providers to report cases and outbreaks to their health department, and for health departments to report to CDC. Reporting helps public health officials take steps to stop Giardia from spreading to more people. […] Evolving Epidemiology of Reported Giardiasis Cases in the United States, 19952016 […] Case-case analyses of cryptosporidiosis and giardiasis using routine national surveillance data in the United States – 2005-2015.

• #47 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  Trends suggest that differences in exposures by sex and age group are important to the epidemiology of giardiasis. Further investigation into the risk factors of populations with higher rates of giardiasis will support prevention and control efforts. […] Giardiasis has been reported to the Centers for Disease Control and Prevention (CDC) since 1992; in 2002 it became nationally notifiable. The most recent published summary data from the National Notifiable Diseases Surveillance System (NNDSS) demonstrated a slight decline in giardiasis rates from 2011 to 2012 across all US regions, compared with relatively steady rates from 2005 to 2010. This article describes the epidemiology of US giardiasis cases for the period 1995-2016 by analyzing 22 years of state-level giardiasis case data reported to NNDSS. Identification of changing patterns and transmission pathways is essential to inform the public health response to giardiasis.

• #48 Giardia Infection: Data and Publications | Giardia | CDC

  https://www.cdc.gov/giardia/publications/index.html

  CDC collects and publishes data about illnesses and outbreaks caused by Giardia. This information helps public health officials better understand how Giardia spreads and prevent future illnesses. […] Giardiasis (illness caused by Giardia) is a nationally notifiable disease. This means that healthcare providers and laboratories that diagnose laboratory-confirmed giardiasis are required to report those cases to their health department. […] State health departments voluntarily report outbreaks of giardiasis affecting multiple people to CDC. Health departments can report giardiasis outbreaks spread through water, food, or from person to person to CDC’s National Outbreak Reporting System (NORS). […] It is important for healthcare providers to report cases and outbreaks to their health department, and for health departments to report to CDC. Reporting helps public health officials take steps to stop Giardia from spreading to more people. […] Evolving Epidemiology of Reported Giardiasis Cases in the United States, 19952016 […] Case-case analyses of cryptosporidiosis and giardiasis using routine national surveillance data in the United States – 2005-2015.

• #49 Surveillance of Giardia infection (giardiasis) – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/giardia-infection/surveillance.html

  In 2016, there were 3,818 reported cases of giardiasis. […] Canada uses different surveillance systems to monitor cases of food-borne illness. […] Giardia is a nationally notifiable disease and is reported by all provinces and territories. […] Cases are reported to: provincial or territorial departments of health […] the federal government, if they meet the national case definition.

• #50 Giardiasis – Wikipedia

  https://en.wikipedia.org/wiki/Giardiasis

  Giardiasis occurs worldwide. […] It is one of the most common parasitic human diseases. […] Infection rates are as high as 7% in the developed world and 30% in the developing world. […] In 2013, there were approximately 280 million people worldwide with symptomatic cases of giardiasis. […] The World Health Organization classifies giardiasis as a neglected disease. […] The number of reported cases in the United States in 2018 was 15,584. […] All states that classify giardiasis as a notifiable disease had cases of giardiasis. […] There are seasonal trends associated with giardiasis. […] July, August, and September are the months with the highest incidence of giardiasis in the United States. […] In the ECDC’s (European Centre for Disease Prevention and Control) annual epidemiological report containing 2014 data, 17,278 confirmed giardiasis cases were reported by 23 of the 31 countries that are members of the EU/EEA.

• #51 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  Indeed, this disease is being increasingly considered as a re-emerging disease because of its recognised role in numerous outbreaks of diarrhoeal diseases in daycare centres and also due to water-borne associated outbreaks. […] The routes of transmission are responsible for a substantial proportion of both diagnosed and undiagnosed giardiasis cases. […] Transmission from ill children to household contacts has also been documented in outbreak investigations. […] There are several factors hampering the rapid diagnosis of Giardia infection in industrialised countries. […] Giardiasis may, therefore, go undiagnosed or may be treated inappropriately by physicians who are unfamiliar with this disease. […] The discovery of Giardia as the cause of a large waterborne outbreak in Bergen, Norway was delayed due to no history of travel abroad among the many patients seeking medical care for diarrhoeal disease.

• #52 Prevalence of Giardia infection in households of Giardia cases and risk factors for household transmission | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2586-3

  Giardia is a leading but neglected cause of infectious gastroenteritis worldwide and is treatable. There is a substantial burden of undetected Giardia in the UK and for every one case of Giardia reported to national surveillance there are 14 cases in the community. […] The reported prevalence of Giardia in human populations is 443% and 17% in low and high income countries respectively. […] Between 3000 and 4000 cases are reported annually in England and Wales. […] The incidence of Giardia in Northwest England increased four-fold following the introduction of the enzyme linked-immunosorbent assay for the detection of parasite antigens in stools. […] The aim of this study was to estimate the prevalence of Giardia infection in households of index cases of giardiasis and to identify characteristics of households with more than one case of giardiasis.

• #53 Epidemiology of Giardiasis in Humans | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-7091-0198-8_2

  Giardia lamblia is a widespread flagellated parasite of mammalian species, including humans, and is regarded as the most common cause of protozoan diarrhea worldwide. […] A number of molecular assays have been developed to help unravel the complex epidemiology of this infection. […] A specific database for the storage and analysis of sequence and epidemiologic data has been recently developed, and represents an important tool for future studies. […] However, the occurrence of mixed infections, the allelic sequence heterozygosity between the nuclei, and the reported occurrence of several distinct recombinational events indicate a level of biological complexity that affects the molecular typing, particularly for assemblage B. […] Under these circumstances, caution must be applied in the interpretation of molecular data in epidemiology of giardiasis.

• #54 Giardia Infection: Data and Publications | Giardia | CDC

  https://www.cdc.gov/giardia/publications/index.html

  CDC collects and publishes data about illnesses and outbreaks caused by Giardia. This information helps public health officials better understand how Giardia spreads and prevent future illnesses. […] Giardiasis (illness caused by Giardia) is a nationally notifiable disease. This means that healthcare providers and laboratories that diagnose laboratory-confirmed giardiasis are required to report those cases to their health department. […] State health departments voluntarily report outbreaks of giardiasis affecting multiple people to CDC. Health departments can report giardiasis outbreaks spread through water, food, or from person to person to CDC’s National Outbreak Reporting System (NORS). […] It is important for healthcare providers to report cases and outbreaks to their health department, and for health departments to report to CDC. Reporting helps public health officials take steps to stop Giardia from spreading to more people. […] Evolving Epidemiology of Reported Giardiasis Cases in the United States, 19952016 […] Case-case analyses of cryptosporidiosis and giardiasis using routine national surveillance data in the United States – 2005-2015.

• #55 Controlling Spread of Giardiasis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/giardiasis-0

  Since giardiasis may be transmitted person-to-person through fecal-oral transmission, it is important to carefully follow up on cases of giardiasis in child care settings. […] Since giardiasis may be transmitted person-to-person through fecal-oral transmission, it is important to carefully follow up on cases of giardiasis in a school setting. General recommendations include: […] Since Giardia may be transmitted via food, it is important to follow up on outbreaks of Giardia in any setting carefully. […] If the number of reported cases of giardiasis in your city or county is higher than usual, or if an outbreak is suspected, investigate to determine the source of infection and mode of transmission. […] Control of person-to-person transmission requires special emphasis on personal cleanliness and sanitary disposal of feces. […] CADE can help to determine a course of action to prevent further cases and can perform surveillance for cases in an outbreak that may cross several county lines and therefore be difficult to identify at a local level.

• #56 Giardiasis | Washington State Department of Health

  https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/giardiasis

  Infection may be asymptomatic or may cause diarrhea, abdominal pain, nausea, fatigue, and weight loss. […] Giardiasis is one of the most common waterborne diseases in the country. […] Reported cases have been declining somewhat over the past decade. Incidence is highest in the summer and fall months. […] To identify outbreaks and potential sources of ongoing transmission. […] To prevent further transmission from such sources. […] Health care providers and health care facilities: notifiable to local health jurisdiction within 3 business days. […] Laboratories: notifiable to local health jurisdiction within 2 business days; submission on request within 2 business days. […] Local health jurisdictions: notifiable to the Washington State Department of Health Office of Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days.

• #57 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #58 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #59 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  The overall prevalence rate of Giardia infection was 11.6% (154/1330), with a significantly higher infection rate in Peninsular Malaysia when compared to Sabah. The prevalence of infection was also significantly higher among participants aged under 12 years of age. There was a significant association between Giardia infection and subjects educational level, with a higher prevalence among those who were either non educated or only had primary education when compared to those who had a secondary education. […] The associations of Giardia infection with demographic, socioeconomic and environmental factors are illustrated. Besides location (Peninsular Malaysia) and age (12 years), participants from large households experienced a significantly higher prevalence of Giardia infection than those from smaller families. The prevalence of Giardia infection was significantly higher among those who live in houses without toilets when compared to those living in houses with functioning toilets.

• #60 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged 12 years compared to their older counterparts. Multivariate logistic regression identified age of 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.

• #61 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged 12 years compared to their older counterparts. Multivariate logistic regression identified age of 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.

• #62 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #63 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia infection was strongly associated with international travel (aOR = 13.9), supporting the results of previous case-control studies in the USA and other developed countries. […] Despite this strong association, only 11.2% of the illness in this group of case-patients was attributed to international travel, underscoring the importance of domestic risk factors for giardiasis. […] Direct person-to-person transmission represented the most important transmission pathway in our study, as the risk factors within this pathway were responsible for the largest proportion of illness among case-patients. […] Our results indicate that many Giardia infections could be prevented by targeting diaper-handling hygiene practices in home and childcare settings. […] Further, same-gender sexual behaviour remained associated with giardiasis after semi-Bayes adjustment, which strengthened the evidence of risk because this method reduces the potential to overestimate true associations. […] The relatively high PAFs associated with person-to-person transmission suggest that person-to-person transmission represents an important pathway for sporadic giardiasis transmission in the USA and prevention efforts should target behaviours associated with the direct faecal contact.

• #64 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #65 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #66 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged 12 years compared to their older counterparts. Multivariate logistic regression identified age of 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.

• #67 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged 12 years compared to their older counterparts. Multivariate logistic regression identified age of 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.

• #68 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged 12 years compared to their older counterparts. Multivariate logistic regression identified age of 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.

• #69 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #70 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia duodenalis is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. […] The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. […] Identified risk factors included international travel (aOR = 13.9; 95% CI 4.939.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.020.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.57.0), malemale sexual behaviour (aOR = 45.7; 95% CI 5.8362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.012.6), taking antibiotics (aOR = 2.5; 95% CI 1.25.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.13.0).

• #71 Giardiasis: Pediatric OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-pediatric-opportunistic-infections/giardiasis

  A recent study in Kenya described the association of enteric pathogens with HIV infection and HIV exposure in children. Giardia was the second most frequently associated pathogen, but the prevalence of Giardia was similar between the children with HIV and those exposed to HIV. […] Symptoms of giardiasis in individuals with HIV infection appear to be no more severe than in individuals who are HIV negative, and giardiasis is not typically considered a major cause of enteritis in patients with HIV. […] However, with progressive immunosuppression and reduced CD4 T-lymphocyte (CD4) cell counts, the risk of symptomatic Giardia infections increases. […] Studies in adults have demonstrated that enteritis due to G. duodenalis is a frequent event among patients with AIDS, especially in the most advanced stage of disease. […] Given the evidence, it is reasonable to recommend initiation of ART and immune reconstitution as a primary mode of Giardia prevention, which is consistent with standard practice to treat all children with HIV infection in the United States.

• #72 Giardiasis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/giardiasis.html

  A number of other factors such as number of G. lamblia cysts ingested (dose), varying virulence among G. lamblia strains, human or animal origin of the parasite, etc., may have an influence on the clinical course of infection. […] Giardiasis epidemics have commonly resulted from contaminated drinking water. The long-term solution to waterborne outbreaks involving municipal water systems requires use of water filtration equipment in the water treatment process. […] Because the cysts of G. lamblia resist conventional disinfection, effective filtration must serve as an additional barrier to prevent disease transmission. Studies have shown that diatomaceous earth filtration is an effective process for the removal of G. lamblia cysts. […] Person-to-person transmission of G. lamblia can be prevented by practicing good personal hygiene and maintaining a sanitary environment. Good handwashing and fingernail cleaning should be stressed, especially after using the toilet, handling soiled diapers of infants and before eating.

• #73 Giardiasis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/giardiasis.html

  A number of other factors such as number of G. lamblia cysts ingested (dose), varying virulence among G. lamblia strains, human or animal origin of the parasite, etc., may have an influence on the clinical course of infection. […] Giardiasis epidemics have commonly resulted from contaminated drinking water. The long-term solution to waterborne outbreaks involving municipal water systems requires use of water filtration equipment in the water treatment process. […] Because the cysts of G. lamblia resist conventional disinfection, effective filtration must serve as an additional barrier to prevent disease transmission. Studies have shown that diatomaceous earth filtration is an effective process for the removal of G. lamblia cysts. […] Person-to-person transmission of G. lamblia can be prevented by practicing good personal hygiene and maintaining a sanitary environment. Good handwashing and fingernail cleaning should be stressed, especially after using the toilet, handling soiled diapers of infants and before eating.

• #74 Risk factors for sporadic Giardia infection in the USA: a case-control study in Colorado and Minnesota | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/risk-factors-for-sporadic-giardia-infection-in-the-usa-a-casecontrol-study-in-colorado-and-minnesota/63B6FA03D86700897DFEA5473695A217

  Giardia infection was strongly associated with international travel (aOR = 13.9), supporting the results of previous case-control studies in the USA and other developed countries. […] Despite this strong association, only 11.2% of the illness in this group of case-patients was attributed to international travel, underscoring the importance of domestic risk factors for giardiasis. […] Direct person-to-person transmission represented the most important transmission pathway in our study, as the risk factors within this pathway were responsible for the largest proportion of illness among case-patients. […] Our results indicate that many Giardia infections could be prevented by targeting diaper-handling hygiene practices in home and childcare settings. […] Further, same-gender sexual behaviour remained associated with giardiasis after semi-Bayes adjustment, which strengthened the evidence of risk because this method reduces the potential to overestimate true associations. […] The relatively high PAFs associated with person-to-person transmission suggest that person-to-person transmission represents an important pathway for sporadic giardiasis transmission in the USA and prevention efforts should target behaviours associated with the direct faecal contact.

• #75 Controlling Spread of Giardiasis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/giardiasis-0

  Since giardiasis may be transmitted person-to-person through fecal-oral transmission, it is important to carefully follow up on cases of giardiasis in child care settings. […] Since giardiasis may be transmitted person-to-person through fecal-oral transmission, it is important to carefully follow up on cases of giardiasis in a school setting. General recommendations include: […] Since Giardia may be transmitted via food, it is important to follow up on outbreaks of Giardia in any setting carefully. […] If the number of reported cases of giardiasis in your city or county is higher than usual, or if an outbreak is suspected, investigate to determine the source of infection and mode of transmission. […] Control of person-to-person transmission requires special emphasis on personal cleanliness and sanitary disposal of feces. […] CADE can help to determine a course of action to prevent further cases and can perform surveillance for cases in an outbreak that may cross several county lines and therefore be difficult to identify at a local level.

• #76 Giardiasis – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/giardiasis/

  To confirm the diagnosis, a stool sample should be collected and tested at a laboratory. […] Persons can excrete Giardia in their stools for a few weeks to a few months. Treatment can shorten the illness and the time the parasite remains in the stool. […] People with diarrhea need to be excluded from childcare, patient care, or food handling, where they might pose a risk to others.

• #77 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  These scattered reports underline the need to enhance efforts to provide education among general practitioners and pediatricians to be aware of Giardia as a cause of indigenous cases of diarrhoea and on how best to diagnose and effectively treat them. […] There are important reasons to pay attention to under-diagnosis of Giardia infection. […] This infection may also be accompanied with or without malabsorption, abdominal cramps, nausea, vomiting, increased flatulence and weight loss. […] A controlled prospective study of a cohort of individuals who had confirmed Giardia infection during a waterborne outbreak found a significantly increased risk for post-infectious irritable bowel syndrome and chronic fatigue even 6 years after the infection. […] Giardiasis may exceed the current prevalence estimates. […] The evidence shows that public health problems like giardiasis are a global issue that needs to be addressed collectively by industrialised and developing countries.

• #78

  https://journals.lww.com/jfmpc/fulltext/2023/12100/trends_and_clinico_epidemiological_profile_of.42.aspx

  Awareness and knowledge amongst the primary healthcare professionals and family physicians will help in early diagnosis and treatment of Giardiasis. […] Fecal antigen detection should be done along with microscopy for detection of Giardiasis. […] Globally, about 280 million people suffer from symptomatic Giardia infection annually. […] Although distributed worldwide, the prevalence of Giardiasis ranges from 20% to 30% in developing countries compared to 2% to 5% in developed countries. […] In India, the prevalence of Giardia varies from 3.8 to 23.5%. […] Giardiasis commonly presents as acute or chronic diarrhea, weight loss, abdominal cramp, and malabsorption. […] Early identification of Giardiasis will help in its treatment simply with antigiardial drugs and thus minimize postinfectious and long-term sequelae.

• #79 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged 12 years compared to their older counterparts. Multivariate logistic regression identified age of 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.

• #80 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  Giardiasis is the most common intestinal parasitic disease of humans identified in the United States (US) and an important waterborne disease. In the United States, giardiasis has been variably reportable since 1992 and was made a nationally notifiable disease in 2002. Our objective was to describe the epidemiology of US giardiasis cases from 1995 through 2016 using National Notifiable Diseases Surveillance System data. […] During 1995-2016, the average number of reported cases was 19,781 per year (range, 14,623-27,778 cases). The annual incidence of reported giardiasis in the United States decreased across all age groups. This decrease differs by age group and sex and may reflect either changes in surveillance methods (eg, changes to case definitions or reporting practices) or changes in exposure. Incidence rates in males and older age groups did not decrease to the same extent as rates in females and children.

• #81 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  Trends suggest that differences in exposures by sex and age group are important to the epidemiology of giardiasis. Further investigation into the risk factors of populations with higher rates of giardiasis will support prevention and control efforts. […] Giardiasis has been reported to the Centers for Disease Control and Prevention (CDC) since 1992; in 2002 it became nationally notifiable. The most recent published summary data from the National Notifiable Diseases Surveillance System (NNDSS) demonstrated a slight decline in giardiasis rates from 2011 to 2012 across all US regions, compared with relatively steady rates from 2005 to 2010. This article describes the epidemiology of US giardiasis cases for the period 1995-2016 by analyzing 22 years of state-level giardiasis case data reported to NNDSS. Identification of changing patterns and transmission pathways is essential to inform the public health response to giardiasis.

• #82

  https://journals.lww.com/co-infectiousdiseases/fulltext/2020/10000/giardiasis_treatment__an_update_with_a_focus_on.6.aspx

  Giardiasis remains a common cause of diarrhea and intestinal enteropathy globally. […] The prevalence of treatment refractory giardiasis is increasing. […] Recent studies reveal 5-nitroimidazole refractory infection occurs in up to 50% of cases. […] No randomized controlled trials of treatment of refractory infection have been performed the last 25 years. […] In low-resource settings, Giardia infection is common both in diarrheal and nondiarrheal cases, and is associated with chronic diarrhea. […] Nitroimidazole failure in up to 50% is reported in giardiasis, both among travelers and in high endemic countries. […] Further research into more recent clinical isolates seems necessary to uncover mechanisms for the emerging metronidazole refractory cases.

• #83

  https://journals.lww.com/co-infectiousdiseases/fulltext/2020/10000/giardiasis_treatment__an_update_with_a_focus_on.6.aspx

  Giardiasis remains a common cause of diarrhea and intestinal enteropathy globally. […] The prevalence of treatment refractory giardiasis is increasing. […] Recent studies reveal 5-nitroimidazole refractory infection occurs in up to 50% of cases. […] No randomized controlled trials of treatment of refractory infection have been performed the last 25 years. […] In low-resource settings, Giardia infection is common both in diarrheal and nondiarrheal cases, and is associated with chronic diarrhea. […] Nitroimidazole failure in up to 50% is reported in giardiasis, both among travelers and in high endemic countries. […] Further research into more recent clinical isolates seems necessary to uncover mechanisms for the emerging metronidazole refractory cases.

• #84 Giardiasis in Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/giardiasis-giardia/giardiasis-in-animals

  The two main methods to diagnose Giardia infection are identification of Giardia cysts, and considerably less frequently, trophozoites in fecal samples and detection of Giardia antigen in fecal samples. […] Drug treatment regimens should probably aim to stop clinical signs rather than eliminate cyst shedding. […] Giardia cysts are immediately infective when passed in the feces and survive well in the environment, particularly in damp and cool conditions in which cysts may stay infective for months. […] Many infections are subclinical, and clinical infections are generally associated with chronic diarrhea with steatorrhea. […] Various diagnostic options are available and are generally focused on identification of either transmission stages (cysts) in feces or fecal antigen testing. […] Various treatment options are available, some of which are off-label.

• #85

  https://journals.lww.com/jfmpc/fulltext/2023/12100/trends_and_clinico_epidemiological_profile_of.42.aspx

  Awareness and knowledge amongst the primary healthcare professionals and family physicians will help in early diagnosis and treatment of Giardiasis. […] Fecal antigen detection should be done along with microscopy for detection of Giardiasis. […] Globally, about 280 million people suffer from symptomatic Giardia infection annually. […] Although distributed worldwide, the prevalence of Giardiasis ranges from 20% to 30% in developing countries compared to 2% to 5% in developed countries. […] In India, the prevalence of Giardia varies from 3.8 to 23.5%. […] Giardiasis commonly presents as acute or chronic diarrhea, weight loss, abdominal cramp, and malabsorption. […] Early identification of Giardiasis will help in its treatment simply with antigiardial drugs and thus minimize postinfectious and long-term sequelae.

• #86 Giardiasis from a One Health Perspective | SpringerLink

  https://link.springer.com/10.1007/978-3-031-27164-9_33

  The flagellated protozoan Giardia duodenalis is the etiologic agent of giardiasis, a very common gastrointestinal infection of mammals, including humans, with a global distribution. […] Water plays a very important role in the epidemiology of giardiasis, with widespread contamination of different water sources leading to waterborne outbreaks. […] To understand the complex epidemiology of giardiasis, a One Health approach is needed.

• #87 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  Although Giardia, the aetiological agent of giardiasis, is one of the most prevalent intestinal parasitic infections world-wide, for industrialised countries, it is mainly appreciated as an imported disease with the minimal local transmission. […] This infection may be asymptomatic or cause gastrointestinal complains and long-term sequelae, including irritable bowel syndrome, chronic fatigue and impaired child growth and cognitive development. […] The evidence shows that public health problems like giardiasis are global issues that need to be addressed collectively by both high and low prevalence countries. […] Giardia is estimated to cause annually 184 million clinical cases and an associated 171 100 (115 777257 315) disability-adjusted life years. […] In industrialised countries, where the incidence of human giardiasis, the disease that Giardia causes, decreased after improvements of sanitary infrastructures and safe drinking water, it is seen to be principally associated with travelling to or immigration from endemic areas.

• #88 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  These scattered reports underline the need to enhance efforts to provide education among general practitioners and pediatricians to be aware of Giardia as a cause of indigenous cases of diarrhoea and on how best to diagnose and effectively treat them. […] There are important reasons to pay attention to under-diagnosis of Giardia infection. […] This infection may also be accompanied with or without malabsorption, abdominal cramps, nausea, vomiting, increased flatulence and weight loss. […] A controlled prospective study of a cohort of individuals who had confirmed Giardia infection during a waterborne outbreak found a significantly increased risk for post-infectious irritable bowel syndrome and chronic fatigue even 6 years after the infection. […] Giardiasis may exceed the current prevalence estimates. […] The evidence shows that public health problems like giardiasis are a global issue that needs to be addressed collectively by industrialised and developing countries.

• #89 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  We describe significant declines in the rates of reported giardiasis in the United States during 1995-2016. We observed considerable variations in the incidence of reported giardiasis cases between age groups and sex and among US states and jurisdictions. […] Giardiasis has declined significantly in the United States, and the age and sex groups at highest risk have changed. Our findings should be used by federal, state, and local public health agencies to guide and implement targeted evidence-based disease prevention strategies and research priorities for giardiasis. Further investigation is needed to explain the apparent plateau in rates between 2012 and 2015, if the increase in 2016 continues thereafter; higher and increasing reporting in males, especially among certain age groups; variability in geographical distribution; and how the increasing use of molecular diagnostics will influence the future notification and surveillance of giardiasis in the United States.

• #90 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  We describe significant declines in the rates of reported giardiasis in the United States during 1995-2016. We observed considerable variations in the incidence of reported giardiasis cases between age groups and sex and among US states and jurisdictions. […] Giardiasis has declined significantly in the United States, and the age and sex groups at highest risk have changed. Our findings should be used by federal, state, and local public health agencies to guide and implement targeted evidence-based disease prevention strategies and research priorities for giardiasis. Further investigation is needed to explain the apparent plateau in rates between 2012 and 2015, if the increase in 2016 continues thereafter; higher and increasing reporting in males, especially among certain age groups; variability in geographical distribution; and how the increasing use of molecular diagnostics will influence the future notification and surveillance of giardiasis in the United States.

• #91 Evolving Epidemiology of Reported Giardiasis Cases in the United States, 1995–2016

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9651178/

  We describe significant declines in the rates of reported giardiasis in the United States during 1995-2016. We observed considerable variations in the incidence of reported giardiasis cases between age groups and sex and among US states and jurisdictions. […] Giardiasis has declined significantly in the United States, and the age and sex groups at highest risk have changed. Our findings should be used by federal, state, and local public health agencies to guide and implement targeted evidence-based disease prevention strategies and research priorities for giardiasis. Further investigation is needed to explain the apparent plateau in rates between 2012 and 2015, if the increase in 2016 continues thereafter; higher and increasing reporting in males, especially among certain age groups; variability in geographical distribution; and how the increasing use of molecular diagnostics will influence the future notification and surveillance of giardiasis in the United States.

• #92 Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia | Scientific Reports

  https://www.nature.com/articles/srep06909

  This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged 12 years compared to their older counterparts. Multivariate logistic regression identified age of 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.

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