1887

Abstract

Summary

In one of the largest outbreaks of waterborne giardiasis reported from Europe, more than 3000 persons were exposed to contaminated water and over 1400 cases of giardiasis were diagnosed by microscopy. The outbreak resulted from an overflow of sewage water into the drinking water system of a Swedish ski resort. The period of contamination was about 1 week. Sweden is a non-endemic area for infection and, for most individuals affected, this was their first contact with the parasite. Few other enteropathogens were isolated from the patients involved. Therefore, an immune response to was unlikely to be biased by other concomitant infections.

Serum samples from 352 exposed persons were collected and analysed for specific IgG and IgA antibodies to by indirect immunofluorescence and the results were related to the microscopic examination of faeces and the occurrence of diarrhoea. As controls, sera from 428 healthy persons were analysed at the same time by identical methods. IgG or IgA antibodies, or both, were found in 68% of patients whose diagnosis was made by microscopy, and in 22% of exposed but microscopically -negative persons, but in only 10% of healthy controls. The findings show that patients reported as negative for parasites might be infected. The time between infection and blood sampling influenced the result of the antibody test. The results suggest that stool examination should be the primary means of diagnosis of infection and that serological analysis performed at least 3 weeks after infection could contribute to diagnosis in a non-endemic region, when giardiasis is suspected but the parasite has not been detected.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-36-5-347
1992-05-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/36/5/medmicro-36-5-347.html?itemId=/content/journal/jmm/10.1099/00222615-36-5-347&mimeType=html&fmt=ahah

References

  1. Mseyer E. A., Jarroll E. L. Reviews and commentary, Giardiasis. Am JEpidemiol 1980; 111:1–12
    [Google Scholar]
  2. Farthing M. J. G. Host-parasite interactions in human giardiasis. Quart J Med, New Series 70 1989; 263:191–204
    [Google Scholar]
  3. Ormiston G., Taylor J., Wilson G. S. Enteritis in a nursery home associated with Giardia lamblia. Br Med J 1942; 2:151–154
    [Google Scholar]
  4. Aust Kettis A., Thoren G. Inter- and intrafamiliar distribution of Giardia lamblia infection. Scand J Infect Dis 1974; 6:349–353
    [Google Scholar]
  5. Black R. E., Dykes A. C., Sinclair S. P., Wells J. G. Giardiasis in day-care centers: evidence of person-to-person transmission. Pediatrics 1977; 60:486–491
    [Google Scholar]
  6. Sealy D. P., Schuman S. H. Endemic giardiasis and day care. Pediatrics 1983; 72:154–158
    [Google Scholar]
  7. Craun G. F. Waterborne giardiasis in the United States 1965 84. Lancet 1986; 2:513–514
    [Google Scholar]
  8. Neringer R., Andersson Y., Eitrem R. A water-borne outbreak of giardiasis in Sweden. Scand J Infect Dis 1987; 19:85–90
    [Google Scholar]
  9. Ridley D. S., Hawgood B. C. The value of formol-ether concentra tion of faecal cysts and ova. J Clin Pathol 1956; 9:74–76
    [Google Scholar]
  10. Kamath K. R., Murugasu R. A comparative study of four methods for detecting Giardia lamblia in children with diarrheal disease and malabsorption. Gastroenterology 1974; 66:16–21
    [Google Scholar]
  11. Rosenthal P., Liebman W. M. Comparative study of stool examinations, duodenal aspiration, and pediatric Enter-Test for giardiasis in children. J Pediatr 1980; 96:278–279
    [Google Scholar]
  12. Owen R. L., Nemanic P. C., Stevens D. P. Ultrastructural observations on giardiasis in a murine model. I. Intestinal distribution, attachment, and relationship to the immune system of Giardia muris. Gastroenterology 1979; 76:757–769
    [Google Scholar]
  13. Farthing M. J. G., Goka A. K. J., Butcher P. D., Arvind A. S. Serodiagnosis in giardiasis. Serodiagnosis and Immunotherapy 1987; 1:233–238
    [Google Scholar]
  14. Visvesvara G. S., Smith P. D., Healy G. R., Brown W. R. An immunofluorescence test to detect serum antibodies to Giardia lamblia. Ann Intern Med 1980; 93:802–805
    [Google Scholar]
  15. Smith P. D., Gillin F. D., Brown W. R., Nash T. E. IgG antibody to Giardia lamblia detected by enzyme-linked immunosorbent assay. Gastroenterology 1981; 80:1476–1480
    [Google Scholar]
  16. Islam A., Stoll B. J., Ljungstrdm I., Biswas J., Nazrul H., Huldt G. Giardia lamblia infections in a cohort of Bangladeshi mothers and infants followed for one year. J Pediatr 1983; 103:996–1000
    [Google Scholar]
  17. Miotti P. G., Gilman R. H., Santosham M., Ryder R. W., Yolken R. H. Age-related rate of seropositivity of antibody to Giardia lamblia in four diverse populations. J Clin Microbiol 1986; 24:972–975
    [Google Scholar]
  18. Hautus M. A., Abdillahi H., Laarman J. J. Circulating IgG and IgA anti-Giardia lamblia antibodies in sera of symptomatic giardiasis patients. Acta Leidensia 1987; 56:47–55
    [Google Scholar]
  19. Rojas L., Torres D. R., Mediola B. J., Finlay C. M. Detection of specific anti-Giardia serum antibody by an immunofluorescence test in children with clinical giardiasis. Am J Trop Med Hyg 1989; 40:477–479
    [Google Scholar]
  20. Svensson R. Studies on human intestinal protozoa. Acta Med ScandSuppl 1935; 70:1–115
    [Google Scholar]
  21. Svanteson S., Thoren A., Castor B. Acute diarrhoea in adults: Aetiology, clinical appearance and therapeutic aspects. ScandJ Infect Dis 1988; 20:303–314
    [Google Scholar]
  22. Winiecka J., Kasprzak W., Kociecka W., Plotkowiak J., Myjak P. Serum antibodies to Giardia intestinalis detected by immunofluorescence using trophozoites as antigen. Tro-penmed Parasitol 1984; 35:20–22
    [Google Scholar]
  23. Baveja U. K., Warhurst D. C. Humoral response in giardiasis. J Commun Dis 1983; 15:256–260
    [Google Scholar]
  24. Nash T. E., Herrington D. A., Losonsky G. A., Levine M. M. Experimental human infections with Giardia lamblia. J Infect Dis 1987; 156:974–984
    [Google Scholar]
  25. Birkhead G., Janoff E. N., Vogt R. L., Smith P. D. Elevated levels of immunoglobulin A to Giardia lamblia during a waterborne outbreak of gastroenteritis. J Clin Microbiol 1989; 27:1707–1710
    [Google Scholar]
  26. Goka A. K. J., Rolston D. D. K., Mathan V. I., Farthing M. G. J. Serum anti-Giardia IgA in human Giardia lamblia infection. Serodiagnosis and Immunotherapy 1989; 3:273–277
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-36-5-347
Loading
/content/journal/jmm/10.1099/00222615-36-5-347
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error