Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct;145(14):3007-3011.
doi: 10.1017/S0950268817001959. Epub 2017 Sep 7.

Under-reporting giardiasis: time to consider the public health implications

S L Currie  1 , N Stephenson  2 , A S Palmer  3 , B L Jones  1 , G Hawkins, C L Alexander  1
Affiliations

Under-reporting giardiasis: time to consider the public health implications

S L Currie et al. Epidemiol Infect. 2017 Oct.

Erratum in

Abstract

Giardiasis is a treatable disease, caused by the flagellated protozoan parasite, Giardia duodenalis (G. duodenalis). It is one of the most common enteric parasites found globally to cause gastrointestinal disturbances, and infections may result in long-term irritable bowel syndrome-like symptoms. It is a common misconception that giardiasis is associated with foreign travel, which results in locally acquired cases in the UK being underdiagnosed. This report highlights the findings from one large Scottish Health Board, arising from a change in testing methodology, which resulted in the screening of all stools submitted for enteric investigations for G. duodenalis. Previous selection criteria were restricted to patients with a travel history to specific regions of the world, or on the basis of certain clinical details. In this report, clinical details were recorded from samples shown to be positive using two methods: an ELISA-based antigen detection assay and microscopy. Clinical details were assessed for a total of 28 laboratory-confirmed positive cases against the original selection criteria. Twenty-six cases (93%) would have been excluded from Giardia testing if the previous selection criteria had been applied. Although nine cases stated foreign travel, only two had been to regions deemed to be 'high risk'. Therefore, those seven cases that travelled to perceived 'low-risk' regions would have been excluded from testing for this reason. This summary highlights the need for significant improvements to the selection criteria for Giardia testing. Laboratories should be encouraged towards the testing of all routinely submitted stools for this neglected pathogen to ensure cases that are acquired locally are properly identified and treated effectively.

Keywords: Giardia lamblia; Gastrointestinal infections; giardiasis; parasites; public health microbiology.

PubMed Disclaimer

Conflict of interest statement

None.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Wensaas KA, et al. Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study. Gut 2012; 61(2): 214–219. doi: 10.1136/gutjnl-2011-300220. Epub 2011 Sep 12. - DOI - PubMed
    1. Feng Y, Xiao L. Zoonotic potential and molecular epidemiology of Giardia species and giardiasis. Clinical Microbiology Reviews 2011; 24: 110–140. - PMC - PubMed
    1. Adam EA, et al. Giardiasis outbreaks in the United States, 1971–2011. Epidemiology and Infection 2016; 144: 2790–2801. - PMC - PubMed
    1. Minetti C, et al. Case-control study of risk factors for sporadic giardiasis and parasite assemblages in North-west England. Journal of Clinical Microbiology 2015; 53: 3133–3140. - PMC - PubMed
    1. Steinmuller N, et al. Outbreaks of enteric disease associated with animal contact: not just a foodborne problem anymore. Clinical Infectious Diseases 2006; 43: 1596–1602. - PubMed