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Giardiasis outbreaks in the United States, 1971-2011.
Epidemiol Infect. 2016 Oct; 144(13):2790-801.EI

Abstract

Giardia intestinalis is the leading parasitic aetiology of human enteric infections in the United States, with an estimated 1·2 million cases occurring annually. To better understand transmission, we analysed data on all giardiasis outbreaks reported to the Centers for Disease Control and Prevention for 1971-2011. The 242 outbreaks, affecting ~41 000 persons, resulted from waterborne (74·8%), foodborne (15·7%), person-to-person (2·5%), and animal contact (1·2%) transmission. Most (74·6%) waterborne outbreaks were associated with drinking water, followed by recreational water (18·2%). Problems with water treatment, untreated groundwater, and distribution systems were identified most often during drinking water-associated outbreak investigations; problems with water treatment declined after the 1980s. Most recreational water-associated outbreaks were linked to treated swimming venues, with pools and wading pools implicated most often. Produce was implicated most often in foodborne outbreaks. Additionally, foods were most commonly prepared in a restaurant and contaminated by a food handler. Lessons learned from examining patterns in outbreaks over time can help prevent future disease. Groundwater and distribution system vulnerabilities, inadequate pool disinfection, fruit and vegetable contamination, and poor food handler hygiene are promising targets for giardiasis prevention measures.

Authors+Show Affiliations

Division of Foodborne,Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,GA,USA.Division of Foodborne,Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,GA,USA.Division of Foodborne,Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,GA,USA.Division of Foodborne,Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,GA,USA.Division of Foodborne,Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,GA,USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26750152

Citation

Adam, E A., et al. "Giardiasis Outbreaks in the United States, 1971-2011." Epidemiology and Infection, vol. 144, no. 13, 2016, pp. 2790-801.
Adam EA, Yoder JS, Gould LH, et al. Giardiasis outbreaks in the United States, 1971-2011. Epidemiol Infect. 2016;144(13):2790-801.
Adam, E. A., Yoder, J. S., Gould, L. H., Hlavsa, M. C., & Gargano, J. W. (2016). Giardiasis outbreaks in the United States, 1971-2011. Epidemiology and Infection, 144(13), 2790-801. https://doi.org/10.1017/S0950268815003040
Adam EA, et al. Giardiasis Outbreaks in the United States, 1971-2011. Epidemiol Infect. 2016;144(13):2790-801. PubMed PMID: 26750152.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Giardiasis outbreaks in the United States, 1971-2011. AU - Adam,E A, AU - Yoder,J S, AU - Gould,L H, AU - Hlavsa,M C, AU - Gargano,J W, Y1 - 2016/01/11/ PY - 2016/1/12/entrez PY - 2016/1/12/pubmed PY - 2017/6/3/medline KW - Community outbreaks KW - Giardia lamblia KW - foodborne infections KW - waterborne infections KW - zoonoses SP - 2790 EP - 801 JF - Epidemiology and infection JO - Epidemiol. Infect. VL - 144 IS - 13 N2 - Giardia intestinalis is the leading parasitic aetiology of human enteric infections in the United States, with an estimated 1·2 million cases occurring annually. To better understand transmission, we analysed data on all giardiasis outbreaks reported to the Centers for Disease Control and Prevention for 1971-2011. The 242 outbreaks, affecting ~41 000 persons, resulted from waterborne (74·8%), foodborne (15·7%), person-to-person (2·5%), and animal contact (1·2%) transmission. Most (74·6%) waterborne outbreaks were associated with drinking water, followed by recreational water (18·2%). Problems with water treatment, untreated groundwater, and distribution systems were identified most often during drinking water-associated outbreak investigations; problems with water treatment declined after the 1980s. Most recreational water-associated outbreaks were linked to treated swimming venues, with pools and wading pools implicated most often. Produce was implicated most often in foodborne outbreaks. Additionally, foods were most commonly prepared in a restaurant and contaminated by a food handler. Lessons learned from examining patterns in outbreaks over time can help prevent future disease. Groundwater and distribution system vulnerabilities, inadequate pool disinfection, fruit and vegetable contamination, and poor food handler hygiene are promising targets for giardiasis prevention measures. SN - 1469-4409 UR - https://www.unboundmedicine.com/medline/citation/26750152/full_citation L2 - https://www.cambridge.org/core/product/identifier/S0950268815003040/type/journal_article DB - PRIME DP - Unbound Medicine ER -