Skip to main content
SpringerLink
Log in

Epidemiology of Giardiasis in Humans

  • Chapter
Giardia

Abstract

Giardia lamblia is a widespread flagellated parasite of mammalian species, including humans, and is regarded as the most common cause of protozoan diarrhea worldwide. Owing to its invariant morphology, investigation on aspects such as host specificity and transmission patterns requires a direct genetic characterization of cysts and trophozoites from host and environmental samples. A number of molecular assays have been developed to help unravel the complex epidemiology of this infection. A coherent picture has emerged from those studies, indicating the existence of seven genetic groups (or assemblages), two of which (A and B) are found in both humans and animals, whereas the remaining five (C-G) are relatively host-specific. With the rapid accumulation of sequence data and the refinement of the assays, the elucidation of many epidemiologic aspects seemed only a matter of time and proper study design. 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. 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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Adam RD (2001) Biology of Giardia lamblia. Clin Microbiol Rev 14: 447–475

    Article  PubMed  CAS  Google Scholar 

  • Ajjampur SS, Sankaran P, Kannan A, et al. (2009) Giardia duodenalis assemblages associated with diarrhea in children in South India identified by PCR-RFLP. Am J Trop Med Hyg 80: 16–19

    PubMed  Google Scholar 

  • Almeida AA, Pozio E, and Cacciò SM (2010) Genotyping of Giardia duodenalis cysts by new Real-Time PCR assays for detection of mixed infections in human samples. Appl Environ Microbiol 76: 1895–1201

    Article  PubMed  CAS  Google Scholar 

  • Andrews RH, Adams M, Boreham PF, Mayrhofer G, and Meloni BP (1989) Giardia intestinalis: electrophoretic evidence for a species complex. Int J Parasitol 19: 183–190

    Article  PubMed  CAS  Google Scholar 

  • Aydin AF, Besirbellioglu BA, Avci IY, Tanyuksel M, Araz E, and Pahsa A (2004) Classification of Giardia duodenalis parasites in Turkey into groups A and B using restriction fragment length polymorphism. Diagn Microbiol Infect Dis 50: 147–151

    Article  PubMed  CAS  Google Scholar 

  • Baruch A, Isaac-Renton J, and Adam RD (1996) The molecular epidemiology of Giardia lamblia: a sequence-based approach. J Infect Dis 174: 233–236

    Article  PubMed  CAS  Google Scholar 

  • Berrilli F, Di Cave D, D’Orazi C, et al. (2006) Prevalence and genotyping of human isolates of Giardia duodenalis from Albania. Parasitol Int 55: 295–297

    Article  PubMed  CAS  Google Scholar 

  • Breathnach AS, McHugh TD, and Butcher PD (2010) Prevalence and clinical correlations of genetic subtypes of Giardia lamblia in an urban setting. Epidemiol Infect (In press)

    Google Scholar 

  • Cacciò SM, Thompson RCA, McLauchlin J, and Smith H (2005) Unravelling cryptosporidfium and Giardia epidemiology. Trends Parasitol 21: 430–437

    Article  PubMed  Google Scholar 

  • Cacciò SM and Ryan U (2008) Molecular epidemiology of giardiasis. Mol Biochem Parasitol 160: 75–80

    Article  PubMed  Google Scholar 

  • Cacciò SM, Beck R, Lalle M, Marinculic A, and Pozio E (2008) Multilocus genotyping of Giardia duodenalis reveals striking differences between assemblages A and B. Int J Parasitol 38: 1523–1531

    Article  PubMed  Google Scholar 

  • Cacciò SM, Sprong H (2010) Giardia duodenalis: genetic recombination and its implications for taxonomy and molecular epidemiology. Exp Parasitol 124: 107–112

    Article  PubMed  Google Scholar 

  • Chute CG, Smith RP, and Baron JA (1987) Risk factors for endemic giardiasis. Am J Public Health 77: 585–587

    Article  PubMed  CAS  Google Scholar 

  • Cooper MA and Adam RD, Worobey M, and Sterling CR (2007) Population genetics provides evidence for recombination in Giardia. Curr Biol 17: 1984–1988

    Article  PubMed  CAS  Google Scholar 

  • de Wit MA, Koopmans MP, Kortbeek LM, Wannet WJ, Vinje J, van Leusden F, Bartelds AI, and van Duynhoven YT (2001a) Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology. Am J Epidemiol 154: 666–674

    Article  PubMed  Google Scholar 

  • de Wit MA, Koopmans MP, Kortbeek LM, van Leeuwen NJ, Bartelds AI, and van Duynhoven YT (2001b) Gastroenteritis in sentinel general practices, The Netherlands. Emerg Infect Dis 7: 82–91

    Article  PubMed  Google Scholar 

  • Dib HH, Lu SQ, and Wen SF (2008) Prevalence of Giardia lamblia with or without diarrhea in South East, South East Asia and the Far East. Parasitol Res 103: 239–251

    Article  PubMed  Google Scholar 

  • Dwivedi KK, Prasad G, Saini S, et al. (2007) Enteric opportunistic parasites among HIV infected individuals: associated risk factors and immune status. Jpn J Infect Dis 60: 76–81

    PubMed  Google Scholar 

  • Eisenberg JN, Brookhart MA, Rice G, Brown M, and Colford JM Jr (2002) Disease transmission models for public health decision making: analysis of epidemic and endemic conditions caused by waterborne pathogens. Environ Health Perspect 110: 783–790

    Article  PubMed  Google Scholar 

  • Espelage W, an der Heiden M, Stark K, and Alpers K (2010) Prevalence and clinical correlations of genetic subtypes of Giardia lamblia in an urban setting. BMC Public Health (In press)

    Google Scholar 

  • Farthing MJ, Mata L, Urrutia JJ, and Kronmal RA (1986) Natural history of Giardia infection of infants and children in rural Guatemala and its impact on physical growth. Am J Clin Nutr 43: 395–405

    PubMed  CAS  Google Scholar 

  • Faubert G (2000) Immune response to Giardia duodenalis. Clin Microbiol Rev 13: 35–54

    Article  PubMed  CAS  Google Scholar 

  • Faustini A, Marinacci C, Fabrizi E, et al. (2006) The impact of the Catholic Jubilee in 2000 on infectious diseases. A case-control study of giardiasis, Rome, Italy 2000–2001. Epidemiol Infect 134: 649–658

    Article  PubMed  CAS  Google Scholar 

  • Franzen O, Jerlström-Hultqvist J, Castro E, et al. (2009) Draft genome sequencing of Giardia intestinalis assemblage B isolate GS: is human giardiasis caused by two different species? PLOS Pathog (In press)

    Google Scholar 

  • Gelanew T, Lalle M, Hailu A, Pozio E, and Cacciò SM (2007) Molecular characterization of human isolates of Giardia duodenalis from Ethiopia. Acta Trop 102: 92–99

    Article  PubMed  CAS  Google Scholar 

  • Geurden T, Geldhof P, Levecke B, et al. (2007) Mixed Giardia duodenalis assemblage A and E infections in calves. Int J Parasitol 38: 259–264

    Article  PubMed  Google Scholar 

  • Geurden T, Levecke B, Cacciò SM, et al. (2009) Multilocus genotyping of Cryptosporidium and Giardia in nonoutbreak related cases of diarrhoea in human patients in Belgium. Parasitology 136: 1161–1168

    Article  PubMed  CAS  Google Scholar 

  • Haque R, Roy S, Kabir M, Stroup SE, Mondal D, and Houpt ER (2005) Giardia assemblage A infection and diarrhea in Bangladesh. J Infect Dis 192: 2171–2173

    Article  PubMed  Google Scholar 

  • Haque R, Mondal D, Karim A, et al. (2009) Prospective casecontrol study of the association between common enteric protozoal parasites and diarrhea in Bangladesh. Clin Infect Dis 48: 1191–1197

    Article  PubMed  CAS  Google Scholar 

  • Hollm-Delgado MG, Gilman RH, Bern C, Cabrera L, Sterling CR, Black RE, and Checkley W (2008) Lack of an adverse effect of Giardia intestinalis infection on the health of Peruvian children. Am J Epidemiol 168: 647–655

    Article  PubMed  Google Scholar 

  • Homan WL and Mank TG (2001) Human giardiasis: genotype linked differences in clinical symptomatology. Int J Parasitol 31: 822–826

    Article  PubMed  CAS  Google Scholar 

  • Hopkins RM, Meloni BP, Groth DM, Wetherall JD, Reynoldson JA, and Thompson RC (1997) Ribosomal RNA sequencing reveals differences between the genotypes of Giardia isolates recovered from humans and dogs living in the same locality. J Parasitol 83: 44–51

    Article  PubMed  CAS  Google Scholar 

  • Hoque ME, Hope VT, Scragg R, Kjellström T, and Lay-Yee R (2001) Nappy handling and risk of giardiasis. Lancet 357: 1017–1018

    Article  PubMed  CAS  Google Scholar 

  • Hoque E, Hope V, Scragg R, Baker M, and Shrestha R (2004) A descriptive epidemiology of giardiasis in New Zealand and gaps in surveillance data. N Z J Med 117: U1149

    Google Scholar 

  • Hörman A, Korpela H, Sutinen J, Wedel H, and Hanninen ML (2004) Meta-analysis in assessment of the prevalence and annual incidence of Giardia spp. and Cryptosporidium spp. infections in humans in the Nordic countries. Int J Parasitol 34: 1337–1346

    Article  PubMed  Google Scholar 

  • Kohli A, Bushen OY, Pinkerton RC, et al. (2008) Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children. Trans R Soc Trop Med Hyg 102: 718–725

    Article  PubMed  Google Scholar 

  • Kosuwin R, Putaporntip C, Pattanawong U, and Jongwutiwes S (2010) Clonal diversity in Giardia duodenalis isolates from Thailand: evidences for intragenic recombination and purifying selection at the beta giardin locus. Gene 449: 1–8

    Article  PubMed  CAS  Google Scholar 

  • Koulda J and Nohynkova E (1978) Flagellates of the human intestine and of intestines of other species. In: Protozoa of veterinary and medical interest 1978 (J.P. Kreier, ed.), New York, N.Y., Academic Press Inc., pp 69–104

    Google Scholar 

  • Lalle M, Pozio E, Capelli G, Bruschi F, Crotti D, Cacciò SM (2005) Genetic heterogeneity at the β-giardin locus among human and animal isolates of Giardia duodenalis and identification of potentially zoonotic sub-genotypes. Int J Parasitol 35: 207–213

    Article  PubMed  CAS  Google Scholar 

  • Lane S and Lloyd D (2002) Current trends in research into the waterborne parasite Giardia. Crit Rev Microbiol 28: 123–147

    Article  PubMed  Google Scholar 

  • Lasek-Nesselquist E, Bogomolni AL, Gast RJ, et al. (2008) Molecular characterization of Giardia intestinalis haplotypes in marine animals: variation and zoonotic potential. Dis Aquat Organ 81: 39–51

    Article  PubMed  CAS  Google Scholar 

  • Lasek-Nesselquist E, Welch DM, Thompson RC, Steuart RF, and Sogin ML (2009) Genetic exchange within and between assemblages of Giardia duodenalis. J Euk Microbiol 56: 504–518

    Article  PubMed  CAS  Google Scholar 

  • Lebbad M, Ankarklev J, Tellez A, Leiva B, Andersson JO, and Svärd S (2008) Dominance of Giardia assemblage B in Leon, Nicarauga Acta Trop 106: 44–53

    Article  Google Scholar 

  • Logsdon JM Jr (2008) Evolutionary genetics: sex happens in Giardia. Curr Biol 18: R66–R68

    Article  PubMed  CAS  Google Scholar 

  • Mahdy AK, Surin J, Mohd-Adnan A, Wan KL, and Lim YA (2009) Molecular characterization of Giardia duodenalis isolated from Semai Pahang Orang Asli (Peninsular Malaysia aborigines). Parasitology 136: 1237–1241

    Article  PubMed  Google Scholar 

  • Mayrhofer G, Andrews RH, Ey PL, and Chilton NB (1995) Division of Giardia isolates from humans into two genetically distinct assemblages by electrophoretic analysis of enzymes encoded at 27 loci and comparison with Giardia muris. Parasitology 111: 11–17

    Article  PubMed  CAS  Google Scholar 

  • Miller KM and Sterling CR (2007) Sensitivity of nested PCR in the detection of low numbers of Giardia lamblia cysts. Appl Environ Microbiol 73: 5949–5950

    Article  PubMed  CAS  Google Scholar 

  • Monis PT, Andrews RH, Mayrhofer G, and Ey PL (1999) Molecular systematics of the parasitic protozoan Giardia intestinalis. Mol Biol Evol 16: 1135–1144

    Article  PubMed  CAS  Google Scholar 

  • Monis PT, Andrews RH, Mayrhofer G, and Ey PL (2003) Genetic diversity within the morphological species Giardia intestinalis and its relationship to host origin. Infect Genet Evol 3: 29–38

    Article  PubMed  CAS  Google Scholar 

  • Morrison HG, McArthur AG, Gillin FD, et al. (2007) Genomic minimalism in the early diverging intestinal parasite Giardia lamblia. Science 317: 1921–1926

    Article  PubMed  CAS  Google Scholar 

  • Paintlia AS, Descoteaux S, Spencer B, et al. (1998) Giardia lamblia groups A and B among young adults in India. Clin Infect Dis 26: 190–191

    Article  PubMed  CAS  Google Scholar 

  • Pelayo L, Nuñez FA, Rojas L, et al. (2008) Giardia infections in Cuban children: the genotypes circulating in a rural population. Ann Trop Med Parasitol 102: 585–595

    Article  PubMed  CAS  Google Scholar 

  • Sahagun J, Clavel A, Goni P, et al. (2007) Correlation between the presence of symptoms and the Giardia duodenalis genotype. Eur J Clin Microbiol Infect Dis 27: 81–83

    Article  Google Scholar 

  • Savioli L, Smith H, and Thompson A (2006) Giardia and Cryptosporidfium join the “Neglected Diseases Initiative”. Trends Parasitol 22: 203–208

    Article  PubMed  CAS  Google Scholar 

  • Smith H, Cacciò SM, Tait A, McLauchlin J, and Thompson RCA (2006) Tools for investigating the environmental transmission of Cryptosporidfium and Giardia infections in humans. Trends Parasitol 22: 160–167

    Article  PubMed  Google Scholar 

  • Sprong H, Cacciò SM, and van der Giessen J (2009) Identification of zoonotic genotypes of Giatrdia duodenalis. PLOS Neg Trop Dis 3: e558

    Article  Google Scholar 

  • Stark D, Barratt JNL, van Hal S, Marriot D, Harkness J, and Ellis JT (2009) Clinical Significance of enteric protozoa in the immunosuppressed human population. Clin Microbiol Rev 22: 634–650

    Article  PubMed  CAS  Google Scholar 

  • Stuart JM, Orr HJ, Warburton FG, et al. (2004) Risk Factors for sporadic giardiasis: a case-control study in Southwestern England. Emerg Infect Dis 9: 229–233

    Article  Google Scholar 

  • Sulaiman IM, Fayer R, Bern C, et al. (2003) Triosephosphate isomerase gene characterization and potential zoonotic transmission of Giardia duodenalis. Emerg Infect Dis 9: 1444–1452

    Article  PubMed  CAS  Google Scholar 

  • Teodorovic S, Braverman JM, and Elmendorf HG (2007) Unusually low levels of genetic variation among Giardia lamblia isolates. Eukaryot Cell 6: 1421–1430

    Article  PubMed  CAS  Google Scholar 

  • Thompson RC (2000) Giardiasis as a re-emerging infectious disease and its zoonotic potential. Int J Parasitol 30: 1259–1267

    Article  PubMed  CAS  Google Scholar 

  • Traub RJ, Monis P, Robertson I, Irwin P, Mencke N, and Thompson RCA (2004) Epidemiological and molecular evidence support the zoonotic transmission of Giardia among humans and dogs living in the same community. Parasitology 128: 53–262

    Article  Google Scholar 

  • Traub RJ, Inpankaew T, Reid SA, et al. (2009) Transmission cycles of Giardia duodenalis in dogs and humans in Temple communities in Bangkok — a critical evaluation of its prevalence using three diagnostic tests in the field in the absence of a gold standard. Acta Trop 111: 125–132

    Article  PubMed  Google Scholar 

  • WHO Expert Committee (1981) Intestinal protozoan and helminthic infections. WHO Tech Rep Ser 58: 666–671

    Google Scholar 

  • WHO, The World Health Report (1996) Fighting Disease Fostering Development. World Health Organization, Geneva.

    Google Scholar 

  • Wielinga CM and Thompson RC (2007) Comparative evaluation of Giardia duodenalis sequence data. Parasitology 134: 1795–1821

    Article  PubMed  CAS  Google Scholar 

  • Yoder JS and Beach MJ (2007) Giardiasis surveillance — United States, 2003–2005. MMWR Surveill Summ 56: 11–18

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Infectious Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy

    Simone M. Cacciò

  2. Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Mailbox 63, Antonie van Leeuwenhoeklaan 9, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands

    Hein Sprong

Authors
  1. Simone M. Cacciò
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hein Sprong
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Laboratory of Biochemistry and Molecular Biology, School of Medicine, Catholic University of Córdoba, Córdoba, Argentina

    Hugo D. Luján PhD

  2. Department of Cell and Molecular Biology, Uppsala University, Uppsala, Sweden

    Staffan Svärd PhD

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag/Wien

About this chapter

Cite this chapter

Cacciò, S.M., Sprong, H. (2011). Epidemiology of Giardiasis in Humans. In: Luján, H.D., Svärd, S. (eds) Giardia. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0198-8_2

Download citation

Publish with us

Policies and ethics

Search

Navigation