Skip to main content
Top
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Post epidemic giardiasis and gastrointestinal symptoms among preschool children in Bergen, Norway. A cross-sectional study

Authors: Kristin M Mellingen, Anita Midtun, Kurt Hanevik, Geir E Eide, Øystein Søbstad, Nina Langeland

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

A surprisingly low number of children became ill with giardiasis during the large waterborne outbreak of Giardia lamblia in Bergen, Norway during autumn 2004. The aim of the present study was to evaluate the prevalence of giardiasis among exposed children one year after an outbreak and compare faecal carriage of Giardia and abdominal symptoms among exposed versus unexposed children one year after the epidemic.

Methods

Children between 1 and 6 years old were recruited from the local health care centres in Bergen municipality in the period between June 2005 and January 2006. One faecal sample per child was collected and examined for presence of Giardia with a rapid immunoassay antigen test, and parents were asked to answer a questionnaire. A total of 513 children participated, 378 in the group exposed to contaminated water, and 135 in the in the group not exposed.

Results

In the exposed group eleven children had been treated for giardiasis during the epidemic and none in the unexposed group. Giardia positive faecal tests were found in six children, all in the exposed group, but the difference between the groups did not reach statistical significance. All six Giardia positive children were asymptomatic. No differences were found between the groups regarding demographic data, nausea, vomiting, different odour from stools and eructation. However, the reported scores of abdominal symptoms (diarrhoea, bloating and stomach ache) during the last year were higher in the exposed group than in the unexposed group.

Conclusions

A low prevalence of asymptomatic Giardia infection (1.7%) was found among exposed children around one year after the epidemic (1.2% overall prevalence in the study). In the present setting, pre-school children were therefore unlikely to be an important reservoir for continued transmission in the general population.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ortega YR, Adam RD: Giardia: overview and update. Clin Infect Dis. 1997, 25: 545-549. 10.1086/513745.CrossRefPubMed Ortega YR, Adam RD: Giardia: overview and update. Clin Infect Dis. 1997, 25: 545-549. 10.1086/513745.CrossRefPubMed
2.
go back to reference Nygard K, Schimmer B, Sobstad O, Walde A, Tveit I, Langeland N, Hausken T, Aavitsland P: A large community outbreak of waterborne giardiasis-delayed detection in a non-endemic urban area. BMC Public Health. 2006, 6: 141-10.1186/1471-2458-6-141.CrossRefPubMedPubMedCentral Nygard K, Schimmer B, Sobstad O, Walde A, Tveit I, Langeland N, Hausken T, Aavitsland P: A large community outbreak of waterborne giardiasis-delayed detection in a non-endemic urban area. BMC Public Health. 2006, 6: 141-10.1186/1471-2458-6-141.CrossRefPubMedPubMedCentral
3.
go back to reference Katz DE, Heisey-Grove D, Beach M, Dicker RC, Matyas BT: Prolonged outbreak of giardiasis with two modes of transmission. Epidemiol Infect. 2006, 134: 935-941. 10.1017/S0950268805005832.CrossRefPubMedPubMedCentral Katz DE, Heisey-Grove D, Beach M, Dicker RC, Matyas BT: Prolonged outbreak of giardiasis with two modes of transmission. Epidemiol Infect. 2006, 134: 935-941. 10.1017/S0950268805005832.CrossRefPubMedPubMedCentral
4.
go back to reference Ish-Horowicz M, Korman SH, Shapiro M, Har-Even U, Tamir I, Strauss N, Deckelbaum RJ: Asymptomatic giardiasis in children. Pediatr Infect Dis J. 1989, 8: 773-779.CrossRefPubMed Ish-Horowicz M, Korman SH, Shapiro M, Har-Even U, Tamir I, Strauss N, Deckelbaum RJ: Asymptomatic giardiasis in children. Pediatr Infect Dis J. 1989, 8: 773-779.CrossRefPubMed
5.
go back to reference Rauch AM, Van R, Bartlett AV, Pickering LK: Longitudinal study of Giardia lamblia infection in a day care center population. Pediatr Infect Dis J. 1990, 9: 186-189.CrossRefPubMed Rauch AM, Van R, Bartlett AV, Pickering LK: Longitudinal study of Giardia lamblia infection in a day care center population. Pediatr Infect Dis J. 1990, 9: 186-189.CrossRefPubMed
6.
go back to reference Pickering LK, Woodward WE, DuPont HL, Sullivan P: Occurrence of Giardia lamblia in children in day care centers. J Pediatr. 1984, 104: 522-526. 10.1016/S0022-3476(84)80540-5.CrossRefPubMed Pickering LK, Woodward WE, DuPont HL, Sullivan P: Occurrence of Giardia lamblia in children in day care centers. J Pediatr. 1984, 104: 522-526. 10.1016/S0022-3476(84)80540-5.CrossRefPubMed
7.
go back to reference Wilcoxon F: Individual comparisons by ranking methods. Biometrics Bulletin. 1945, 1: 80-83. 10.2307/3001968.CrossRef Wilcoxon F: Individual comparisons by ranking methods. Biometrics Bulletin. 1945, 1: 80-83. 10.2307/3001968.CrossRef
8.
go back to reference Mann HB, Whitney DR: On a Test of Whether one of Two Random Variables is Stochastically Larger than the Other. The annals of mathematical statistics. 1947, 18: 50-60. 10.1214/aoms/1177730491.CrossRef Mann HB, Whitney DR: On a Test of Whether one of Two Random Variables is Stochastically Larger than the Other. The annals of mathematical statistics. 1947, 18: 50-60. 10.1214/aoms/1177730491.CrossRef
9.
go back to reference Horman A, Korpela H, Sutinen J, Wedel H, Hanninen ML: 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. 2004, 34: 1337-1346. 10.1016/j.ijpara.2004.08.009.CrossRefPubMed Horman A, Korpela H, Sutinen J, Wedel H, Hanninen ML: 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. 2004, 34: 1337-1346. 10.1016/j.ijpara.2004.08.009.CrossRefPubMed
10.
go back to reference Hoque ME, Hope VT, Scragg R, Kjellstrom T: Children at risk of giardiasis in Auckland: a case-control analysis. Epidemiol Infect. 2003, 131: 655-662. 10.1017/S0950268803008598.CrossRefPubMedPubMedCentral Hoque ME, Hope VT, Scragg R, Kjellstrom T: Children at risk of giardiasis in Auckland: a case-control analysis. Epidemiol Infect. 2003, 131: 655-662. 10.1017/S0950268803008598.CrossRefPubMedPubMedCentral
11.
go back to reference Birkhead G, Vogt RL: Epidemiologic surveillance for endemic Giardia lamblia infection in Vermont. The roles of waterborne and person-to-person transmission. Am J Epidemiol. 1989, 129: 762-768.PubMed Birkhead G, Vogt RL: Epidemiologic surveillance for endemic Giardia lamblia infection in Vermont. The roles of waterborne and person-to-person transmission. Am J Epidemiol. 1989, 129: 762-768.PubMed
12.
go back to reference Novotny TE, Hopkins RS, Shillam P, Janoff EN: Prevalence of Giardia lamblia and risk factors for infection among children attending day-care facilities in Denver. Public Health Rep. 1990, 105: 72-75.PubMedPubMedCentral Novotny TE, Hopkins RS, Shillam P, Janoff EN: Prevalence of Giardia lamblia and risk factors for infection among children attending day-care facilities in Denver. Public Health Rep. 1990, 105: 72-75.PubMedPubMedCentral
13.
go back to reference Pickering LK, Evans DG, DuPont HL, Vollet JJ, Evans DJ: Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: prospective study. J Pediatr. 1981, 99: 51-56. 10.1016/S0022-3476(81)80956-0.CrossRefPubMed Pickering LK, Evans DG, DuPont HL, Vollet JJ, Evans DJ: Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: prospective study. J Pediatr. 1981, 99: 51-56. 10.1016/S0022-3476(81)80956-0.CrossRefPubMed
14.
go back to reference Polis MA, Tuazon CU, Alling DW, Talmanis E: Transmission of Giardia lamblia from a day care center to the community. Am J Public Health. 1986, 76: 1142-1144. 10.2105/AJPH.76.9.1142.CrossRefPubMedPubMedCentral Polis MA, Tuazon CU, Alling DW, Talmanis E: Transmission of Giardia lamblia from a day care center to the community. Am J Public Health. 1986, 76: 1142-1144. 10.2105/AJPH.76.9.1142.CrossRefPubMedPubMedCentral
15.
go back to reference Hoque ME, Hope VT, Scragg R, Kjellstrom T, Lay-Yee R: Nappy handling and risk of giardiasis. Lancet. 2001, 357: 1017-1018. 10.1016/S0140-6736(00)04251-3.CrossRefPubMed Hoque ME, Hope VT, Scragg R, Kjellstrom T, Lay-Yee R: Nappy handling and risk of giardiasis. Lancet. 2001, 357: 1017-1018. 10.1016/S0140-6736(00)04251-3.CrossRefPubMed
16.
go back to reference Hanevik K, Dizdar V, Langeland N, Hausken T: Development of functional gastrointestinal disorders after Giardia lamblia infection. BMC Gastroenterol. 2009, 9: 27-10.1186/1471-230X-9-27.CrossRefPubMedPubMedCentral Hanevik K, Dizdar V, Langeland N, Hausken T: Development of functional gastrointestinal disorders after Giardia lamblia infection. BMC Gastroenterol. 2009, 9: 27-10.1186/1471-230X-9-27.CrossRefPubMedPubMedCentral
17.
go back to reference Garcia LS, Shimizu RY, Novak S, Carroll M, Chan F: Commercial assay for detection of Giardia lamblia and Cryptosporidium parvum antigens in human fecal specimens by rapid solid-phase qualitative immunochromatography. J Clin Microbiol. 2003, 41: 209-212. 10.1128/JCM.41.1.209-212.2003.CrossRefPubMedPubMedCentral Garcia LS, Shimizu RY, Novak S, Carroll M, Chan F: Commercial assay for detection of Giardia lamblia and Cryptosporidium parvum antigens in human fecal specimens by rapid solid-phase qualitative immunochromatography. J Clin Microbiol. 2003, 41: 209-212. 10.1128/JCM.41.1.209-212.2003.CrossRefPubMedPubMedCentral
18.
go back to reference Johnston SP, Ballard MM, Beach MJ, Causer L, Wilkins PP: Evaluation of three commercial assays for detection of Giardia and Cryptosporidium organisms in fecal specimens. J Clin Microbiol. 2003, 41: 623-626. 10.1128/JCM.41.2.623-626.2003.CrossRefPubMedPubMedCentral Johnston SP, Ballard MM, Beach MJ, Causer L, Wilkins PP: Evaluation of three commercial assays for detection of Giardia and Cryptosporidium organisms in fecal specimens. J Clin Microbiol. 2003, 41: 623-626. 10.1128/JCM.41.2.623-626.2003.CrossRefPubMedPubMedCentral
19.
go back to reference Strand EA, Robertson LJ, Hanevik K, Alvsvag JO, Morch K, Langeland N: Sensitivity of a Giardia antigen test in persistent giardiasis following an extensive outbreak. Clin Microbiol Infect. 2008, 14: 1069-1071. 10.1111/j.1469-0691.2008.02078.x.CrossRefPubMed Strand EA, Robertson LJ, Hanevik K, Alvsvag JO, Morch K, Langeland N: Sensitivity of a Giardia antigen test in persistent giardiasis following an extensive outbreak. Clin Microbiol Infect. 2008, 14: 1069-1071. 10.1111/j.1469-0691.2008.02078.x.CrossRefPubMed
Metadata
Title
Post epidemic giardiasis and gastrointestinal symptoms among preschool children in Bergen, Norway. A cross-sectional study
Authors
Kristin M Mellingen
Anita Midtun
Kurt Hanevik
Geir E Eide
Øystein Søbstad
Nina Langeland
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-163

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue