Outbreak of giardiasis in a daycare nursery
1West Kent Health Authority, Kent. lihean.ang@wkent-ha.sthames.nhs.uk
Communicable Disease and Public Health
|October 3, 2000
Insights
Giardia lamblia outbreaks in nurseries can spread easily among young children. Prompt hygiene measures and metronidazole treatment effectively controlled this nursery infection.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- Giardia lamblia is a common cause of gastrointestinal illness in children.
- Nursery settings present a high risk for the transmission of infectious agents due to close contact and hygiene challenges.
- Uncontrolled outbreaks can lead to significant illness and disruption.
Purpose of the Study:
- To investigate an outbreak of Giardia lamblia infection in a nursery setting.
- To identify the transmission routes and control measures for the outbreak.
- To evaluate the effectiveness of interventions in managing Giardia infections in young children.
Main Methods:
- Epidemiological investigation of symptomatic cases and asymptomatic carriers.
- Microbiological screening of all nursery staff and children.
- Implementation of enhanced hygiene protocols.
- Antimicrobial treatment of confirmed cases and carriers with metronidazole.
Main Results:
- Seven children and one staff member were diagnosed with Giardiasis.
- Three additional children were identified as asymptomatic carriers.
- Person-to-person transmission, likely due to lack of toilet training, was identified as the primary spread mechanism.
- Reinforced hygiene and metronidazole treatment successfully controlled the outbreak.
Conclusions:
- Nursery environments are vulnerable to Giardia lamblia transmission, particularly among non-toilet-trained children.
- Effective control requires a multi-faceted approach including screening, hygiene reinforcement, and targeted antimicrobial therapy.
- Metronidazole is an effective treatment for both symptomatic Giardia infections and asymptomatic carriage in outbreak settings.
Abstract:
Seven children and one member of staff in a nursery in Kent became ill with Giardia lamblia infection in three months in a nursery in Kent and three further children were found to carry giardia. Person to person spread among young children who were not toilet trained appeared to be responsible. All staff and children were screened for infection, and the outbreak was controlled by reinforcing hygiene measures, and treating microbiologically confirmed cases and carriers with metronidazole.
Related Concept Videos
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Transmission-based precautions are for patients known to be infected or suspected to be infected or colonized with organisms that pose a significant risk to others. Some transmission-based precautions include contact, enteric, and droplet.
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:23Investigation of Disease Outbreaks
Multistate foodborne outbreaks pose significant public health risks and require meticulous investigation to identify sources and implement control measures. The Centers for Disease Control and Prevention (CDC) utilizes a dynamic seven-step process for these investigations, integrating data from laboratories, interviews, and environmental assessments to protect public health.Outbreak Detection: The detection of multistate outbreaks typically begins with PulseNet, the CDC's national laboratory...
01:18Bacterial Gastroenteritis
Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid receptor...
01:28Toxoplasmosis
Toxoplasmosis, a zoonotic disease caused by the protozoan Toxoplasma gondii, poses significant public health challenges globally due to its high seroprevalence and varied clinical manifestations. As an obligate intracellular parasite, T. gondii can infect all warm-blooded vertebrates, but felids are its only definitive hosts, shedding unsporulated oocysts into the environment. Humans typically acquire the infection through ingestion of tissue cysts in undercooked meat or oocysts from...
01:12Giardiasis
Giardiasis is a globally prevalent intestinal infection caused by the protozoan parasite Giardia duodenalis (also known as G. lamblia or G. intestinalis). This flagellated protozoan is the most frequently identified intestinal parasite in the United States and worldwide. Transmission primarily occurs via the fecal-oral route, with infection arising from ingestion of water or food contaminated with cysts. Individuals in low-resource settings, international travelers, outdoor enthusiasts, daycare...
01:28Amebiasis
Entamoeba histolytica, a protozoan parasite, is responsible for intestinal and extraintestinal amebiasis. Though a significant proportion of infections remain asymptomatic, approximately 50 million individuals annually are estimated to present with clinical disease, resulting in up to 100,000 deaths globally. The disease burden is disproportionately high in regions with lower socioeconomic status, such as parts of India, Africa, Mexico, and Latin America.Etiology and TransmissionThe infective...