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Longitudinal study of Giardia lamblia infection in a day care center population
A M Rauch1, R Van, A V Bartlett
1Department of Pediatrics, University of Texas Medical School, Houston.
Insights
Giardia lamblia infections are common in daycare centers year-round, affecting one-third of children. However, Giardia infection rarely causes illness and is not typically introduced by asymptomatic carriers.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Daycare centers are environments where infectious diseases can spread rapidly among young children.
- Giardia lamblia is a common enteric parasite, but its prevalence and clinical significance in daycare settings require ongoing investigation.
Purpose of the Study:
- To investigate the incidence, duration, and clinical manifestations of Giardia lamblia infections in children attending a daycare center.
- To compare Giardia infection rates with rotavirus and identify potential outbreak triggers within the daycare environment.
Main Methods:
- A 15-month longitudinal study involving weekly stool specimen collection from 82 children (1-24 months old) at a Houston daycare center.
- Enzyme-linked immunosorbent assay (ELISA) was used for Giardia detection; rotavirus and bacterial enteropathogens were also assessed.
Main Results:
- Giardia infection was detected in 33% of children (27/82), with 48 episodes over 15 months. Rotavirus was detected in 45% (37/82) with 57 episodes.
- Most Giardia infections were asymptomatic (93%), and 37% of infected children experienced multiple infections.
- Giardia was present year-round, with two outbreaks linked to overcrowding, not new asymptomatic carriers.
Conclusions:
- Giardia lamblia infections are highly prevalent in daycare settings, often asymptomatic, and persist throughout the year.
- The findings suggest that Giardia transmission in daycares is not solely driven by the introduction of asymptomatic carriers.
- Strategies to control Giardia in daycares should consider its endemic nature and frequent asymptomatic carriage.
Abstract:
An enzyme-linked immunosorbent assay was used to detect Giardia lamblia in stool specimens collected during a 15-month longitudinal study of diarrhea in 82 children 1 to 24 months old attending a day care center (DCC) in Houston. A total of 2727 stool specimens were collected on a weekly basis from the DCC children and were evaluated for rotavirus and Giardia. For DCC children who developed diarrhea stool specimens were also cultured for bacterial enteropathogens. During the 15-month study period, 48 episodes of Giardia infection were detected in 27 of 82 (33%) DCC children, compared with 57 episodes of rotavirus detected in 37 (45%) of these same DCC children. The duration of Giardia excretion was 2.0 +/- 1.5 weeks (mean +/- SD). Only 6 (7%) of the 82 DCC children, or 6 of the 27 (22%) with infection, developed symptoms attributable to Giardia. Ten of the 27 (37%) DCC children infected with Giardia had 2 or more episodes of infection. Giardia was identified in the DCC in all months except June. Two Giardia outbreaks occurred in 1 of the 6 DCC rooms under study. One outbreak was associated with overcrowding. Neither outbreak was associated with the introduction of a new Giardia-positive child into the involved room. In this study Giardia infection occurred commonly in the DCC throughout the year, was rarely associated with illness and was not associated with introduction of asymptomatic carriers into the DCC rooms.
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