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Intestinal parasitism in the United States: update on a continuing problem

K D Kappus1, R G Lundgren, D D Juranek

  • 1Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

The American Journal of Tropical Medicine and Hygiene
|June 1, 1994
PubMed
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Intestinal parasitic infections, particularly Giardia lamblia, are prevalent in the U.S. Data from 1987 and 1991 show increasing Giardia rates, highlighting its significance in gastrointestinal illnesses.

Area of Science:

  • Medical Parasitology
  • Public Health Surveillance
  • Epidemiology

Background:

  • Intestinal parasitic infections are a significant public health concern in the United States.
  • Previous data indicated lower prevalence rates for certain parasites, necessitating updated surveillance.

Purpose of the Study:

  • To document the patterns and prevalence of intestinal parasitism across the U.S. using state diagnostic laboratory data.
  • To analyze trends in specific parasitic infections, focusing on Giardia lamblia and hookworm, between 1987 and 1991.
  • To identify geographical and seasonal patterns of these infections.

Main Methods:

  • Analysis of stool specimen results from state diagnostic laboratories in 1987 (216,275 specimens) and 1991 (178,786 specimens).
  • Categorization of identified parasites into protozoans and helminths, with specific species quantified.

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  • Comparison of prevalence data between the two survey years and examination of geographical and seasonal variations.

    • Main Results:

    • In 1987, 20.0% of specimens were positive for parasites, with protozoans like Giardia lamblia (7.2%) being most common. Nematodes such as hookworm (1.5%) were the most frequent helminths.
    • Giardia lamblia identification increased significantly from 4.0% in 1979 to 7.2% in 1987 and 5.6% in 1991, with notable increases in the Midwest and Northwest.
    • Cryptosporidium, not previously surveyed, was identified in 25 states in both 1987 and 1991, indicating widespread presence.

    Conclusions:

    • Intestinal parasitism remains an important, often overlooked, cause of gastrointestinal illness in the U.S.
    • The prevalence of Giardia lamblia appears to be increasing, warranting continued monitoring and public health attention.
    • The widespread identification of Cryptosporidium suggests its growing importance in the U.S. parasitic disease landscape.