AMEBIASIS

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)

EFFECTIVE MARCH 1, 2008 THIS DISEASE IS NO LONGER REPORTABLE IN THE STATE OF WISCONSIN. THE GUIDELINES BELOW SHOULD BE FOLLOWED FOR CASES DIAGNOSED PRIOR TO MARCH 1, 2008

I. IDENTIFICATION

A. CLINICAL DESCRIPTION: Parasitic infection of the large intestine by Entamoeba histolytica resulting in an illness of variable severity ranging from mild, chronic diarrhea to fulminant dysentery. In the U.S. most cases are asymptomatic. Extra-intestinal infection may occur, most commonly liver abscesses.

B. REPORTING CRITERIA: Laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

Intestinal amebiasis:

• Demonstration of E. histolytica cysts or trophozoites in stool, OR
• Demonstration of trophozoites in tissue biopsy, culture or histopathology.

Extra-intestinal amebiasis:

• Demonstration of E. histolytica trophozoites in extra-intestinal tissue.

D. WISCONSIN CASE DEFINITION: A clinically compatible illness that is laboratory confirmed. Asymptomatic intestinal carriage of E. histolytica should not be reported.

NOTE: Other species of Entamoeba (e.g., Entamoeba coli) are not pathogenic and should not be reported.

II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.

B. EPIDEMIOLOGY REPORTS REQUESTED: Acute and Communicable Diseases Case Report (DPH 4151).

C. PUBLIC HEALTH INTERVENTIONS:

• Educate public about proper hand washing after toileting or handling contaminated clothing or linens, before cooking, or associating with high-risk individuals.
• Assess patient’s activities for high-risk settings.
• Educate and advise high-risk patients and food handlers on enteric precautions.
• Educate high-risk groups to avoid sexual practices that may permit fecal-oral transmission.
• Source investigation by LHD.
• Treatment recommended for known carriers.
• Determine if case is outbreak-related and notify Regional Office or CDES.

III. CONTACTS FOR CONSULTATION

A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-9009.

B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL STAFF CONTACTS”.

C. WSLH / PARASITOLOGY UNIT: PARASITOLOGY (608) 263-3421.

IV. RELATED REFERENCES

1. “Amebiasis” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
   
2. Heymann DL, ed. AMOEBIASIS. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:11-15.
   
3. Pickering LK, ed. Amebiasis. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:192-194.

V. DISEASE TRENDS

From 1999-2003, 72 cases of amebiasis were reported in Wisconsin