I. IDENTIFICATION
A. CLINICAL DESCRIPTION: An illness caused by the protozoan Giardia lamblia and characterized by diarrhea, abdominal cramps, bloating, weight loss, or malabsorption. Infected persons may be asymptomatic.
B. REPORTING CRITERIA: Laboratory diagnosis.
C. LABORATORY CRITERIA FOR CONFIRMATION:
- Demonstration of Giardia lamblia cysts in stool, OR
- Demonstration of Giardia lamblia trophozoites in stool, duodenal fluid, or small bowel biopsy, OR
- Demonstration of Giardia lamblia antigen by specific immunodiagnostic test such as Direct Fluorescent Antigen (DFA).
D. WISCONSIN CASE DEFINITION: A case that is laboratory confirmed.
II. ACTIONS REQUIRED / PREVENTION MEASURESA. 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).
- Routine Enteric Follow-up Worksheet – (See page 1 of the Worksheet for specific recommendations regarding which sections are recommended during routine follow-up)
C. PUBLIC HEALTH INTERVENTIONS:
- Educate public about proper hand washing after using the toilet 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.
- Source investigation by LHD.
- Determine if case is outbreak-related and notify LHS&EMS Regional Office or CDES.
III. CONTACTS FOR CONSULTATION
A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-7422.
B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
C. WSLH / PARASITOLOGY: (608) 263-3421.
IV. RELATED REFERENCES1. “Giardiasis” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
2. Heymann DL, ed. GIARDIASIS. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:229-231.
3. Pickering LK, ed. Giardia lamblia Infections In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:283-285.
4. Giardia Manual: Guidelines for Prevention and Control for Local Health Agencies , Wisconsin Division of Public Health, DPH 4036 (8/96).
5. Addiss DG, Davis JP, Roberts JM, Mast EE. Epidemiology of giardiasis in Wisconsin : Increasing incidence of reported cases and unexplained seasonal trends. Am J Trop Med Hyg 1992;47:13-19.
V. DISEASE TRENDS