GIARDIASIS

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

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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 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).
  • 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 REFERENCES

1. “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