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. 1989 Apr;79(4):485–490. doi: 10.2105/ajph.79.4.485

Recurrent outbreaks of giardiasis in a child day care center, Wisconsin.

R W Steketee 1, S Reid 1, T Cheng 1, J S Stoebig 1, R G Harrington 1, J P Davis 1
PMCID: PMC1349982  PMID: 2929809

Abstract

In the 19-month period September 1983-March 1985, three outbreaks of giardiasis occurred in one large child day care center. Control measures instituted during each outbreak included case finding; pharmacologic treatment and follow-up testing of stool specimens for cases of giardia infection in day care children and staff, and their household contacts; facilitating and stressing personal and environmental hygiene, including altering diapering practices and teaching appropriate hand washing techniques. In the first, second, and third outbreaks, overall attack rates (stool analysis positive for Giardia lamblia) were determined for those persons with greater than or equal to 2 stool specimens submitted; attack rates in children were 47, 17, and 37 per cent, respectively; for tested staff, the rates were 35, 13, and 9 per cent; and for tested household contacts were 18, 9, and 5 per cent. Attack rates were highest for ambulatory diapered children, children attending the day care center greater than or equal to 40 hours per week, and children who were infected with G. lamblia in the most recent previous outbreak. Despite extensive efforts to identify cases, a cure rate of greater than 90 per cent in treated cases, and improvements in personal and environmental hygiene practices, G. lamblia infections recurred in outbreak proportions.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barbour A. G., Nichols C. R., Fukushima T. An outbreak of giardiasis in a group of campers. Am J Trop Med Hyg. 1976 May;25(3):384–389. doi: 10.4269/ajtmh.1976.25.384. [DOI] [PubMed] [Google Scholar]
  2. Belosevic M., Faubert G. M. Temporal study of acquired resistance in infections of mice with Giardia muris. Parasitology. 1983 Dec;87(Pt 3):517–524. doi: 10.1017/s0031182000083037. [DOI] [PubMed] [Google Scholar]
  3. Black R. E., Dykes A. C., Anderson K. E., Wells J. G., Sinclair S. P., Gary G. W., Jr, Hatch M. H., Gangarosa E. J. Handwashing to prevent diarrhea in day-care centers. Am J Epidemiol. 1981 Apr;113(4):445–451. doi: 10.1093/oxfordjournals.aje.a113112. [DOI] [PubMed] [Google Scholar]
  4. Black R. E., Dykes A. C., Sinclair S. P., Wells J. G. Giardiasis in day-care centers: evidence of person-to-person transmission. Pediatrics. 1977 Oct;60(4):486–491. [PubMed] [Google Scholar]
  5. Doyle A. B. Incidence of illness in early group and family day-care. Pediatrics. 1976 Oct;58(4):607–613. [PubMed] [Google Scholar]
  6. Ekanem E. E., DuPont H. L., Pickering L. K., Selwyn B. J., Hawkins C. M. Transmission dynamics of enteric bacteria in day-care centers. Am J Epidemiol. 1983 Oct;118(4):562–572. doi: 10.1093/oxfordjournals.aje.a113661. [DOI] [PubMed] [Google Scholar]
  7. Gordts B., Hemelhof W., Retoré P., Rahman M., Cadranel S., Butzler J. P. Routine culture of Giardia lamblia trophozoites from human duodenal aspirates. Lancet. 1984 Jul 21;2(8395):137–138. doi: 10.1016/s0140-6736(84)91050-x. [DOI] [PubMed] [Google Scholar]
  8. Harter L., Frost F., Grunenfelder G., Perkins-Jones K., Libby J. Giardiasis in an infant and toddler swim class. Am J Public Health. 1984 Feb;74(2):155–156. doi: 10.2105/ajph.74.2.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Islam A., Stoll B. J., Ljungström I., Biswas J., Nazrul H., Huldt G. Giardia lamblia infections in a cohort of Bangladeshi mothers and infants followed for one year. J Pediatr. 1983 Dec;103(6):996–1000. doi: 10.1016/s0022-3476(83)80739-2. [DOI] [PubMed] [Google Scholar]
  10. Istre G. R., Dunlop T. S., Gaspard G. B., Hopkins R. S. Waterborne giardiasis at a mountain resort: evidence for acquired immunity. Am J Public Health. 1984 Jun;74(6):602–604. doi: 10.2105/ajph.74.6.602. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kamath K. R., Murugasu R. A comparative study of four methods for detecting Giardia lamblia in children with diarrheal disease and malabsorption. Gastroenterology. 1974 Jan;66(1):16–21. [PubMed] [Google Scholar]
  12. Pickering L. K., Evans D. G., DuPont H. L., Vollet J. J., 3rd, Evans D. J., Jr Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: prospective study. J Pediatr. 1981 Jul;99(1):51–56. doi: 10.1016/s0022-3476(81)80956-0. [DOI] [PubMed] [Google Scholar]
  13. Pickering L. K., Woodward W. E. Diarrhea in day care centers. Pediatr Infect Dis. 1982 Jan-Feb;1(1):47–52. doi: 10.1097/00006454-198201000-00015. [DOI] [PubMed] [Google Scholar]
  14. Pickering L. K., Woodward W. E., DuPont H. L., Sullivan P. Occurrence of Giardia lamblia in children in day care centers. J Pediatr. 1984 Apr;104(4):522–526. doi: 10.1016/s0022-3476(84)80540-5. [DOI] [PubMed] [Google Scholar]
  15. Stevens D. P., Frank D. M., Mahmoud A. A. Thymus dependency of host resistance to Giardia muris infection: studies in nude mice. J Immunol. 1978 Feb;120(2):680–682. [PubMed] [Google Scholar]
  16. Sullivan P., Woodward W. E., Pickering L. K., DuPont H. L. Longitudinal study of occurrence of diarrheal disease in day care centers. Am J Public Health. 1984 Sep;74(9):987–991. doi: 10.2105/ajph.74.9.987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Vogt R. L. Giardiasis in day care centers. J Pediatr. 1985 May;106(5):857–858. doi: 10.1016/s0022-3476(85)80374-7. [DOI] [PubMed] [Google Scholar]
  18. WHEATLEY W. B. A rapid staining procedure for intestinal amoebae and flagellates. Am J Clin Pathol. 1951 Oct;21(10):990–991. doi: 10.1093/ajcp/21.10_ts.990. [DOI] [PubMed] [Google Scholar]

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