Demographics of Giardia infections in Bergen, Norway, subsequent to a waterborne outbreak

Robertson, Lucy J.; Forberg, Torunn; Hermansen, L.; Gjerde, Bjørn; Langeland, Nina

doi:10.1080/00365540701558672

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…In those positive for giardiasis, men predominated among those infected, but women among those tested. It can be assumed that women more actively seek a diagnosis and therefore are more often tested (20). In our study, the proportion of Giardia‐positives among those tested was very high among young children born abroad indicating that this demographic group was justly suspected to be infected.…”

Section: Discussionmentioning

confidence: 99%

Giardia and Cryptosporidium infection in Finland: a registry-based study of their demographic determinants

Rimhanen-Finne

Jokiranta

Virtanen

et al. 2011

Apmis

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Giardia and Cryptosporidium are protozoan parasites that can cause prolonged gastrointestinal infection especially in immunocompromised individuals. We studied the characteristics of giardiasis and cryptosporidiosis cases notified to the Finnish Infectious Disease Registry (FIDR) during 1995-2006, and of persons tested for these parasites in the clinical laboratory of the healthcare district of Helsinki and Uusimaa during 2004-2006. According to reporting, the incidence of both infections was higher in persons residing in the Helsinki area than in other parts of Finland. Persons born abroad were more often tested than were persons born in Finland, and the proportion of the Giardia infected among those tested was very high (14%) in children under the age of five born abroad. Giardia was tested for over 70 times as often as Cryptosporidium, which thus appears to be heavily under tested and therefore underdetected.

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Section: Discussionmentioning

confidence: 99%

Giardia and Cryptosporidium infection in Finland: a registry-based study of their demographic determinants

Rimhanen-Finne

Jokiranta

Virtanen

et al. 2011

Apmis

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“…The investigating laboratory is the only parasitology laboratory in the region, and prior to the outbreak about 50 cases a year were diagnosed, mainly infected abroad [9]. …”

Section: Methodsmentioning

confidence: 99%

Severity of Giardiainfection associated with post-infectious fatigue and abdominal symptoms two years after

et al. 2009

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BackgroundA high rate of post-infectious fatigue and abdominal symptoms two years after a waterborne outbreak of giardiasis in Bergen, Norway in 2004 has previously been reported. The aim of this report was to identify risk factors associated with such manifestations.MethodsAll laboratory confirmed cases of giardiasis (n = 1262) during the outbreak in Bergen in 2004 received a postal questionnaire two years after. Degree of post-infectious abdominal symptoms and fatigue, as well as previous abdominal problems, was recorded. In the statistical analyses number of treatment courses, treatment refractory infection, delayed education and sick leave were used as indices of protracted and severe Giardia infection. Age, gender, previous abdominal problems and symptoms during infection were also analysed as possible risk factors. Simple and multiple ordinal logistic regression models were used for the analyses.ResultsThe response rate was 81% (1017/1262), 64% were women and median age was 31 years (range 3-93), compared to 61% women and 30 years (range 2-93) among all 1262 cases. Factors in multiple regression analysis significantly associated with abdominal symptoms two years after infection were: More than one treatment course, treatment refractory infection, delayed education, bloating and female gender. Abdominal problems prior to Giardia infection were not associated with post-infectious abdominal symptoms. More than one treatment course, delayed education, sick leave more than 2 weeks, and malaise at the time of infection, were significantly associated with fatigue in the multiple regression analysis, as were increasing age and previous abdominal problems.ConclusionProtracted and severe giardiasis seemed to be a risk factor for post-infectious fatigue and abdominal symptoms two years after clearing the Giardia infection.

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“…Some of these may have been outbreak related (as assessed by genotype), and some were more probably not, particularly those of Assemblage A and from patients with a history of visiting, or previous residence in, developing countries. Interestingly, of the giardiasis cases diagnosed in the months subsequent to the outbreak, young women continued to be the predominant demographic group, although this was presumably no longer related to water intake habits (Robertson et al. 2007b).…”

Section: Introductionmentioning

confidence: 99%

Giardia cysts in sewage influent in Bergen, Norway 15–23 months after an extensive waterborne outbreak of giardiasis

2008

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Aims: In autumn/winter 2004, a large outbreak of waterborne giardiasis occurred in Bergen, Norway. Over 1 year later, the concentrations and genotypes of Giardia cysts occurring in sewage influent were studied to investigate the impact of the outbreak event on Giardia infections in the community. Methods and Results: Sewage influent samples from four sewage treatment works (STW) serving Bergen were analysed for Giardia cysts on four occasions between 15 and 23 months after the outbreak. Cysts genotypes were investigated at one to three genes. Data from influent analysis from one of the STW before the outbreak, and from patient faecal samples analysed during the outbreak, provided baseline comparative data. Relatively high concentrations of Giardia cysts of diverse genotypes, both from Assemblages A and B, were detected at all STW. Conclusions: Comparison of data suggests that although Giardia cyst concentrations in sewage influent returned to pre‐outbreak levels within 18 months after the outbreak peak, the genetic composition of the isolates remained significantly influenced by the Assemblage B isolate associated with the outbreak. Significance and Impact of the Study: Genotypes associated with an extensive outbreak of giardiasis continued to occur in Giardia infections in Bergen’s population many months after the outbreak was considered to be over.

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Demographics of Giardia infections in Bergen, Norway, subsequent to a waterborne outbreak

Cited by 5 publications

References 10 publications

Giardia and Cryptosporidium infection in Finland: a registry-based study of their demographic determinants

Giardia and Cryptosporidium infection in Finland: a registry-based study of their demographic determinants

Severity of Giardiainfection associated with post-infectious fatigue and abdominal symptoms two years after

Giardia cysts in sewage influent in Bergen, Norway 15–23 months after an extensive waterborne outbreak of giardiasis

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