Outbreak of amebiasis in Tbilisi, Republic of Georgia, 1998.

Abstract

In 1998, we investigated a suspected outbreak of amebic liver abscesses caused by Entamoeba histolytica in the Republic of Georgia, using a case-control study. A questionnaire was administered and blood samples were obtained from cases and controls for serologic diagnosis. Medical records showed that E. histolytica infections were rarely diagnosed before 1998. However, from July through September 1998, 177 cases of suspected amebiasis were identified. Of 52 persons who had diagnosed liver abscesses, 37 (71%) were confirmed serologically to have antibodies against E. histolytica, compared with 11 of 53 persons (20.8%) diagnosed with intestinal amebiasis. In addition, 9-14% of asymptomatic controls were seropositive. Logistic regression identified the fact that interruptions in the water supply, decreases in water pressure, and increased water consumption were significantly associated with infection. The data support the hypothesis that drinking water was the source of infection, either because of inadequate municipal water treatment or contamination of municipal water in the distribution system.

G protein signaling in the parasite Entamoeba histolytica

“…Although E. histolytica infection is relatively rare in developed countries, such as the United States, it does occur among travelers, immigrants and select susceptible subpopulations. 11, 12 Furthermore, outbreaks of E. histolytica have occurred due to contaminated municipal water supplies (for example, Barwick et al 13 ).…”

Bacterial and Parasitic Agents of Infectious Diarrhoea in the Era of HIV and AIDS - The Case of a Semi Rural Community in South Africa

“…E. histolytica has also been associated with traveler's diarrhea. In a study in Sweden, when the patients were divided into immigrants and travelers, the percentages with E. histolytica were 3.8% and 9.5%, respectively (Barwick et al, 2002). In invasive amoebiasis, white blood cells can be present in the stool, and in severe cases pus can be visible, but faecal leukocyte numbers are generally not as high as in shigellosis (Speelman et al, 1984).…”

Entamoeba histolytica

“…In 1993, 730 students acquired amebiasis from contaminated underground well water at a private school in Taiwan (Chen et al, 2001). A large waterborne outbreak was reported in Tbilisi, in the former Soviet Republic of Georgia resulting from deficiencies with surface water filtration (Barwick et al, 2002). At the time of the outbreak, Tbilisi's population was advised to boil the drinking water and the city brought some modifications to the water treatment process: (i) the improvement of the coagulation step, (ii) the increase of the chlorine doses and (iii) the reduction of the filtration velocities (United Nations Economic commission for Europe, 2003), nevertheless 106 residents developed hepatic abscess cases.…”