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2010-02-28Zeitschriftenartikel DOI: 10.1186/1471-2458-10-41
Characteristics and risk factors for symptomatic Giardia lamblia infections in Germany
dc.contributor.authorEspelage, Werner
dc.contributor.authorHeiden, Matthias an der
dc.contributor.authorStark, Klaus
dc.contributor.authorAlpers, Katharina
dc.date.accessioned2018-05-07T13:44:23Z
dc.date.available2018-05-07T13:44:23Z
dc.date.created2010-02-26
dc.date.issued2010-02-28none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/reI4rHZqUm2AM/PDF/23qnYGezys2bw.pdf
dc.identifier.urihttp://edoc.rki.de/176904/595
dc.description.abstractBackground: In developed countries, giardiasis is considered a travel related disease. However, routine surveillance data from Germany indicate that >50% of infections were acquired indigenously. We studied the epidemiological characteristics of symptomatic Giardia infections acquired in Germany and abroad, and verified the proportion of cases acquired in Germany in order to investigate risk factors for sporadic autochthonous Giardia infections. Methods: We identified Giardia cases notified by 41 local health authorities between February 2007 and January 2008 and interviewed them on their clinical symptoms, underlying morbidities, travel abroad and potential risk factors for the disease. We conducted a case-control-study including laboratory-confirmed (microscopy or antigen-test) autochthonous Giardia cases with clinical manifestations (diarrhoea, cramps, bloating) and randomly selected controls from the local population registry matched by county of residence and age-group (0-5, 6-19, ≥20 years). Secondary cases, controls with diarrhoea and persons who had travelled outside Germany in the three weeks prior to disease onset (exposure period) were excluded. We calculated adjusted odds ratios (aOR) with 95% confidence intervals (CI) using conditional logistic regression. Results: Of 273 interviewed cases, 131 (48%) had not travelled abroad during the defined exposure period. Of these 131, 85 (65%) were male, 68 (54%) were living in communities with >100,000 inhabitants and 107 (83%) were aged 20 years or older. We included 120 cases and 240 controls in the case-control study. Cases were more likely to be male (aOR 2.5 CI 1.4-4.4), immunocompromised (aOR 15.3 CI 1.8-127) and daily consumers of green salad (aOR 2.9 CI 1.2-7.2). Contact with animals (pets/farm animals) and exposure to surface water (swimming/water sports) were not associated with symptomatic disease. Conclusions: A substantial proportion of Giardia lamblia cases in Germany are indigenously acquired. Symptomatic cases are significantly more likely to be immunocompromised than control persons from the general population. Physicians should consider Giardia infections among patients with no recent history of travel abroad, particularly if they have immune deficiencies. Green salads may be an important vehicle of infection. Information campaigns highlighting this food-borne risk should emphasise the risk to persons with immune deficiencies.ger
dc.language.isoeng
dc.publisherRobert Koch-Institut
dc.subject80 and overeng
dc.subjectPreschooleng
dc.subjectHumanseng
dc.subjectFemaleeng
dc.subjectGermany/epidemiologyeng
dc.subjectMaleeng
dc.subjectMiddle Agedeng
dc.subjectPopulation Surveillanceeng
dc.subjectRisk Factorseng
dc.subjectTravel/statistics & numerical dataeng
dc.subjectChildeng
dc.subjectCase-Control Studieseng
dc.subjectAgedeng
dc.subjectInfanteng
dc.subjectLogistic Modelseng
dc.subject* Adolescenteng
dc.subjectInterviews as Topiceng
dc.subjectSex Factorseng
dc.subjectYoung Adulteng
dc.subject* AdultAgedeng
dc.subjectFood Parasitologyeng
dc.subjectGiardia lambliaeng
dc.subjectGiardiasis/epidemiologyeng
dc.subjectGiardiasis/immunologyeng
dc.subjectGiardiasis/transmissioneng
dc.subjectImmunocompromised Hosteng
dc.subject.ddc610 Medizin
dc.titleCharacteristics and risk factors for symptomatic Giardia lamblia infections in Germany
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-1005947
dc.identifier.doi10.1186/1471-2458-10-41
dc.identifier.doihttp://dx.doi.org/10.25646/520
local.edoc.container-titleBMC Public Health
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://www.biomedcentral.com/1471-2458/10/41
local.edoc.container-publisher-nameBioMedCentral
local.edoc.container-volume10
local.edoc.container-issue41
local.edoc.container-year2010

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