Advertisement

Infection

, Volume 20, Issue 2, pp 78–82 | Cite as

Outbreak ofEntamoeba histolytica andGiardia lamblia infections in travellers returning from the tropics

  • F. de Lalla
  • R. Nicolin
  • A. Tramarin
  • E. Rinaldi
  • D. Santoro
Originalia

Summary

Of 160 travellers from various regions in Italy who had taken part in a five-day organized trip to Phuket, Thailand, and been accommodated in the same luxury hotel, 17 showed either amebic abscess or colitis. A pretested questionnaire that focused on the consumption of foods and beverages well known to be a source of intestinal infection in endemic areas was available from these 17 patients as well as from 41 out of 74 asymptomatic travellers. Stool samples for parasitological examination were also available. In patients affected with amebic abscess, antibodies toEntamoeba histolytica were also determined. Overall, parasitological examinations were negative in eight (13.8%) patients, and 50 out of 58 (86.2%) were found to be positive. The prevalence ofGiardia lamblia andE. histolytica infections was 67.2% and 72.4%, respectively, and 28 subjects (48.3%) were stool-positive for both of these protozoa. No other intestinal parasites were found. No particular food or beverage was consumed by all of the parasitized subjects and by none of the stool-negative individuals. However, the consumption of drinks with ice, ice cream and raw fruit in ice was significantly associated withE. histolytica and/orG. lamblia infections (Fisher's exact test, p ranging from 0.03 to 0.003).

Keywords

Intestinal Parasite Entamoeba Histolytica Intestinal Infection Giardia Lamblia Parasitological Examination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Ausbruch von Infektionen durch Entamoeba histolytica und Giardia lamblia bei Touristen nach Rückkehr von einer Tropenreise

Zusammenfassung

17 Fälle von Amöbenabszessen oder Kolitis traten in einer Gruppe von 160 Touristen aus verschiedenen italienischen Regionen auf, die an einer fünf-Tage-Reise nach Phuket, Thailand, teilgenommen hatten und im selben Luxushotel untergebracht worden waren. Von diesen 17 Patienten und weiteren 41 von 74 asymptomatischen Teilnehmern lag ein geprüfter Fragebogen vor, der sich auf den Genuß von Speisen und Getränken bezog, die als Quellen intestinaler Infektionen in Endemiegebieten bekannt sind. Stuhlproben für parasitologische Untersuchungen standen ebenfalls zur Verfügung. Bei Patienten mit Amöbenabszessen wurden auch Antikörperbestimmungen fürEntamoeba histolytica vorgenommen. Die parasitologischen Untersuchungen waren bei acht von 58 Untersuchten negativ (13,8%) und bei 50 positiv (86,2%). Die Prävalenz derGiardia lamblia-Infektionen betrug 67,2% und die derE. histolytica-Infektionen 72,4%. Beide Protozoen wurden bei 28 Personen (43,3%) im Stuhl nachgewiesen. Andere intestinale Parasiten fanden sich nicht. Bei Personen, die durch Parasiten infestiert waren, konnte keine bestimmte Nahrungsquelle ausgemacht werden. Doch war der Genuß von Getränken mit Eiswürfeln, Speiseeis und rohen Früchten signifikant mit Infektionen durchE. histolytica und/oderG. lamblia assoziiert (p 0,03-0,003 Fisher's exact test).

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Walsh, J. A. Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality. Rev. Infect. Dis. 8 (1986) 228–238.Google Scholar
  2. 2.
    Weinke, T., Friedrich-Janicke, B., Hopp, P., Janitschke, K. Prevalence and clinical importance ofEntamoeba histolytica in two high- risk groups: travelers returning from the tropics and male homosexuals. J. Infect. Dis. 161 (1990) 1029–1031.Google Scholar
  3. 3.
    Petersen, L. R., Cartter, M. L., Hadler, J. L. A food-borne outbreak ofGiardia lamblia. J. Infect. Dis. 157 (1988) 846–848.Google Scholar
  4. 4.
    Osterholm, M. T., Forfang, J. C., Ristenen, B. A., Dean, A. G., Washburn, J. W., Codes, J. R., Rude, R. A., McGullough, J. G. An outbreak of foodborne giardiasis. N. Engl. J. Med. 304 (1981) 24–38.Google Scholar
  5. 5.
    de Lalla, F., Rizzardini, F., Cairoli, G. A., Rinaldi, E., Santoro, D., Ostinelli, A. Outbreak of amoebiasis in tourists returning from Thailand. Lancet ii (1988) 847.Google Scholar
  6. 6.
    Ravdin, J. I., Guerrant, R. L. Current problems in diagnosis and treatment of amebic infections. In:Remington, J. S., Swartz, M. N. (eds.): Current clinical topics in infectious diseases. McGraw-Hill Book Company, New York 1986, pp. 82–111.Google Scholar
  7. 7.
    Pehrson, P. O. Amoebiasis in a non-endemic country. Scand. J. Infect. Dis. 15 (1983) 207–212.Google Scholar
  8. 8.
    Hopkins, R. S., Shillam, P., Gaspard, B., Eisnach, L., Karlin, R. J. Waterborne disease in Colorado: three years' surveillance and 18 outbreaks. Am. J. Public Health 75 (1985) 254–257.Google Scholar
  9. 9.
    Wright, R. A., Spencer, H. C., Brodsky, R. E., Vernon, T. M. Giardiasis in Colorado: an epidemiological study. Am. J. Epidemiol. 105 (1977) 330–336.Google Scholar
  10. 10.
    Brodsky, R. E., Spencer, H. C. Jr., Schultz, M. G. Giardiasis in American travelers to the Soviet Union. J. Infect. Dis. 130 (1974) 319–323.Google Scholar
  11. 11.
    Thompson, J. E. Jr., Forlenza, S., Verma, R. Amebic liver abscess: a therapeutic approach. Rev. Infect. Dis. 7 (1985) 171–179.Google Scholar
  12. 12.
    Ahmed, L., El Rooby, A., Kassem, M. I., Salama, Z. A., Strickland, G. T. Ultrasonography in the diagnosis and management of 52 patients with amebic liver abscess in Cairo. Rev. Infect. Dis. 12 (1990) 330–337.Google Scholar
  13. 13.
    Waheed, A., Saleemi, M. S., Ashraf, R. M. Amebic abscess of spleen. JPMA 36 (1986) 93–95.Google Scholar
  14. 14.
    Gupta, R. K., Pant, C. S., Ganguly, S. K. Ultrasound demonstration of amebic splenic abscess. J. Clin. Ultrasound 15 (1987) 55–57.Google Scholar
  15. 15.
    Sargeaunt, P. G. The reliability ofEntamoeba histolytica zymodemes in clinical diagnosis. Parasitol. Today 3 (1987) 40–43.Google Scholar
  16. 16.
    Markell, E. K., Voge, M., John, D. T. Lumen-dwelling protozoa. In:Markell, E. K., Voge, M., John, D. T. (eds.): Medical parasitology. W. B. Saunders Co., Philadelphia 1986, pp. 20–78.Google Scholar
  17. 17.
    Juraneck, D. D., Visvesvara, G., Dickerson, J., Walker, E. M.: The effects of water temperature on the infectivity ofGiardia lamblia cysts (abstract no. 177). In: Program and Abstracts of the 36th Annual Meeting of the American Society of Tropical Medicine and Hygiene. Los Angeles: American Society of Tropical Medicine, 1987.Google Scholar

Copyright information

© MMV Medizin Verlag GmbH München 1992

Authors and Affiliations

  • F. de Lalla
    • 1
  • R. Nicolin
    • 1
  • A. Tramarin
    • 1
  • E. Rinaldi
    • 2
  • D. Santoro
    • 2
  1. 1.Divisione di Malattie Infettive, Ospedale S. BortoloVicenza
  2. 2.Divisione di Malattie Infettive, Ospedale S. AnnaComoItaly

Personalised recommendations