==================================CMR35================================== 35. Giardiasis: 1. Clinical symptoms and signs. 2. Diagnosis: - Enterotest - Intraduodenal intubation 3. Serology: Enzyme linked immuosorbent assay (ELISA) - Indirect hemagglutination assay (IHA) - Counterimmunoelectrophoresis (CIE) 1 UI - 87073935 AU - Speelman P ; Ljungstr:om I TI - Protozoal enteric infections among expatriates in Bangladesh. AB - In order to study the prevalence, incidence, and symptoms of infections with Giardia lamblia and Entamoeba histolytica, we followed 251 expatriates in Bangladesh over a 1-year period. Microscopic examination of fecal specimens was performed upon enrollment, at 3-month intervals, and during episodes of diarrhea. Specimens were cultured for bacteria and samples of serum and saliva were collected for antibody studies (IgG and SIgA). The prevalence of G. lamblia infections was 5.2% and the incidence 11.8%. Children aged less than or equal to 10 years and newcomers were most frequently infected (P less than 0.02). Symptoms were present in 37% of the subjects infected with G. lamblia. A systemic antibody response was observed in 57% of symptomatic patients and 35% of asymptomatic subjects during the first 2 months of infection. The prevalence and the incidence of E. histolytica infection were 3.2% and 8.6%, respectively. Infections with E. histolytica were correlated with the duration of stay in Bangladesh; less than 1 year 7% vs. greater than 3 years 26% (P less than 0.01). Most expatriates infected with E. histolytica were asymptomatic (90%). Three adult patients, who were resident in Bangladesh for less than 1 year, were symptomatic but none of them developed dysentery or a serological response. Four of 25 asymptomatic subjects had significant antibody titers. Three of these people were seropositive for ameba at the beginning of the study. The local immune response, reflected by specific secretory IgA in saliva samples, correlated poorly with both E. histolytica and G. lamblia infections. MH - Adult ; Age Factors ; Amebiasis/*OCCURRENCE ; Bangladesh ; Child ; Entamoebiasis/*OCCURRENCE ; Feces/PARASITOLOGY ; Female ; Giardiasis/*OCCURRENCE ; Human ; Male ; Support, Non-U.S. Gov't ; Time Factors SO - Am J Trop Med Hyg 1986 Nov;35(6):1140-5 2 UI - 87058066 AU - Miotti PG ; Gilman RH ; Santosham M ; Ryder RW ; Yolken RH TI - Age-related rate of seropositivity of antibody to Giardia lamblia in four diverse populations. AB - We used a solid-phase enzyme immunoassay to determine the age-specific rates of acquisition of antibody to Giardia lamblia in populations living in an inner city area of Baltimore, Md., on an Apache Indian reservation in Arizona, in a rural area of Panama, and in an urban area of Peru (Lima). Antibody to G. lamblia was found in a portion of the adults living in all of the study areas. Similar prevalence rates and quantitative levels of antibody were found in the adults living in Arizona (44%), Panama (48%), and Peru (46%). However, a significantly lower (P less than 0.05) percentage of the adults living in Baltimore (18%) displayed serological evidence of infection. Different patterns of age-associated acquisition of antibody were noted in the study populations. In the United States, children living in Baltimore had low levels of seropositivity throughout childhood, whereas children living on the Arizona Indian reservation showed a progressive acquisition of antibody early in childhood, with adult levels achieved by 8 years of age. In Latin America, children living in Panama attained adult levels of seropositivity between 9 and 20 years of age, whereas children in Peru displayed adult levels of seropositivity in the first 6 months of life. Our findings documented the widespread occurrence of G. lamblia infections in diverse populations. Children living in different areas and under different environmental conditions displayed widely differing rates of acquisition of antibody to G. lamblia, possibly resulting from different levels of sanitation, water contamination, and person-to-person contact.(ABSTRACT TRUNCATED AT 250 WORDS) MH - Adolescence ; Adult ; Age Factors ; Antibodies/*ANALYSIS ; Arizona ; Child ; Child, Preschool ; Comparative Study ; Enzyme-Linked Immunosorbent Assay ; Giardia/*IMMUNOLOGY ; Giardiasis/*OCCURRENCE ; Human ; Infant ; Maryland ; Panama ; Peru ; Prospective Studies ; Rural Population ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Urban Population SO - J Clin Microbiol 1986 Dec;24(6):972-5 3 UI - 87058042 AU - Rosoff JD ; Stibbs HH TI - Physical and chemical characterization of a Giardia lamblia-specific antigen useful in the coprodiagnosis of giardiasis. AB - We recently reported the isolation and identification of a Giardia lamblia-specific antigen (GSA 65) that is shed in the stool of giardiasis patients. In the present study, this antigen was affinity purified from sonic extracts of axenically cultured G. lamblia trophozoites and characterized to better understand its biological function and its potential usefulness in the design of coprodiagnostic assays for giardiasis. GSA 65 was resistant to proteolytic digestion with trypsin, chymotrypsin, and protease but was sensitive to treatment with NaIO4 as assessed by Western blotting. This antigen was also stable during prolonged storage at 4 and -20 degrees C in 10% Formalin or distilled H2O as assessed by counterimmunoelectrophoresis. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and isoelectric focusing gel banding patterns, in conjunction with protein and carbohydrate assays and lectin binding studies, confirmed that this antigen is a highly glycosylated glycoprotein. The resistance of GSA 65 to proteolytic degradation, together with previous immunofluorescence data that indicate the antigen is an integral part of the G. lamblia cyst wall, suggests that this molecule may play a role in maintaining the integrity of the cyst in vivo. The ability of GSA 65 to maintain its antigenic structure under a wide variety of conditions makes it an ideal antigen around which to design sensitive immunodiagnostic assays for giardiasis. MH - Animal ; Antigens, Protozoan/*ANALYSIS ; Chromatography, Affinity ; Counterimmunoelectrophoresis ; Electrophoresis, Polyacrylamide Gel ; Giardia/*IMMUNOLOGY ; Giardiasis/*DIAGNOSIS/IMMUNOLOGY ; Human ; Immunologic Technics ; Isoelectric Focusing ; Support, Non-U.S. Gov't SO - J Clin Microbiol 1986 Dec;24(6):1079-83 4 UI - 87056054 AU - Edson CM ; Farthing MJ ; Thorley-Lawson DA ; Keusch GT TI - An 88,000-Mr Giardia lamblia surface protein which is immunogenic in humans. AB - Human anti-Giardia lamblia sera specifically immunoprecipitated an 88,000-Mr surface protein from radioiodinated trophozoites, establishing this protein as a potentially important immunogen in humans. A mouse monoclonal antibody (GL-1) was isolated which immunoprecipitated the same 88,000-Mr surface protein recognized by the human sera. GL-1 gave uniform fluorescent staining of the cell surface and flagella of G. lamblia trophozoites from the Portland 1 and WB strains as well as fresh clinical isolates, but not of Giardia muris, suggesting that the surface antigen is specific to G. lamblia. Other human parasites, including Entamoeba histolytica, Trichomonas vaginalis, and Trichomonas hominis, were not stained. A second mouse monoclonal antibody (GL-2) gave weaker immunofluorescent staining of living G. lamblia trophozoites but intense staining of fixed cells. None of the other parasites tested were stained, with the exception of E. histolytica, which may contain a cross-reactive antigen. No proteins were recognized in immunoprecipitation studies with iodinated trophozoites. MH - Antibodies, Monoclonal/*IMMUNOLOGY ; Antibody Specificity ; Antigens, Protozoan/*ANALYSIS ; Antigens, Surface/IMMUNOLOGY ; Fluorescent Antibody Technic ; Giardia/*IMMUNOLOGY ; Giardiasis/ *IMMUNOLOGY ; Human ; Molecular Weight ; Proteins/IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Infect Immun 1986 Dec;54(3):621-5 5 UI - 86292657 AU - Fern:andez M ; Tabar A ; Guisantes J ; Oehling A TI - Incidence of intestinal parasitism in allergic children. AB - Enteroparasites rarely reach limits of clinical severity although their different manifestations oblige one to consult pediatricians and other specialists. In our cases, patients consulted the Department of Allergology for the presentation of recurrent urticarial reactions, recurrent cough and other manifestations that can be interpreted as allergic in origin. It is the objective of this present study to carry out a review and a statistical study of the incidence of intestinal parasitism in children who consulted for some type of allergic manifestation. We intend to evaluate the unfavorable effects that enteroparasites produce in these patients which can perpetuate the clinical symptomatology. Six hundred and eleven children with ages ranging from 2 to 12 years, and who were attended in our allergology consultancy during a 2 year period, were studied. An intracutaneous test to the different group of food and inhalant antigens, stool examination and investigation of enterobius was carried out on all of them. On 37 children an "in vitro: test to evaluate cellular and humoral immunity was carried out aside from the other explorations mentioned. MH - Antibody Formation ; Child ; Child, Preschool ; Female ; Giardiasis/*IMMUNOLOGY/OCCURRENCE ; Human ; Immunity, Cellular ; Intestinal Diseases, Parasitic/*IMMUNOLOGY/OCCURRENCE ; Male ; Oxyuriasis/*IMMUNOLOGY/OCCURRENCE ; Seasons ; Skin Tests ; Spain SO - Allergol Immunopathol (Madr) 1986 May-Jun;14(3):205-13 6 UI - 86289696 AU - Nacapunchai D ; Tepmongkol M ; Tharavanij S ; Thammapalerd N ; Subchareon A TI - A comparative study of four methods for detecting antibody in asymptomatic giardiasis. AB - Four immunological methods for diagnosis of giardiasis comprising complement fixation (CF) test, indirect hemagglutination (IHA) test, enzyme-linked immuno sorbent assay (ELISA) and lectin immuno test (LIT) were studied. Fifty sera from asymptomatic giardiasis patients, 40 from patients with other diseases and 50 from healthy controls were evaluated. The seropositive rates in asymptomatic giardiasis were 36% for CF, 58% for LIT, 30% for IHA and 72% for ELISA. The seropositive rates in patients with other diseases were 22.5% for CF, 52.5% for LIT, 12.5% for IHA and 67.5% for ELISA. The results suggest that the test of choice for giardiasis was CF with 88% specificity, nevertheless this test showed low sensitivity (36%). Other two tests, ELISA and LIT were more sensitive than CF with percent sensitivity of 72 and 58 respectively, but these two tests had severe disadvantages in being less specific with percentage specificity of 48 and 60 respectively. MH - Antibodies/*ANALYSIS ; Antigens, Protozoan/IMMUNOLOGY ; Comparative Study ; Complement Fixation Tests ; Concanavalin A ; Enzyme-Linked Immunosorbent Assay ; Giardia/*IMMUNOLOGY ; Giardiasis/*DIAGNOSIS ; Hemagglutination Tests/METHODS ; Human SO - Southeast Asian J Trop Med Public Health 1986 Mar;17(1):96-100 7 UI - 86256024 AU - Goka AK ; Rolston DD ; Mathan VI ; Farthing MJ TI - Diagnosis of giardiasis by specific IgM antibody enzyme-linked immunosorbent assay. AB - An enzyme-linked immunosorbent assay (ELISA) was used to detect serum IgM and IgG antibodies against Giardia in fifty-two patients with diarrhoea from the United Kingdom and south India. Serum anti-Giardia IgM responses occurred in patients with giardiasis; in two of three patients studied longitudinally IgM levels had fallen to normal 2-3 weeks after treatment. At serum dilutions of 1/200 to 1/400 there was almost complete separation of ELISA readings between patients with Giardia and Giardia-free controls; the sensitivity and specificity of the ELISA were both 96%. Serum anti-Giardia IgG was detected in patients and controls but was unable to distinguish current from previous infection. MH - Acute Disease ; Antibodies/*ANALYSIS ; Diarrhea/DIAGNOSIS ; Enzyme-Linked Immunosorbent Assay/*METHODS ; Evaluation Studies ; Giardiasis/*DIAGNOSIS/IMMUNOLOGY ; Great Britain ; Human ; IgG/ ANALYSIS ; IgM/*ANALYSIS ; India ; Longitudinal Studies ; Support, Non-U.S. Gov't SO - Lancet 1986 Jul 26;2(8500):184-6 8 UI - 86224506 AU - Rosoff JD ; Stibbs HH TI - Isolation and identification of a Giardia lamblia-specific stool antigen (GSA 65) useful in coprodiagnosis of giardiasis. AB - A Giardia lamblia-specific antigen (GSA 65) was isolated from stools of G. lamblia-positive patients by crossed- and line-immunoelectrophoresis and counterimmunoelectrophoresis (CIE) in agarose by using rabbit antiserum prepared against G. lamblia cysts. CIE with rabbit anti-GSA 65 monospecific antiserum revealed that GSA 65 was present in aqueous stool eluates of giardiasis patients and in cysts and trophozoites of the parasite. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of immunoaffinity-purified antigen followed by Western blotting showed that the molecular weight of this molecule was about 65,000. GSA 65 was detectable by CIE in stool eluates of 36 of 40 giardiasis patients but not in eluates of 10 G. lamblia-negative asymptomatic controls. GSA 65 was detected in stool eluates of 2 of 18 individuals with chronic diarrhea who were negative for parasites by microscopic examination. Cross-specificity studies with other genera of parasitic protozoa performed by using CIE and immunofluorescence indicated that GSA 65 was present only in strains of G. lamblia. Based on these findings, GSA 65 may prove to have an important application in the design of sensitive diagnostic tests for giardiasis. MH - Animal ; Antigens, Protozoan/*ANALYSIS ; Feces/IMMUNOLOGY ; Fluorescent Antibody Technic ; Giardia/*IMMUNOLOGY ; Giardiasis/ *DIAGNOSIS ; Human ; Immunoelectrophoresis, Two-Dimensional ; Immunosorbent Technics ; Molecular Weight ; Support, Non-U.S. Gov't SO - J Clin Microbiol 1986 May;23(5):905-10 9 UI - 86210475 AU - Korman SH ; Le Blancq SM ; Spira DT ; el On J ; Reifen RM ; Deckelbaum RJ TI - Giardia lamblia: identification of different strains from man. AB - Four axenically cultured human Giardia lamblia isolates from Jerusalem (KC-1, 2, 3 and 4) and one from Bethesda (WB) were compared. Three distinct groups were defined by agglutination response to rabbit anti-G. lamblia sera viz. WB; KC-3; and KC-1, 2 and 4. The same major groups were identified by isoenzyme analysis using thin-layer starch-gel electrophoresis, each group differing from the others in three or more of five enzymes studied. In addition, a single enzyme difference distinguished KC-2 from KC-1 and 4. These findings reveal significant heterogeneity in G. lamblia isolates both from widely separated areas and within a single region. Immunoassays for diagnosis of giardiasis should take into account the differences between strains. Heterogeneity among G. lamblia strains may explain the variable clinical manifestations, host response and treatment efficacy characteristic of human giardiasis. MH - Agglutination Tests ; Animal ; Antigens, Protozoan/IMMUNOLOGY ; Electrophoresis, Starch Gel ; Giardia/*CLASSIFICATION/ENZYMOLOGY/ IMMUNOLOGY ; Giardiasis/DIAGNOSIS/*PARASITOLOGY ; Human ; Isoenzymes/*ANALYSIS ; Support, Non-U.S. Gov't SO - Z Parasitenkd 1986;72(2):173-80