{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:51:35Z","timestamp":1780624295501,"version":"3.54.1"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"14","license":[{"start":{"date-parts":[[2017,9,7]],"date-time":"2017-09-07T00:00:00Z","timestamp":1504742400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Giardiasis is a treatable disease, caused by the flagellated protozoan parasite, <jats:italic>Giardia duodenalis (G. duodenalis)<\/jats:italic>. It is one of the most common enteric parasites found globally to cause gastrointestinal disturbances, and infections may result in long-term irritable bowel syndrome-like symptoms. It is a common misconception that giardiasis is associated with foreign travel, which results in locally acquired cases in the UK being underdiagnosed. This report highlights the findings from one large Scottish Health Board, arising from a change in testing methodology, which resulted in the screening of all stools submitted for enteric investigations for <jats:italic>G. duodenalis<\/jats:italic>. Previous selection criteria were restricted to patients with a travel history to specific regions of the world, or on the basis of certain clinical details. In this report, clinical details were recorded from samples shown to be positive using two methods: an ELISA-based antigen detection assay and microscopy. Clinical details were assessed for a total of 28 laboratory-confirmed positive cases against the original selection criteria. Twenty-six cases (93%) would have been excluded from <jats:italic>Giardia<\/jats:italic> testing if the previous selection criteria had been applied. Although nine cases stated foreign travel, only two had been to regions deemed to be \u2018high risk\u2019. Therefore, those seven cases that travelled to perceived \u2018low-risk\u2019 regions would have been excluded from testing for this reason. This summary highlights the need for significant improvements to the selection criteria for <jats:italic>Giardia<\/jats:italic> testing. Laboratories should be encouraged towards the testing of all routinely submitted stools for this neglected pathogen to ensure cases that are acquired locally are properly identified and treated effectively.<\/jats:p>","DOI":"10.1017\/s0950268817001959","type":"journal-article","created":{"date-parts":[[2017,9,7]],"date-time":"2017-09-07T09:30:49Z","timestamp":1504776649000},"page":"3007-3011","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":21,"title":["Under-reporting giardiasis: time to consider the public health implications"],"prefix":"10.1017","volume":"145","author":[{"given":"S. L.","family":"CURRIE","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"STEPHENSON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S.","family":"PALMER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. L.","family":"JONES","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. L.","family":"ALEXANDER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,9,7]]},"reference":[{"key":"S0950268817001959_ref16","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1998.59.717"},{"key":"S0950268817001959_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268813002604"},{"key":"S0950268817001959_ref14","doi-asserted-by":"publisher","DOI":"10.3201\/eid0902.010488"},{"key":"S0950268817001959_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2016.08.017"},{"key":"S0950268817001959_ref10","first-page":"1","article-title":"Surveillance of giardiasis in North-west England 1996\u20132006: impact of an enzyme immunoassay test","volume":"37","author":"Ellam","year":"2008","journal-title":"Eurosurveillance"},{"key":"S0950268817001959_ref9","first-page":"284","article-title":"Protozoal infections: incidence of protozoal infection reported to HPS in 2015","volume":"37","year":"2016","journal-title":"HPS Weekly Report"},{"key":"#cr-split#-S0950268817001959_ref7.1","unstructured":"1. 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Accessed April 2017."},{"key":"S0950268817001959_ref5","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1086\/509576","article-title":"Outbreaks of enteric disease associated with animal contact: not just a foodborne problem anymore","volume":"43","author":"Steinmuller","year":"2006","journal-title":"Clinical Infectious Diseases"},{"key":"S0950268817001959_ref2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00033-10"},{"key":"S0950268817001959_ref11","volume-title":"Annual Epidemiological Report 2016 \u2013 Giardiasis","year":"2016"},{"key":"S0950268817001959_ref18","first-page":"201","article-title":"Clinical update on giardiasis","volume":"355","author":"Minetti","year":"2016","journal-title":"BMJ"},{"key":"#cr-split#-S0950268817001959_ref6.1","unstructured":"3. Public Health England. Investigation of specimens other than blood for parasites. UK Standards for Microbiology Investigations 2017"},{"key":"#cr-split#-S0950268817001959_ref6.2","unstructured":"4. B 31: Issue 5 (https:\/\/www.gov.uk\/uk-standards-for-microbiology-investigations-smi-quality-and-consistency-in-clinical-laboratories). 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