{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:04:26Z","timestamp":1787774666044,"version":"build-2784847793"},"reference-count":52,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T00:00:00Z","timestamp":1525824000000},"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":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Giardia duodenalis<\/jats:italic> is the most common intestinal parasite of humans in the USA, but the risk factors for sporadic (non-outbreak) giardiasis are not well described. The Centers for Disease Control and Prevention and the Colorado and Minnesota public health departments conducted a case-control study to assess risk factors for sporadic giardiasis in the USA. Cases (<jats:italic>N<\/jats:italic> = 199) were patients with non-outbreak-associated laboratory-confirmed <jats:italic>Giardia<\/jats:italic> infection in Colorado and Minnesota, and controls (<jats:italic>N<\/jats:italic> = 381) were matched by age and site. Identified risk factors included international travel (aOR = 13.9; 95% CI 4.9\u201339.8), drinking water from a river, lake, stream, or spring (aOR = 6.5; 95% CI 2.0\u201320.6), swimming in a natural body of water (aOR = 3.3; 95% CI 1.5\u20137.0), male\u2013male sexual behaviour (aOR = 45.7; 95% CI 5.8\u2013362.0), having contact with children in diapers (aOR = 1.6; 95% CI 1.01\u20132.6), taking antibiotics (aOR = 2.5; 95% CI 1.2\u20135.0) and having a chronic gastrointestinal condition (aOR = 1.8; 95% CI 1.1\u20133.0). Eating raw produce was inversely associated with infection (aOR = 0.2; 95% CI 0.1\u20130.7). Our results highlight the diversity of risk factors for sporadic giardiasis and the importance of non-international-travel-associated risk factors, particularly those involving person-to-person transmission. Prevention measures should focus on reducing risks associated with diaper handling, sexual contact, swimming in untreated water, and drinking untreated water.<\/jats:p>","DOI":"10.1017\/s0950268818001073","type":"journal-article","created":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T05:57:17Z","timestamp":1525845437000},"page":"1071-1078","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":34,"title":["Risk factors for sporadic <i>Giardia<\/i> infection in the USA: a case-control study in Colorado and Minnesota"],"prefix":"10.1017","volume":"146","author":[{"given":"H. 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