{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T07:26:18Z","timestamp":1781594778600,"version":"3.54.5"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Giardiasis is a common gastrointestinal illness in travellers. Data on the actual giardiasis risk of travellers to different travel destinations are scarce. We aim to estimate the risk of giardiasis in travellers from Germany by destination country and region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analysed travel-related giardiasis cases, their countries and regions of exposure and the age and sex distribution of cases reported in 2014\u201319 in Germany. We defined a travel-related giardiasis case as a laboratory-confirmed (i.e. positive microscopy, antigen test or nucleic acid test) symptomatic individual with outbound travel abroad within 3\u201325\u00a0days before symptom onset. Based on the number of reported cases per exposure country and UNWTO travel data for Germany, we calculated the number of travel-related giardiasis cases per 100\u2009000 travellers and compared the incidence in 2014\u201316 and 2017\u201319 to identify potential trends.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 2014\u201319, 21\u2009172 giardiasis cases were reported in Germany, corresponding to an overall incidence of 4.3 per 100\u2009000 population. Of all cases, 6879 (32%) were travel-related with a median age of 34 [interquartile range (IQR): 25\u201350], 51% were male. Southern Asia was the most frequently reported exposure region and had the highest incidence in travellers (64.1 per 100\u2009000 returning travellers) in 2017\u201319, followed by Latin America (19.2) and Sub-Saharan Africa (12.9). We observed statistically significant decreasing trends for Southern Asia and Sub-Saharan Africa. Latin America was the only region with a statistically significant increasing trend.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Almost one-third of recent giardiasis cases in Germany were travel-related. Giardiasis incidence in travellers differs greatly depending on the destination region. Decreasing trends in many regions might be due to improvements in food hygiene or travel conditions. Our results may inform medical consultation pre and post patient\u2019s travel.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taad107","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T12:45:53Z","timestamp":1691585153000},"source":"Crossref","is-referenced-by-count":5,"title":["Travel-related giardiasis: incidence and time trends for various destination countries"],"prefix":"10.1093","volume":"30","author":[{"given":"Franziska","family":"Hommes","sequence":"first","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Robert Koch Institute , 13353 Berlin , Germany"},{"name":"Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute , 13353 Berlin , Germany"},{"name":"ECDC Fellowship Programme , Field Epidemiology Path (EPIET), , 171 83 Stockholm , Sweden"},{"name":"European Centre for Disease Prevention and Control (ECDC) , Field Epidemiology Path (EPIET), , 171 83 Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"D\u00f6rre","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Robert Koch Institute , 13353 Berlin , Germany"},{"name":"Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute , 13353 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne C","family":"Behnke","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Robert Koch Institute , 13353 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Stark","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Robert Koch Institute , 13353 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Robert Koch Institute , 13353 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"2023110710121241300_ref1","doi-asserted-by":"crossref","first-page":"e1001921","DOI":"10.1371\/journal.pmed.1001921","article-title":"World Health Organization estimates of the global and regional disease burden of 22 foodborne bacterial, protozoal, and viral diseases, 2010: a data synthesis","volume":"12","author":"Kirk","year":"2015","journal-title":"PLoS Med"},{"key":"2023110710121241300_ref2","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S1473-3099(14)71000-X","article-title":"Travel-associated infection presenting in Europe (2008\u201312): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation","volume":"15","author":"Schlagenhauf","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"2023110710121241300_ref3","doi-asserted-by":"crossref","first-page":"304","DOI":"10.15585\/mmwr.mm7009a2","article-title":"Giardiasis outbreaks \u2014 United States, 2012\u20132017","volume":"70","author":"Conners","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2023110710121241300_ref4","first-page":"134","article-title":"Giardiasis: an overview","volume":"13","author":"Visvesvara","year":"1983","journal-title":"IMJ Ill Med J"},{"key":"2023110710121241300_ref5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jtm\/taac011","article-title":"Persistent abdominal symptoms in returning travellers: clinical and molecular findings","volume":"29","author":"Gefen-Halevi","year":"2022","journal-title":"J Travel Med"},{"key":"2023110710121241300_ref6","doi-asserted-by":"crossref","first-page":"8974","DOI":"10.3748\/wjg.v19.i47.8974","article-title":"Extra-intestinal and long term consequences of giardia duodenalis infections","volume":"19","author":"Halliez","year":"2013","journal-title":"World J Gastroenterol"},{"key":"2023110710121241300_ref7","volume-title":"ECDC. 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