A Communitywide Outbreak of Giardiasis with Evidence of Transmission by a Municipal Water Supply

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Abstract
Residents (350) of Rome, New York, [USA] had laboratory-confirmed cases of giardiasis between Nov. 1, 1974 and June 7, 1975. A random household survey showed an overall attack rate for giardiasis (defined as a diarrheal illness of 5 days or more) of 10.6%. A significant association was discovered between having giardiasis and using city water and between having illness and drinking 1 or more glasses of water a day. The presence of human settlements in the Rome watershed area suggested that the water supply could have been contaminated by untreated human waste. The infectivity of municipal water was confirmed by producing giardiasis in specific pathogen-free dogs fed sediment samples of raw water obtained from an inlet of a city reservoir. A microscopic examination of the water sediments uncovered a Giardia lamblia cyst in 1 sample. This was the 1st time that a G. lamblia cyst was found in municipal water in an epidemic and the 1st time that such water was shown to infect laboratory animals.

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