Occurrence of Giardia lamblia in children in day care centers.

We prospectively evaluated excretion of Giardia lamblia in children in day care centers in Houston by conducting two prevalence studies of 600 children enrolled in 30 DCC, day care centers, and an 18-month longitudinal study in 82 children in one center. In the two prevalence surveys, Giardia cysts were identified in 72 (21%) and 67 (26%) children, respectively, who provided stool specimens. Trophozoites were found in 15 (4%) and 8 (3%), respectively. There was no correlation between the frequency of recent diarrheal episodes and the finding of Giardia. Stool specimens containing cysts were significantly (P less than 0.0001) more frequent in the 13- to 30-month-old children than in children younger than 12 months. Children attending day care centers for more than 3 months were more likely to be excreting Giardia than those attending for less than 3 months. In the longitudinal study, cysts were detected in stool specimens from 27 (33%) of the 82 children at least once during the survey. Twelve children had Giardia cysts in weekly stool specimens for a mean of 6.2 +/- 1.2 months and trophozoites for 3.3 +/- 1.2 months. The number of enteric symptoms observed in children and the classification of nutritional status based on monthly height and weekly weight measurements did not differ significantly when infected and noninfected children were compared. Asymptomatic Giardia excretion in children younger than 36 months is common and appears to be well tolerated.