The role of lambliosis in human’s patology
Abstract
Lambliosis is a widespread parasite of mammalian species, including humans. Lambliosis caused by the intestinal pritozoan parasite Lamblia intestinalis. Today eight major genetic groups have been identified, two of which are found in both human and animals. Lambliosis is zoonotic infection. The dogs, cats and beavers are take part in transmission of lambliosis. A participation of some hoofed animals in transmission infection are discussed. The factors of transmission are water, foods, especially milks products and everydays contacts. The sexually transmission infection is disсussed. Lambliosis coursed as asymptomatic, subclinical and with clinical symptomatics. The main clinical syndroms are painful, dyspeptic, asteno-neurotic and allergodermatological. The some atipic for lambliosis symptomes (ophthalmologic changes, growth retardation in children, a cause of hypokalemic myopathy in congenital immunodeficiency with lambliosis, severe systemic symptoms and marked hypereosinophilia, eosinophilic ascites and enterocolitis and others nospecifi c symptoms) are obsered. The metod of diagnosis, treatment and profi lactic is discussed.
About the Author
N. I. Tumolskaya
I.M. Sechenov First MSMU
Russian Federation
Russian Federation
Nelly Ignatievna Tumolskaya, MD, parasitologist, prof. of the Institute of medical parasitology and tropical medicine named after E.I. Martsinovsky
20 M. Pirogovskaya str., Moscow, 119435
8 (499) 246–80–49
References
1. WHO Report of the WHO Commission on Health and Environment. Resume. Geneva. 1992.
2. Guzeeva T.M., Sergiev V.P., Romanenko N.A. The role of parasitology laboratories in public health monitoring // Med. paraz. i paraz. bol. 2006; 2: 3–5.
3. Drynov I.D., Sergiev V.P., Malyshev N.A. // Med. paraz. i paraz. bol. 1999; 3: 3–6.
4. Dekkhan-Khodzhaeva N.A. Giardiasis. Pathogenesis, clinical features and treatment. Tashkent. 1970. 220 p.
5. Ermakova L.A., Pshenichnaya N.Yu., Ambalov Yu.M., Chernikova E.A. Evaluating the eff ectiveness of multiple coprological investigation for the diagnosis of giardiasis // Med. paraz. i paraz. bol. 2007; 4: 32–34.
6. Zalipaeva T.L. Clinical symptoms of giardiasis in children // Med. paraz. i paraz. bol. 2002; 3: 29–32.
7. Zalnova N.S. Giardiasis in patients with resected stomach // Med. paraz. i paraz. bol. 1964; 33: 433–436.
8. Isaeva G.Sh., Efi mova N.G. Gastro-intestinal giardiasis associated with Helicobacter pylori // Eks. klin. gastroenter. 2010; 6: 30–34.
9. Islamova Z.I., Serov V.N., Kushbaktova Z.A., Osipova S.O. Comparative effi cacy and ecdistin and metranidazol in the treatment of giardiasis // Med. paraz. i paraz. bol. 2010; 2: 14–17.
10. Using the model tests lamblia cysts and cryptosporidium oocysts for hygienic evaluation of the eff ectiveness of water treatment MUK.
11. Irikov O.A. Evaluation of informative methods of laboratory diagnosis of giardiasis infection // Med. paraz. i paraz. bol. 2008; 3: 22–32.
12. Kataeva L.I., Stepanova K.V., Stepanova T.F. et al. Agedependent manifestations of dysbiosis with giardiasis // Med. paraz. i paraz. bol. 2011; 1: 7–10.
13. Landa A.L., Ilinich V.K. The pathology of the internal organs of patients with giardiasis and their treatment. L. «Meditsina». 1973. 287 p.
14. Lysenko A.Ya., Vladimova M.G., Kondrashin A.V., Maori J. Giardiasis // Clinical Parasitology. Geneva. 2002: 232– 240.
15. Nikiforova T.F., Nurieva G.B., Gevorkyan G.G. et al. Giardiasis infection and some indicators of the upper digestive tract // Med. paraz. i paraz. bol. 1980; 49(5): 21–26.
16. Nurieva B.B., Soloviev M.M., Ozeretskovskaya N.N. Research in immunofl uorescence sera of patients with giardiasis infection // Med. paraz. i paraz. bol. 1979; 2: 39–43.
17. Onishchenko G.G. Condition incidence of parasitic diseases in 1998 and measures for its stabilization in the Russian Federation // Med. paraz. i paraz. bol. 2000; 1: 3–7.
18. Osipova S.O. Immunological aspects of giardiasis (Literature Review) // Med. paraz. i paraz. bol. 1982; 5: 57–62.
19. Osipova S.O., Gimov Z.A., Dekkhan-Khodzhaeva N.A. et al. Detection of specifi c antibodies in the saliva during giardiasis infection // Med. paraz. i paraz. bol. 1984; 5: 57–60.
20. Drinking water and water supply of populated areas. SAN PIN 2.1.4.1116–02.
21. Pogarelchuk T.Ya., Olejnik V.A., Orlova N.S. et al. Intestinal parasitocenoses in children of closed child care institutions and prevention measures // Med. paraz. i paraz. bol. 2003; 4: 36–43.
22. Prevention of parasitic diseases in the territory of the Russian Federation. SES PiN 3.2.1333–03.
23. Swimming pools. Hygienic requirements for device operation and water quality. Quality control. SES PiN 2.1.2.118–03.
24. Prodeus T.V. Giardiasis // Parasitic diseases of man. St. Petersburg. 2006. P. 124– 131.
25. Romanenko N.A., Sergiev V.P., Chernyshenko A.I. // Med. paraz. i paraz. bol. 1997; 1: 3–5.
26. Sivkova T.N. The role of dogs in the spread of giardiasis // Med. paraz. i paraz. bol. 2011; 1: 10–11.
27. Sergiev V.P. Registered and the true prevalence of parasitic diseases // Med. paraz. i paraz. bol. 1991; 2: 3–5.
28. Sergiev V.P. The value of parasitic diseases in human pathology // Med. paraz. i paraz. bol. 1991; 5: 3–6.
29. Soloviev M.M. Biology of Giardia and their correlations with the host // Med. paraz. i paraz. bol. 1968; 6: 720–726.
30. Tumolskaya N.I. Giardia role in human pathology // Vrach. 2000; 8.
31. Tumolskaya N.I., Zavojkin V.D., Mazmanyan M.V. et al. Tourism: imported parasitosis and its prevention // Med. paraz. i paraz. bol. 2012; 4: 3–7.
32. Tumolskaya N.I. The case of heavy course of opisthorchiasis // Sechenovsky vestnik. 2012; 4(10): 56–59.
33. Tumolskaya N.I., Golovanova N.Yu., Mazmanyan M.V. et al. Clinical masks of parasitic diseases // Infektsionnye bolezni. 2014; 1: 17–27.
34. Ugolev A.M. Parietal (contact) digestion. M.; L. 1963. 169 p.
35. Abou Holw S.A., Anwar M.M., Heshmat M.G., Enany A.Y., Rashad M.M. Eff ect of concommitant Helicobacter pylori infection in patients with Giardiasis lamblia in Egypt // J. Egypt. Soc. Parasitol. 2009 Aug;39(2):439-46.
36. Abou-Shady O., El Raziky M.S., Zaki M.M., Mohamed R.K. Impact of Giardia lamblia on growth, serum levels of zinc, copper, and iron in Egyptian children // Biol. Trace Elem. Res. 2011 Apr;140(1):1-6.
37. Abulhasan M., Elshazly T.A., Eida M., Albadry A. Giardia intestinalis in patients with nonulcer dyspepsia // Arab. J. Gastroenterol. 2013 Sep;14(3):126-9.
38. Adam R.D. Biology of Giardia lamblia // Clin. Microbiol. Rev. 14:447–475.
39. Aguiar A., Saraiva S., Pontes M., Coelho E. Eosinophilia in a newborn: a case of giardiasis and milk allergy // Acta Med. Port. 2011 May-Jun;24(3):463-6.
40. Ajjampur S.S. et al. Eff ect of cryptosporidial and giardial diarrhoea on social maturity, intelligence and physical growth in children in a semi-urban slum in south India // Ann. Trop. Paediatr. 2011;31(3):205–212.
41. Alexander C., Jones B., Inverarity D. et al Genotyping of gardia isolates in Scotland: a descriptive epidemiological study // Epidemiol. Infect. 2013 .- Oct 14: 1-4.
42. Almirall P., Núñez F.A., Bello J. et al. Abdominal pain and asthenia as common clinical features in hospitalized children for giardiasis // Acta Trop.- 2013.- Sep. 127(3).-P.212-5.
43. Almirall P., Alfonso M., Ávila I. et al. Clinical features of giardiasis in diff erent age groups of pediatric in-patients // Rev. Chilena Infectol. 2013 Oct;30(5):502-6.
44. Al-Saeed A.T., Issa S.H. Detection of Giardia lamblia antigen in stool specimens using enzyme-linked immunosorbent assay // East Mediterr. Health J. 2010 Apr;16(4):362-4.
45. Amer S.E. Genotypic and phylogenetic characterization of Giardia intestinalis from human and cattle in Kafr El Sheikh Governorate, Egypt // J. Egypt Soc. Parasitol.- 2013.-Apr 43(1).-P.133-46.
46. Andrew A., Shelton M.D. Sexually transmitted parasitic diseases // Frontline Gastroenter. 2013. January. 4(1). P.22-40.
47. Aronson N.E., Cheney C., Rholl V., Burris D., Hadro N. Biliary giardiasis in a patient with human immunodefi ciency virus // J. Clin. Gastroenterol. 2001 Aug;33(2):167-70.
48. Asher A.J., Waldron L.S., Power M.L. Evaluation of a PCR protocol for sensitive detection of Giardia intestinalis in human faeces // Parasitol. Res. 2012 Feb;110(2):853-8.
49. Ballweber L.R., Xiao L., Bowan D.D. et al. Giardiasis in dogs and cats: update on epidemiology and public health signifi cans // Trends Parasitol. 2010 Apr; 26(4):180-9.
50. Barraquer I. Sur la coïncidence de la lambliase et de certaineslésions du fond de l’oeil // Bulletin de la Sociétéde Pathologie Exotique. 1938;31:55–58.
51. Baran B., Gulluoglu M., Akyuz F. Nodular lymphoid hyperplasia of duodenum caused by giardiasis // Clin. Gastroenterol. Hepatol. 2013 Oct;11(10):A22.
52. Cañete R., Rodríguez P., Mesa L. Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind,clinical trial.C urr // Med. Res. Opin. 2012 Jan;28(1):149-54.
53. Caccio S.M., Ryan U. Molecular epidemiology of giardiasis // Mol. Biochem. Parasitol. 2008. Aug. 160(2) . P. 75-80.
54. Castro M., Sánchez Porto A., Guillén P. et al. Malabsorption syndrome caused by Giardia lamblia in gastrectomized patients // Enferm. Infecc. Microbiol. Clin. 1989 Feb;7(2):100-2.
55. Cervelló A., Alfaro A., Chumillas M.J. Hypokalemic myopathy induced by Giardia lamblia // N. Engl. J. Med. 1993;329:210–211.
56. Corsi A., Nucci C., Knafelz D., Bulgarini D., Di Iorio L., Polito A., De Risi F., Ardenti Morini F., Paone F.M. Ocular changes associated with Giardia lamblia infection in children // Br. J. Ophthalmol. 1998;82:59–62.
57. Dib H.H., Lu S.Q., Wen S.F. Prevalence of Giardia lamblia with or without diarrhea in South East, South East Asia and the Far East // Parasitol. Res. 2008 Jul;103(2):239-51.
58. Doğruman Al F., Adişen E., Kuştimur S., Gürer M.A. The role of protozoan parasites in etiology of urticaria // Turkiye Parazitol. Derg. 2009;33(2):136-9.
59. Doni N.Y., Zeyrek F.Y., Gürses G., Tümer S. Comparison of direct microcopy and antigen casette tests for the detection of giardia and cryptosporidium. // Turkiye Parazitol. Derg. 2013;37(3):169-73.
60. Domínguez-López M.E., González-molero I., RamírezPlaza C.P. et al., Chonic diarrhea and malabsorption due to common variable immunodefi ciency, gastrectomy and giardiasisinfection: a diffi cult nutritional management // Nutr. Hosp. 2011 Jul-Aug;26(4):922-5.
61. Edling L., Rathsman S., Eriksson S., Celiac disease and giardiasis: a case report.// J. Eur. J. Gastroenterol. Hepatol. 2012 Aug;24(8):984-7.
62. Eldash H.H., Bekhit O.E., Algameel A.A. Impact of Helicobacter pylori-giardiasis coinfection on children with recurrent abdominal pain // J. Egypt Soc. Parasitol. 2013 Aug;43(2):509-16.
63. Eckmann L. Mucosal defences against Giardia // Parasite Immunol. 2003 May;25(5):259-70.
64. Edling L., Rathsman S., Eriksson S. Celiac disease and giardiasis: a case report // J. Eur. J. Gastroenterol. Hepatol. 2012 Aug;24(8):984-7.
65. El-Shazly A.M., El-Bendary M., Saker T. et al. Cellular immune response in giardiasis // J. Egypt Soc. Parasitol. 2003 Dec;33(3):887-904.
66. Elsafi S.H., Al-Maqati T.N., Hussein M.I., Adam A.A. et.al. Comparison of microscopy, rapid immunoassay, and molecular techniques for the detection of Giardia lamblia and Cryptosporidium parvum // Parasitol. Res. 2013 Apr;112(4):1641-6.
67. El-Nahas H.A., Salem D.A., El-Henawy A.A. Giardia diagnostic methods in human fecal samples: a comparative study //Cytometry B. Clin. Cytom. 2013 JanFeb;84(1):44-9.
68. Feng Y., Xiao L. Zoonotic potential and molecular epidemiology of Giardia species and giardiasis // Clin. Microbiol. Rev. 2011 Jan;24(1):110-40.
69. França-Botelho A.C., Honório-França A.C., França E.L. Phagocytosis of Giardia lamblia trophozoites by human colostral leukocytes // Acta Paediatr. 2006 Apr;95(4): 438-43.
70. Furtado A.K., Cabral V.L., Santos T.N. Giardia infection: protein-losing enteropathy in an adult with immunodefi ciency // World J. Gastroenterol. 2012 May 21;18(19):2430-3.
71. Genovese A., Spadaro G., Santoro L. et al. Giardiasia as a cause of hypokalemic myopathy in congenital immunodeficiency // Int. J. Clin. Lab. Res. 1996;26:132–135.
72. Gonul C.D., Bilge C., Gazi K.A., Filiz K. Duodenal nodularity in children: a clinical and pathologic study of 17 cases // Indian J. Pathol. Microbiol. 2011.-Apr-Jun;54(2):312-7.
73. Granados C.E., Reveiz L., Uribe L.G., Criollo C.P. Drugs for treating giardiasis // Cochrane Database Syst. Rev. 2012 Dec 12;12:CD007787.
74. Guimarães S., Sogayar M.I. Detection of anti-Giardia lamblia serum antibody among children of day care centers // Rev. Saude Publica. 2002 Feb;36(1):63-8.
75. Hagel I., Cabrera M., Puccio F. et al. Co-infection with Ascaris lumbricoides modulates protective immune responses against Giardia duodenalis in school Venezuelan rural children // Acta Trop. 2011 Mar;117(3):189-95.
76. Hanevik K., Kristoff ersen E., Svard S. Human cellular immune response against Giardia lamblia 5 years after acute giardiasis // J. Infect. Dis. 2011 Dec 1;204(11):1779-86.
77. Hanevik K., Kristoff ersen E.K., Sornes S. et al. Immunophenotyping in post-giardiasis functional gastrointestinal disease and chronic fatigue syndrome // BMCInfectDis. 2012.-12(1).P.258.
78. Hernell O., Ward H., Bläckbrg L., Pereira M.E. Killing of Giardia lamblia by human milk lipases: an eff ect mediated by lipolysis of milk lipids // J. Infect. Dis. 1986 Apr;153(4). P. 715-20.
79. Hunskar G.S., Langeland N., Wensaas K.A. et al. The impact of atopic disease on the risk of post-infectious fatigue and irritable bowel syndrome 3 years after Giardia infection. A historic cohort study // Scand. J. Gastroenterol. 2012.-Sep;47(8-9):956-61.
80. Jimenez J.C., Fontaine J., Grzych J.M. Antibody and cytokine responses in BALB/c mice immunized with the excreted/secreted proteins of Giardia intestinalis: the role of cysteine proteases // Ann. Trop. Med. Parasitol. 2009.- Dec;103(8):693-70.
81. Kamada J.D., Nash T.E. Giardia duodenalis: dendritic cell defects in IL-6b defi cient mice contribute to susceptibility to intestinal infection // Ep. Parasitol.-2012.-Mar;130 (3):288-91.
82. Kampitak T. Selective immunoglobulin M defi ciency in a patient with refractory giardiasis // J. Investig. Allergol. Clin. Immunol. 2010;20(4):35880.
83. Khalil Q., Anusionwu C., Agrawal S. Giardiasis — an unusual cause of iron defi ciency anemia // J. Ark. Med. Soc. 2012 Jun;108(13):294-6.
84. Lalle M., Jimenez-Cardosa E., Caccio S.M. et al. Genotypin of Giardia duodenalis from humans and dogs from Mexico using a beta-giardin nested polymerase chain reacting assay // J. Parasitology. 2005.- Feb; 91 (1) .P. 203-205.
85. Laishram S., Kang G., Ajjampur S.S. Giardiasis: a review on assemblage distribution and epidemiology in India // Indian J. Gastroenterol.- 2012.- Jan;31(1):3-12.
86. Langford T.D., Housley M.P., Boes M. Central importance of immunoglobulin A in host defense againstGiardia spp. // Infect Immun. 2002;70(1):11–18.
87. Li W., Saraiy A.A., Wang C.C. Experimental verifi cation of the identity of variant-specifi c surface proteins in Giardia lamblia trophozoites // MBio. 2013 May 21;4(3):e00321-13.
88. LoGalbo P.R., Sampson H.A., Buckley R.H. Symptomatic giardiasis in three patients with X-linked agammaglobulinemia // J. Pediatr. 1982;101:78–80.
89. López Sáez M.P., Huertas Amorós A.J., Caravaca Espinosa F. Chronic angioedema associated with Giardia lamblia // An. Pediatr. (Barc). 2008 Dec;69(6):588-9.
90. Matowicka-Karna J., Dymicka-Piekarska V., Kemona H. IFN-gamma, IL-5, IL-6 and IgE in patients infected with Giardia intestinalis // Folia Histochem. Cytobiol. 2009;47(1):93-7.
91. Naess H., Nyland M., Hausken T. et al. Chronic fatigue syndrome after Giardia enteritis: clinical characteristics, disability and long-term sickness absence // BMC Gastroenterol. 2012 Feb 8;12:13.
92. Nash T.E., Luján H.T., Mowatt M.R., Conrad J.T. Variant-specifi c surface protein switching in Giardia lamblia // Infect. Immun. 69:1922–1923.
93. Nash T.E. Surface antigenic variation in Giardia lamblia // Mol. Microbiol. 2002 Aug;45(3):585-90.
94. Parasitic zoonoses // Technical Report Series 637. WHO. Geneva. 1979. p. 49.
95. Patiroğlu T., Kürşad A., Kurtoğlu S., Poyrazoğlu H. Growth retardation in children with IgA defi ciency // J. Pediatr. Endocrinol. Metab. 2002 Jul-Aug;15(7):1035-8.
96. Pettoello Mantovani M., Giardino I., Magli A. et al. Intestinal giardiasis associated with ophthalmologic changes // J. Pediatr. Gastroenterol. Nutr. 1990;11:196–200.
97. Prieto-Lastra L., Pérez-Pimiento A., González-Sánchez L.A., Iglesias-Cadarso A. Chronic urticaria and angioedema in Giardia lamblia infection // Med. Clin. (Barc). 2006 Mar 11;126(9):358-9.92.
98. Reiner D.S., Wang C.S., Gillin F.D. Humanmilk kills Giardialamblia by generating toxic lipolytic products // J. Infect. Dis. 1986 Nov;154(5):825-32.
99. Robertson L.J., Hanevik K., Escobedo A.A. Giardiasis — why do the symptoms sometimes never stop? // Trends Parasitol. 2010 Feb; 26(2): 75–82.
100. Roberts-Thomson I.C., Anders R.F., Bhathal P.S. BMC // Gastroenterol. 2009 Apr 21; 9: 27. // Granulomatous hepatitis and cholangitis associated with giardiasis // Gastroenterology. 1982 Aug; 83(2): 480–483.
101. Ruest N., Couture Y., Faubert G.M., Girard C. Morphological changes in the jejunum of calves naturally infected with Giardia spp. and Cryptosporidium spp. // Vet. Parasitol. 1997 May; 69(3–4): 177–186.
102. Ryan U., Caccio S.M. Zoonotic potencial of lamblia // Int. J. Parasitol. 2013 Nov.; 43(12–13): 943-956.
103. Santin M., Dargatz D., Fayer R. Prevalence of Giardia duodenalis assemblages in weaned cattle on cow-calf operations in the United States // Vet. Parasitol. 2012 Feb. 10; 183(3–4): 231–236.
104. Shukla G., Kaur H., Sharma L. Comparative therapeutic eff ect of probiotic Lactobacillus casei alone and in conjunction with antiprotozoal drugs in murine giardiasis // Parasitol. Res. 2013 Jun; 112(6): 2143–2149.
105. Singer S.M., Nash T.E. The role of normal fl ora in Giardia lamblia infections in mice // J. Infect. Dis. 2000. Apr; 181(4): 1510–1512.
106. Singer S.M., Elmendorf H.G., Conrad J.T., Nash T.E. Biological selection of variant-specifi c surface proteins in Giardia lamblia // J. Infect. Dis. 2001 Jan. 1; 183(1): 119-124.
107. Sotto A., Alvarez J.L., García B. Acute hepatic lesion caused by Giardia lamblia // Rev. Esp. Enferm. Dig. 1990 Jan; 77(1): 24–28.
108. Sotto A., Gra B. Hepatic manifestations in giardiasis // Acta Gastroenterol. Latinoam. 1985; 15(2): 89–94.
109. Shatla H.M., el-Hodhod M.T., Mohsen D.M., Salah elDin M.Y. Potential diagnosis of Giardia lamblia infection through specifi c antibody detection in saliva // J. Egypt Soc. Parasitol. 2004 Aug;34(2):621-630.
110. Solaymani-Mohammadi S., Genkinger J.M., Loff redo C.A. et al. A meta-analysis of the eff ectiveness of albendazole compared with metronidazole as treatments for infections with Giardia duodenalis // PLoS Negl. Trop. Dis. 2010 May 11;4(5):e682.
111. Suzuki J., Murata R., Kobayashi S. et al. // Risk of human infection with Giardia duodenalis from cats in Japan and genotyping of the isolatesto assess the route of infection in cats. // Parasitology. 2011 Apr;138(4):493-500.
112. Suzuki Y., Nakamura T., Tokoro M. et al. A case of giardiasis expressing severe systemic symptoms and marked hypereosinophilia // Parasitol. Int. 2010 Sep; 59(3): 487–489.
113. Teles N.S., Fechine F.V., Viana F.A. et al. Evaluation of the therapeutic effi cacy of Mentha crispa in the treatment of giardiasis // Contemp. Clin. Trials. 2011 Nov; 32(6): 809–813
114. Thomas Iv. L.J., Zweig A.P., Tosh A.K. An adolescent with chronic giardiasis mimicking anorexia nervosa // Int. J. Adolesc. Med. Health. 2013 Jul. 24: 1–3.
115. Troeger H., Epple H.J., Schneider T. Eff ect of chronic Giardia lamblia infection on epithelial transport and barrier function in human duodenum // Gut. 2007; 56: 328–335.
116. Turan I., Zengin M., Musoglu A., Aydin A. Giardia lamblia infection as a possible cause of eosinophilic ascites and enterocolitis // Acta Gastroenterol. Belg. 2009 AprJun;72(2): 265–266.
117. Urvinderpal Singh, Nishi Garg and Vishal Chopra. Eosinophilic pleural eff ussion and gardiasis: A causal or casual relationship // Lung India. 2013. Jan-Mar; 30(1): 69–71.
118. von Allmen N., Christen S., Forster U. et al. Acute trichinellosis increases susceptibility to Giardia lamblia infection in the mouse model // Parasitology. 2006. Aug;133(Pt. 2): 139–149.
119. Yereli K., Balcioglu I.C., Ertan P., Limoncu E., Onag A. Albendazole as an alternative therapeutic agent for childhood giardiasis in Turkey // Clin Microbiol Infect. 2001; 10: 527–532.
120. Zhang W., Zhang X., Wang R. et al. Genetic characterizations of Giardia duodenalis in sheep and goats in Heilongjiang Province, China and possibility of zoonotic transmission.// PLoS Negl Trop Dis. 2012; 6(9):e1826.
121. Wensaas K.A., Langeland N., Hanevik K., Mørch K., Eide G.E., Rortveit G. Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study. // Gut. 2012. Feb;61(2): 214–219.
122. Wolfe M.S. Giardiasis // Clin. Microbiol. Rev. 1992. Jan;5(1): 93–100.
123.
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