title: Outbreak of amebiasis in Tbilisi, Republic of Georgia, 1998.
abstract: In 1998, we investigated a suspected outbreak of amebic liver abscesses caused by Entamoeba histolytica in the Republic of Georgia, using a case-control study. A questionnaire was administered and blood samples were obtained from cases and controls for serologic diagnosis. Medical records showed that E. histolytica infections were rarely diagnosed before 1998. However, from July through September 1998, 177 cases of suspected amebiasis were identified. Of 52 persons who had diagnosed liver abscesses, 37 (71%) were confirmed serologically to have antibodies against E. histolytica, compared with 11 of 53 persons (20.8%) diagnosed with intestinal amebiasis. In addition, 9-14% of asymptomatic controls were seropositive. Logistic regression identified the fact that interruptions in the water supply, decreases in water pressure, and increased water consumption were significantly associated with infection. The data support the hypothesis that drinking water was the source of infection, either because of inadequate municipal water treatment or contamination of municipal water in the distribution system.
authors.affiliation: Epidemic Intelligence Service, Epidemiology Program Office, and Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. zvd3@cdc.gov
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Barwick
authors.forename: Amra
authors.initials: A
authors.lastname: Uzicanin
authors.forename: Susan
authors.initials: S
authors.lastname: Lareau
authors.forename: Naile
authors.initials: N
authors.lastname: Malakmadze
authors.forename: Paata
authors.initials: P
authors.lastname: Imnadze
authors.forename: Merab
authors.initials: M
authors.lastname: Iosava
authors.forename: Nana
authors.initials: N
authors.lastname: Ninashvili
authors.forename: Marianna
authors.initials: M
authors.lastname: Wilson
authors.forename: Allen W
authors.initials: AW
authors.lastname: Hightower
authors.forename: Stephanie
authors.initials: S
authors.lastname: Johnston
authors.forename: Henry
authors.initials: H
authors.lastname: Bishop
authors.forename: William A
authors.initials: WA
authors.lastname: Petri
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Juranek
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D004748:Entamoeba histolytica / Q000276:immunology*; D004749:Entamoebiasis / Q000453:epidemiology* / Q000469:parasitology; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D008101:Liver Abscess, Amebic / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014867:Water / Q000469:parasitology; D014881:Water Supply
chemical_list: D000913:Antibodies, Protozoan; D014867:Water