More than 11 million children attend commercial child day care in the US. This number is expected to increase as more mothers of preschool children enter the work force. Infectious diseases are readily transmitted in child day-care settings,1-4 where children are in close contact with one another for approximately 50 hours per week. Diarrheal diseases are common in these settings. Infectious diarrhea can be transmitted by person-to-person contact1,2,5 and, possibly, by contact with fomites.1,3 Many food service surfaces including tables, kitchen counters, ware-washing sinks, and dinner plates in the centers are contaminated with bacterial levels that exceed public health standards.6,7Giardia lamblia is a pathogenic intestinal protozoan that may produce an acute infection characterized by diarrhea and other clinical symptoms.8 It infects children in day care at a higher rate than the general population.2,5 Family members are at risk of acquiring G. lamblia transmitted from children attending child-care centers3 where infectious cysts of G. lamblia may be shed by infected symptomatic or asymptomatic individuals.1,5 Intervention strategies that rely on exclusion of infected children from day-care settings are expensive and do not control Giardia infections in the child day-care environment.4We compared the use of a commercially available, indirect immunofluorescent procedure with direct microscopic examination to detect G. lamblia cysts in stools of children attending day-care centers. Because the detection of G. lamblia on environmental surfaces would show their potential for transmitting giardiasis, we used the immunofluorescent procedure to look for G. lamblia cysts on various surfaces. Cysts were removed by swabbing surfaces, recovered on membrane filters, and detected using the indirect immunofluorescent procedure on the filters.
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