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- Protozoan parasite, reservoir primarily human, potentially domestic and sylvatic animals.
- Most commonly identified fecal parasite in North America
- Mountainous areas of Northeast, Rocky Mtn states, Northwest
- Pockets of high prevalence in urban areas and areas of over-crowding
- Outdoor recreation and swimming pools
- Fecal-oral transmission via contaminated food, person-to-person, and waterborne outbreaks.