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Division of Public Health Services Disease Handbook for Childcare Providers Bureau of Infectious Disease Control REVISED –January 2018 DIARRHEA (Infectious Diarrhea) Diarrhea is defined as: 1) an increase in the number of stools over what is normal for that person, and 2) stools which are not formed (i.e., loose and watery and take the shape of the container they are in). (NOTE: Breas t-fed babies may have stools that are normally not formed). There are two (2) general types of diarrhea: infectious and non-infectious. Infectious Diarrhea is caused by a virus, parasite, or bacterium. It can spread quickly from person-to-person, espec ially in daycare centers. Some of the causes of infectious diarrhea, such as Campylobacteriosis, shiga -toxin producing E. coli, giardiasis, salmonellosis and shigellosis, are discussed in their own fact sheets found in this document. There are other agents that can also cause infectious diarrhea in children. These include parasites (e.g., cryptosporidiosis, amoeba) other bacterial (e.g., yersinia) and other viruses (e.g., Rotavirus). Although these other disease - causing organisms are not discussed in de tail, the general principles outlined in this section are applicable to prevent the spread of any of these germs. Non-infectious Diarrhea can be caused by toxins (e.g., certain types of food poisoning), chronic diseases (e.g., cystic fibrosis) or antibiot ics (e.g., ampicillin). Non -infectious diarrhea DOES NOT spread from person-to-person. Who gets it? Anyone can catch infectious diarrhea. It can spread especially quickly among babies and young children who are not toilet -trained or who may not wash the ir hands well after going to the bathroom. It can also easily spread to the adults taking care of them and helping them with diapering and toileting. How is it spread? The germs that can cause infectious diarrhea are spread by fecal-oral route. How is it diagnosed and treated? The germs can be diagnosed by stool cultures or by looking at stool under a microscope for eggs or parasites. (The healthcare provider will ask for a stool sample and send it to a laboratory for analysis). The physician will deci de on appropriate treatment. How can the spread of diarrhea be prevented? Hand washing is the most important way to stop the spread. Specific methods for preventing the spread of infectious diarrhea are discussed in each fact sheet. Who should be excluded? Any person with diarrhea shall be excluded from food handling, from childcare agencies and from direct care of hospitalized or institutionalized patients until 48 hours after resolution of symptoms.. Children who have 2 or more stools above their normal amount should be excluded as it impedes the caregiver’s ability to care for the children and maintain sanitary conditions. For diarrhea caused by a specific agent, see the related fact sheet to learn if exclusion is necessary. Reportable? Non-specific diarrhea is not reportable. Clusters of diarrhea illness in a facility should be reported to the Division of Public Health Services, Bureau of Infectious Disease and Control at (603) 271- 4496. |