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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. | |