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| Division of Public Health Services Disease Handbook for Childcare Providers | |
| Bureau of Infectious Disease Control REVISED –January 2018 | |
| SHIGELLOSIS | |
| Shigellosis is an intestinal illness caused by | |
| Shigella, which is a family of bacteria that is | |
| comprised of 40 different types. | |
| Who gets this disease? | |
| Anyone can, but shigellosis is recognized more | |
| often in young children. | |
| How is it spread? | |
| Among small children in a childcare facility, the | |
| fecal-oral route usually spreads Shigella. It takes | |
| very few swallowed Shigella bacteria to cause | |
| infection (as opposed to Salmonella, which take | |
| many bacteria to cause infection); so it can easily | |
| become a problem in a childcare setting. Shigella | |
| can also be spread through stool -contaminated | |
| food, drink or water. | |
| What are the symptoms? | |
| Shigella can cause mild or severe diarrhea. In | |
| mild cases, a person may have only watery stools | |
| for several days. In severe cases, the diarrhea | |
| may have traces of blood or mucous and may lead | |
| to dehydration. Fever, severe cramps, vomiting, | |
| headache and even convulsions (in young | |
| children) can occur. | |
| How soon do symptoms appear? | |
| The symptoms usually occur 2 -4 days afte r | |
| exposure, but it can be as long as seven days. | |
| Can a person have this disease without | |
| knowing it? | |
| Yes, Shigella can be in the stool of children or | |
| adult who are not sick and do not have diarrhea. | |
| These asymptomatic carriers may transmit | |
| infection; rare ly the carrier state persists for | |
| months or longer. | |
| What is the treatment? | |
| Although most people with Shigellosis will | |
| recover on their own, antibiotics shorten both the | |
| length of the illness and the amount of time | |
| bacteria is passed in the stool, which i s | |
| particularly important in daycare settings. | |
| How can the spread of this disease be | |
| prevented? | |
| 1. Wash hands thoroughly after using the | |
| toilet or diapering a child. | |
| 2. Wash hands thoroughly before preparing | |
| food. | |
| 3. Keep children who have diarrhea at home. | |
| 4. Staff w ith positive stool cultures for | |
| Shigella should not prepare food or feed | |
| children. | |
| Who should be excluded? | |
| Infected person s shall be excluded from food | |
| handling, from childcare facilities and from direct | |
| care of hospitalized or institutionalized patients | |
| until stool cultures are free of Shigella on two | |
| consecutive specimens collected not less than 24 | |
| hours apart. If antibiotics have been taken, the | |
| initial cultures shall be obtained at least 48 hours | |
| after the last dose. | |
| Reportable? | |
| Yes. Shigellosis is reportable by New Hampshire | |
| law to the Division of Public Health Services, | |
| Bureau of Infectious Disease Control at (603) | |
| 271-4496, | |