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.