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,