Prevention and Control of Communicable Diseases - Missouri ...

July 2011
SHIGELLOSIS
Reportable to local or state health department
Consult the health department before posting/distributing Parent/Guardian fact sheet.
CAUSE Shigella bacteria.
197
PROVIDER
SYMPTOMS Diarrhea (may be watery), fever, stomach cramps, nausea, or vomiting. Feces may
contain blood or mucus. Infected persons may have mild symptoms or may not
have any symptoms at all. Illness usually lasts 4 to 7 days.
SPREAD Shigella bacteria leave the body through the feces of an infected person. Spread
can occur when people do not properly wash their hands after using the toilet or
changing diapers. If not removed by good handwashing, the Shigella bacteria may
contaminate food or objects (such as toys) and infect another person when the food
or object is placed in that person’s mouth. Spread can occur whether or not an
infected person feels sick.
INCUBATION It takes from 1 to 7 days, usually 2 to 4 days, from the time a person is exposed
until symptoms start.
CONTAGIOUS
PERIOD
As long as Shigella bacteria are present in the feces, a person can pass the bacteria
on to other people. For some children, the bacteria can be found in the feces up to 4
weeks after illness.
EXCLUSION Childcare: Children and staff with diarrhea should be excluded from childcare until
they are well. The child care should be closed to new admissions during the
outbreaks, and no transfer of exposed children to other centers should be allowed.
Shigellosis is transmitted easily and can be severe, so all symptomatic persons
(employees and children) should be excluded from childcare setting in which
Shigella infection has been identified, until diarrhea has ceased for 24 hours, and
one (1) stool culture is free of Shigella spp. Specimens should not be obtained
earlier than 48 hours after discontinuation of antibiotics. Antimicrobial therapy is
effective in shortening the duration of diarrhea and eradicating organisms from
feces.
School: None, unless the child is not feeling well and/or has diarrhea. Further
exclusion may be necessary during outbreaks.
No one with Shigella should use swimming beaches, pools, spas, water parks, or
hot tubs until 1 week after diarrhea has stopped.
Food service employees infected with Shigella bacteria should be excluded from
working in food service. An employee may return to work once they are free of the
Shigella infection based on test results showing 2 consecutive negative stool
cultures that are taken at least 24 hours after diarrhea ceases, not earlier than 48
hours after discontinuation of antibiotics, and at least 24 hours apart; or the food
employee may be reinstated once they have been