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Health Department Alert to Child Service Providers
December 17, 2014

The Pennsylvania Department of Health (PADOH) is investigating an outbreak of Shigellosis (i.e., Shigellainfection), linked to daycare facilities in southeastern Pennsylvania. Shigellosis is characterized by diarrhea accompanied by fever, nausea, vomiting, and abdominal cramps. Illness is generally self-limited, with symptoms lasting an average of four to seven days. In order to reduce further transmission and outbreak spread, the PADOH requests that all health care providers maintain a high index of suspicion for Shigellosis.

Due to this highly infectious nature, infected individuals working and/or functioning in high-risk situations where transmission is particularly likely (young children who attend childcare facilities, staff members at childcare facilities, health care workers, and food handlers) are subject to state communicable disease control regulations. Department of Health guidance states:

  • No child or staff member with acute onset diarrhea should attend group settings, such as child care, camp, school, etc., while they are symptomatic, regardless of the cause of the illness.
  • Health care professionals should obtain stool cultures from persons who attend child care or preschool programs who present with diarrhea, irrespective of whether there is a recognized cause of an outbreak of gastrointestinal illness in the facility.
  • When Shigellainfection is identified in a child care setting, either in an attendee or staff member:
    • Infected children and staff must have two negative stool cultures, obtained at least 48 hours after the last dose of antibiotic and at least 24 hours apart, prior to returning to child care facilities.
    • Older, school-aged children may return to school, without proof of negative stool cultures, once they are no longer symptomatic, if the facility provides adequate access to hand washing and the children maintain good hygiene.
  • Attention to hand hygiene is important to limit spread. Counsel all children, families and staff to wash hands after using the bathroom, changing diapers, and before preparing food.
  • Young children should be instructed to wash hands after using the toilet and supervised when doing so.

Any questions or concerns regarding these recommendations should be directed to the PADOH at 1-877-PA-HEALTH. Further information on Shigellosis is available on the PADOH website or the Centers for Disease Control and Prevention website.

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