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Diarrhea Disease in Child Care Facilities and Schools

What are common causes of diarrheal diseases in day cares and schools? 

Two common causes of diarrheal disease in child care facilities and schools are the infectious agents shigella and salmonella. These agents cause diseases (shigellosis and salmonellosis, respectively) characterized by fever, nausea, vomiting, and abdominal cramps. Typically, stools are watery and may contain blood and mucus. Mild and asymptomatic (not showing symptoms) infections occur, and the severity of illness will depend on the age of the child, the child's nutritional status, and the virulence of bacteria causing the disease. Usually the disease is self-limiting, lasting between 4-to-7 days; however, these diseases can potentially lead to death and severe complications in rare cases. Secondary attack rates in households with a case of these diseases can be as high as 40 percent.

How are these diseases transmitted?

Both diseases are primarily transmitted via fecal-oral transmission. Failure to thoroughly clean the hands after using the bathroom is a major means of transmitting both agents. Spread of the agents can then occur by direct contact with the infected person or indirectly by contact with items or consumption of food or water handled by the infected person. Unclean surfaces in diaper changing areas are another source of contamination. 

How can the spread of these diseases be controlled?

There are four major ways to control these diseases in day cares or schools:

  1. Keeping infected children out of day care or school until the infection passes

  2. Thorough washing of hands after toileting

  3. Proper diaper changing procedures

  4. Disinfecting and cleaning of toys and facility surfaces

Where can I get further information about these diseases? 

You can obtain additional information from about these diseases from your physician or by visiting the following CDC websites: shigellosis, salmonellosis, proper hand washing.

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