Carrie Williams

PS 

We've added two awesome new coworkers to our already-amazing Rainbow Fleet team. Heather Carlton has joined our staff as a child care consultant. In this role, Heather works with child care providers to improve the quality of their programs. Anthony Coby is our new program assistant. His primary role is to coordinate our Health Bodies, Healthy Minds initiative. Welcome Heather and Anthony!

Recently, Oklahoma has seen a rise in Shigella cases, especially in the child care setting. Shigella is a diarrheal illness caused by the Shigella bacteria. Symptoms include mild to severe diarrhea, fever, vomiting, abdominal cramps and sometimes blood or mucous in the stool. Shigella can be spread by direct or indirect fecal-oral contact. People who have shigellosis and do not wash their hands after they use the bathroom can contaminate objects (toys, food, water, etc.) which others then put into their mouths. 

Shigellosis can move quickly through groups of diapered children for three reasons:

• Shigella is VERY infectious. It can take as few as ten bacteria to cause illness.
• It can be passed in stools for as long as four weeks after the beginning of symptoms. Even if a person does not feel sick anymore, they can still pass Shigella to others if handwashing habits are poor.
• Children have poor hand hygiene.

The average time between exposure and symptoms is one to three days and symptoms usually resolve in five to seven days. Most people with shigellosis recover with rest and drinking plenty of fluids, however, some people require hospitalization for treatment of dehydration and supportive care. 

What can be done to prevent shigellosis?

• The most important way to prevent the spread of Shigella is thorough hand washing with warm water and soap. People should be especially careful to wash their hands after diapering a child, going to the bathroom and before eating, or preparing food.
• Day care providers should supervise hand washing of all children that are wearing diapers or are not completely toilet-trained.
• Do not allow children to attend day care with diarrhea or allow staff to work if they have diarrhea. 

Shigella is a reportable disease so the Oklahoma State Department of Health (OSDH) is typically notified quickly by the child's doctor or lab that a patient is positive. From there, the county health departments will take action to investigate the case and see if anyone else in the center was exposed. If your child care center has experienced a case of Shigella, your county health department will contact you for information and with further instructions for the staff and families of the children exposed. 

For more information, go to: 

http://www.cdc.gov/shigella/index.html or http://ok.gov

Kristen Millican, RN, BSN

Cleveland County Health Department