Prevention and Control of Communicable Diseases
Diarrhea (Infectious)
Diarrhea is an increased number of bowel movements (compared with a person's normal pattern), along with watery, bloody, and/or mucus-containing feces. Diarrhea often is a symptom of infection caused by organisms such as bacteria, parasites, or viruses.
Cause
Many bacteria, parasites, and viruses can cause diarrhea. Some examples are:
- Bacteria: Salmonella, Shigella, Campylobacter, STEC
- Parasites: Giardia, Cryptosporidium, Cyclospora
- Viruses: Norovirus (Norwalk-like), rotavirus, enterovirus
Symptoms
In addition to diarrhea, there may be blood and mucus in the feces.
Other symptoms may include nausea, stomach pain, vomiting, and fever.
Spread
Infectious 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, they may then 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 a person feels sick.
Incubation
Varies by organism. It may take from 1 day to 4 weeks (sometimes longer) from the time a person is exposed until symptoms start.
Contagious Period
As long as infectious organisms are present in the feces, a person can pass the organism on to other people.
Exclusion
Child Care: Until the child has been free of diarrhea for at least 24 hours. The length of time may vary depending on the organism. For some infections, the person must also be treated with antibiotics or have negative laboratory tests before returning to child care. (See fact sheet for specific organism when known.)
School: Exclude children that have diarrhea that may be infectious until the child has been free of diarrhea for at least 24 hours. Further exclusion may be necessary during outbreaks.
No one with diarrhea should use swimming beaches, pools, spas, water parks, or hot tubs for at least 2 weeks after diarrhea has stopped.
Staff with diarrhea that could be infectious should be restricted from working in food service. Call your local health department to see if other restrictions apply.
Diagnosis
Recommend parents/guardians call their healthcare provider if their child has symptoms. A lab test (feces exam or culture) may be done to determine the cause.
Treatment
Treatment will depend on which organism is present. Vomiting and diarrhea may lead to dehydration, which may be a medical emergency. Ask a healthcare provider how to prevent dehydration.
Prevention/Control
- Regular and thorough handwashing is the best way to prevent the spread of communicable diseases. Wash hands thoroughly with soap and warm running water after using the toilet or changing diapers and before preparing or eating food. Staff should closely monitor or assist all children, as appropriate, with handwashing after children have used the bathroom or been diapered.
- Restrict students from sharing any communal food items that are brought from home. In the classroom, children should not serve themselves food items that are not individually wrapped. The teacher should hand out these items after washing his/her hands. (This is not intended to discourage family-style serving in the absence of an outbreak).
- Clean and disinfect diapering area and potty chairs after each use and the bathroom toilets and sinks at least daily and when soiled.
- Clean and sanitize mouthed objects and surfaces at least daily and when soiled
For more information, call the Missouri Department of Health and Senior Services (MDHSS) Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7), or call your local health department.
Infectious Diarrhea Parent Fact Sheet
Your child may have been exposed to:
Infectious Diarrhea
Diarrhea is more bowel movements that are looser and watery when compared to a person's normal pattern and form. Examples of causes include STEC, Salmonella, and rotavirus.
If you think your child has Infectious Diarrhea:
- Tell your child care provider or call the school.
- Need to stay home?
- Child Care:
Yes, until the child has been free of diarrhea for at least 24 hours.
Follow “stay home” guidelines for specific organism if the child was tested and the cause is known. - School:
Yes, until the child has been free of diarrhea for at least 24 hours.
- Child Care:
Symptoms
A child with infectious diarrhea may have bowel movements that are loose and runny compared to normal. There may be blood and/or mucus in the feces. Other symptoms may include a stomach ache, vomiting, and fever.
If your child is infected, it may take 1 day to 4 weeks (sometimes longer) for symptoms to start.
Spread
- By eating or drinking contaminated food or beverages.
- By touching contaminated hands, surfaces, or objects.
Contagious Period
The illness can spread as long as bacteria are in the feces.
Call your Healthcare Provider
- If anyone in your home has symptoms. There may be a medical test to detect the germ. Treatment may be available, depending on the germ that is causing diarrhea.
- Ask how to prevent dehydration. Your child may become dehydrated due to vomiting and diarrhea.
Prevention
- Wash hands after using the toilet or changing diapers and before preparing food or eating. Your child may need help with handwashing.
- Clean and disinfect any objects that come in contact with feces. This includes toilets (potty chairs), sinks, toys, and diaper changing areas. Use a product that kills bacteria, viruses and parasites.
- DO NOT use beaches, pools, water parks, spas, or hot tubs until 2 weeks after diarrhea has stopped.
For more information, call the Missouri Department of Health and Senior Services (MDHSS) Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7), or call your local health department.