Information for Childcare Facilities

playing babies

Children younger than 5 years are the most likely to get shigellosis, but people of all ages can get this disease 1. Many outbreaks are related to childcare settings and schools, because Shigella germs spread from young children to their family members and others in their community.

Shigellosis outbreaks at childcare facilities can be prevented by following the guidance below at all times.

  • Inform all staff about the symptoms of shigellosis, how Shigella germs spread from person to person, and control measures to be followed, like regular handwashing and good diapering practices.
  • Inform parents about the symptoms of shigellosis, how germs spread, outbreak control policies, and hygiene and cleanliness procedures to reduce spread in the facility and at home.
  • Children who recently recovered from shigellosis can be grouped together in one classroom to reduce spreading Shigella germs to children who were not sick, depending on local health regulations.
  • Move adults who recently recovered from shigellosis to jobs that are less likely to spread germs (for example, administrative work instead of food preparation), depending on local health regulations.
  • Steps to good handwashing:
    • Wet your hands with clean, running water, turn off the tap, and apply soap.
    • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
    • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
    • Rinse your hands well under clean, running water.
    • Dry your hands using a clean towel or air dry them.
  • For children:
    • Supervise or assist handwashing when needed.
    • Wash hands:
      • Upon arrival at the childcare facility
      • After they use the bathroom
      • After having their diapers changed
      • After playing outside
      • After blowing their noses
      • Before eating snacks or meals
      • Before leaving the facility
  • For adults:
    • Wash Hands
      • Upon arrival at the facility
      • Before eating or preparing food
      • After using the bathroom
      • After changing diapers or cleaning up a child who has used the bathroom
      • After helping a child blow his or her nose
      • Before and after caring for someone who is sick, which includes after touching clothing, bedding, toilets, or other surfaces touched by a person sick with diarrhea
  • Where staffing permits, people who change diapers should not prepare or serve food
  • Separate diaper-changing areas from play and food preparation areas.
  • Ensure children wear clothing over their diapers to prevent the spread of germs.
  • Wash hands (both yours and the child’s) after each diaper change.
  • Water tables and basins of water used for activities can spread germs. For this reason, CDC does not recommend their use. In facilities choosing to use them, have children and staff wash their hands before and after water play.
  • Don’t use temporary inflatable or rigid fill-and-drain swimming pools and slides, because the water they contain isn’t treated with chemicals that can kill germs, as it would be in properly maintained permanent swimming pools with circulating water and a filter system.
  • Where pool, splash pads or freshwater swimming venues are provided:
    • Exclude children diagnosed with shigellosis from water play and swimming for one week after their diarrhea has resolved.
    • Have children and staff shower with soap before swimming.
      • If a child is too young to shower independently, have staff wash the child, particularly the rear end, with soap and water.
    • Take frequent bathroom breaks or check their diapers often.
    • Change diapers in a diaper-changing area or bathroom and not by the water.
    • Discourage children from getting the water in their mouths and swallowing it.
  • Shigellosis is a reportable condition in all states, meaning all cases must be reported to the state or local health department.
  • Your state or local health department will contact the patient (or patient’s family member) to learn more about their sickness, recommend ways to prevent the spread of Shigella germs, and tell them when it is safe to return to childcare.
  • Public health departments do not share personal information, such as name and birthdate, to protect the privacy of the patient.
More Information
  1. Adams DA, Thomas KR, Jajosky RA, Foster L, Baroi G, Sharp P, Onweh DH, Schley AW, Anderson WJ; Nationally Notifiable Infectious Conditions Group. Summary of notifiable infectious diseases and conditions – United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;64(53):1-143.