As with any illness, tell the child’s family if you are concerned about their health. Contact 911 or your local emergency system if you think a child may be having a medical emergency.

Shigella infection is a very contagious diarrheal disease caused by bacteria called shigella. Shigella infection causes about 500,000 cases of diarrhea in the United States every year.

What are the symptoms of shigella infection?

Symptoms of shigella infection usually start one to three days after exposure and include:

• Diarrhea (sometimes bloody)
• Fever
• Abdominal pain
• A painful feeling of needing to pass stools even when bowels are empty

How does shigella infection spread?

Shigella infection spreads when people put something in their mouths or swallow something that has had contact with the stool of a person who is infected. This can happen when:

• Contaminated hands touch food or the mouth.
• Hands are contaminated through actions like:
  • Touching surfaces that are contaminated by the stool from an infected person, such as toys, bathroom fixtures, changing tables, or diaper pails
  • Changing the diaper of an infected child
  • Caring for an infected person
• A person eats contaminated food. Food may be contaminated when prepared by someone with shigella infection.
• A person drinks water that was contaminated by infected stool.
• A persons use recreational water, such as in wading pools and sensory tables, that is contaminated.

Shigella germs are in the stools of infected people for up to two weeks after the diarrhea has gone away.

Shigella infection is a notifiable disease.

If a staff member or child is diagnosed with shigella infection or has been around someone who is infected, contact and follow guidance from the public health department in your jurisdiction. Your local health authorities can help you notify parents/guardians about their child’s possible or confirmed exposures to an infectious disease.

Who is at risk?

Young children are the most likely to get shigella infections, but it can affect all age groups. Many outbreaks are related to child care settings and schools. Shigella spreads from young children to their family members and others because it is so contagious.

How can providers limit the spread of shigella infection?

Programs must exclude all diapered children whose stool is not contained in the diaper, and toilet-trained children if the diarrhea is soiling their clothing. Diapered children with diarrhea should be excluded if the child has two or more stools above normal for that child. The definition of diarrhea is watery or loose stools that are not caused by changes in food.

Programs can readmit when diapered children have their stool contained by the diaper (even if the stools are still loose) and when toilet-trained children do not have toileting accidents.

State and local health departments may require your program to meet more conditions before you permit children with shigella infection to return to child care (e.g., they may need a note from a health provider, and one or more laboratory tests to show that the infection has passed).

Providers should also:

• Follow diapering steps that will minimize exposure to germs that cause diarrhea.
• Make sure to clean and disinfect toys.
• Make sure all children and adults use good hand-washing techniques, including scrubbing with liquid soap and water for 20 seconds.
• Separate the staff assignments: diapering or food preparation, but not both.
• Reassign adults with diarrhea to jobs that minimize chances to spread infection, such as desk work and not food preparation. State and local health regulations may require adults with shigella infection to not work in child care while ill.
• Stop water play during a shigella outbreak.

As always, follow regular infection control practices to help keep everyone healthy:

• Stay up to date on vaccines.
• Minimize exposure to illness.
• Encourage children and adults to stay home when they’re sick.
• Do daily health checks when children arrive.
• Watch children for signs of illness. Contact their guardian if a child is too sick to stay. Early identification and treatment can help make the symptoms less severe and decrease the risk of spreading the disease to others.
• Limit germs in the environment.
  • Wash hands with soap and water often throughout the day.
  • Do not let children share mouthed toys, cups, or utensils.
  • Regularly clean, sanitize, and disinfect surfaces and toys.
  • Teach people to cover their coughs and sneezes.
  • Throw away used tissues.
  • Let fresh air indoors.
  • Spend time outdoors.
• Follow, review, and update exclusion policies. Exclude children if they:
  • Are too sick to take part in program activities.
  • Need more care than staff can give them without affecting the health and safety of other children.
  • Show any other signs or symptoms in your “stay home when sick” policy.
• Use your program’s health experts, including your Health and Mental Health Services Advisory Committee or child care health consultant, to stay up to date and to develop policies and procedures to prevent the spread of illness.

How can programs partner with families?

Here are some ways programs can partner with families:

• Check out Preventing Infectious Diseases resources on CDC’s Early Care and Education Portal.
• As with any illness, encourage families to contact the child’s health care provider with questions or concerns about symptoms that get worse.
• Remind families to call 911 or their local emergency system if they think their child may be having a medical emergency.
• Encourage families to talk with their child’s health care provider about vaccines.

« Go to Infectious Disease Fact Sheets

Last Updated: August 27, 2025