Since May, the Douglas County Health Department has investigated 50 confirmed cases of Shigella sonnei (shigellosis) infection, including four that involved hospitalizations. In eight of the nine previous years, Douglas County reported 31 or fewer cases.

Symptoms of shigellosis can range from loose, watery stools with no other symptoms to bloody diarrhea with fever and cramps. People experiencing diarrhea should remain home from school or work until at least 24 hours after their symptoms stop. Anyone with diarrhea should not prepare food or drink for others.

“Hand washing is absolutely critical to controlling any disease that involves diarrhea,” Health Director Dr. Adi Pour said. “It is especially important to wash your hands with soap for at least 20 seconds after changing diapers or using the bathroom, since it takes only a small exposure to pass along the disease.”

Forty-one percent of these recent shigellosis cases involved children less than 5 years old and 29 percent were between 5 and 9 years old. Most of the cases, 62 percent, have been associated with child care settings.

It is also important for anyone who has been sick to stay out of swimming pools and water parks for a week after they have recovered. Most of the recent Douglas County cases are linked to day care facilities, but swallowing pool water is another way shigellosis may be transmitted.