By Barbara Isaacs
Thereís a long list of items kids need to lug to school ó backpacks, crayons, notebooks, erasers.
But thereís one thing school health officials donít want kids bringing with them ó diarrhea.
Diarrhea in school is a special concern now, because since May, 135 cases of shigellosis have been diagnosed in Fayette County. There have been 24 new cases diagnosed since July 28.
Shigellosis is a form of dysentery that causes diarrhea, fever and vomiting.

ìThere is a concern weíll have an increase in the number of cases when school starts,î said Dr. Melinda Rowe, commissioner of the Lexington-Fayette County Health Department. ìItís always a possibility anytime you have kids congregated together.î
ìShigellosis is definitely at the top of the priority list,î said Rebecca White, coordinator of school health nurses for Fayette County. Sixteen school-based nurses work in the countyís public schools.
One strategy to deal with the community-wide outbreak: sending home students and staff who have recurring diarrhea, White said.
ìThat doesnít mean one loose stool,î White said. ìAnybody could have that one time, with school starting and with anxiety.î But several episodes of diarrhea will prompt school officials to send a child or staff member home. They also advise them to get medical evaluation of the problem. ìThat should happen as long as weíre in the midst of a shigella outbreak,î White said.
On the first day of school Monday, every student in Fayette County will also bring home an information sheet in English and Spanish about shigellosis, including its symptoms and how to prevent it, White said. The illness usually begins a day or two after exposure and can last five to seven days. Shigella bacteria remain in the stool for up to two weeks and can still infect others during that time.
Frequent hand-washing with soap and warm water is the best defense against the shigella bacteria. Shigellosis is caused by fecal bacteria that enters the mouth.
Most cases in this outbreak have been among young children in day care. 76 kids, ages 4 and under, have been diagnosed with shigellosis. Rowe said that many elementary school students have younger siblings in day care. Shigellosis cases have been linked to 14 Fayette County daycare providers, including one daycare operated out of a private home. Four daycare workers are among those who have shigella infection.