By MARK ANDERSEN / Lincoln Journal Star
More than 30 probable cases of shigella, the parasitic infection associated with prolonged and often severe diarrhea, have been identified in Lancaster County over the past two weeks.
Dehydration, usually in the very old and young, is the biggest danger of this highly contagious organism, said Tim Timmons of the Lincoln-Lancaster County Health Department.
There have been 14 lab-confirmed cases of the disease.
The cases were reported across the community, in children and adults, but three day care providers have been especially affected. They were not identified.


Shigella bacteria are spread via the fecal-oral route.
“Good hand washing after using the restroom, after changing diapers and before eating is important” Timmons said.
Anybody with loose or watery stools should avoid using swimming or wading pools.
In Lincoln, no cases have been associated with swimming pools, Timmons said.
It’s not unusual for a community to have a shigella outbreak every few years, Timmons said. Nebraska had 117 lab-confirmed cases in 2000 and 47 in 2004, according to the Centers for Disease Control and Prevention.
The health department issued an alert Thursday to try to limit the spread.
“Once it gets going, it can go pretty good,” Timmons said.
Although typically not life-threatening, the resulting one to four days of watery diarrhea can cause serious dehydration.
“It’s important that anybody with a diarrheal illness lasting longer than 24 to 48 hours contact their health care provider,” Timmons said.
Even if it’s not shigella, it needs to be evaluated.
Shigella bacteria can be present in feces for up to four weeks after symptoms disappear. Antibiotics are effective against the parasite and will limit contagiousness.
Diarrhea is the primary symptom. Itís usually watery and may include blood. Possible secondary symptoms include fever, nausea, abdominal cramps and vomiting.
None of the Lancaster County cases has resulted in hospitalization, Timmons said.
Special steps for child care centers
* Any child with two or more loose stools in 24 hours should be excluded from child care and seen by a physician.
* No child should return to child care until seen by a physician and without symptoms for 24 hours since the last incidence of diarrhea.
* Due to the highly contagious nature of shigella, food handlers and child care providers should not return to work until completely free from the disease.
Additional measures
* Avoid sharing foods.
* Discourage sharing of home-prepared foods at church or school.
* Use disposable gloves or a serving spoon when serving food.
* For more information regarding shigella, call the health department at 441-8053.
Source: Lincoln-Lancaster County Health Department
Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.