According to the Post-Dispatch, for the second time in two months, St. Louis city health officials have issued an alert about outbreaks of highly contagious intestinal bacteria that are usually spread by children.

There have been 148 cases of shigellosis in 2009, compared with 11 cases by this date last year, according to the St. Louis City Department of Health. Missouri reports 647 cases this year compared with the yearly average of 604. Illinois has not reported any shigellosis outbreaks this year.

Shigellosis infection is marked by fever, stomach cramps and diarrhea that can be bloody. Most infections resolve without treatment within a week, although antibiotics may be effective in treating severe cases.

Most of the illnesses are linked to day-care centers and schools, health officials reported. Children ages 4 and younger are most commonly infected.

Shigella can live in feces and is typically spread when people don’t wash their hands properly after using the bathroom or changing diapers.

Health officials recommend washing hands frequently and thoroughly with warm water and soap. Children should be supervised when washing hands. Disinfecting toys, eating surfaces and toilets or diaper changing areas can also help prevent the spread of the bacteria.