A little soap and water will go a long way toward containing an outbreak of shigellosis that's spread to more than 800 people in Hamilton County.

        Health officials are stressing that parents, babysitters and day care workers need to wash their hands after changing every diaper on every child in their care and before preparing every meal for their young charges.

        And youngsters need to be taught to wash their hands after using the bathroom, says Kathy Lordo, director of community health information services for the Hamilton County General Health District.

        “It's one of the things that your mother always told you, but people have forgotten,” Ms. Lordo says.

STOPPING SHIGELLOSIS

• Wash your hands. Use warm water and plenty of soap, rub hands together for 20 seconds (sing “Happy Birthday” twice), rinse and dry hands with a clean towel or paper towel. Remember your wrists, backs of hands, between the fingers and under and around rings and fingernails. Use the towel to run off the faucets and open the door when leaving the restroom.    • Day-care workers and parents need to wash their hands after every restroom use and every diaper change and before preparing every meal.    • Disinfect the changing area after every diaper change.    • Adults should supervise children in handwashing after every restroom use.    Source: Hamilton County General Health District

        Local health departments are meeting with day-care operators to stress the importance of hand-washing.

        “And that's something for Mom at home, too,” Ms. Lordo says.

        Shigellosis is a bacterial infection marked by diarrhea — sometimes bloody — fever and stomach cramps. Very young children and the elderly are especially vulnerable, and may require hospitalization. Normally, Hamilton County sees a handful of cases — anywhere from four or five to 21 — a year, officials say. The disease usually affects “diaper-age” children who come in contact with feces, touch their hands to their mouths and become infected.

Control of choice
       
        That's where the soap and water come in, says Dr. Beverly Connelly, director of the infection control program at Children's Hospital Medical Center.

        “Hand-washing is the control method of choice,” Dr. Connelly says.

        Ten to 20 seconds of scrubbing with warm water and soap will kill the bacteria that cause shigellosis — and most other bacterial diseases, experts say.

        Antibacterial soaps aren't necessary, but they won't hurt, Dr. Connelly says, and triclosan, the active ingredient in many household antibacterials “has some longevity” for killing germs.

        “But honestly, 15 seconds of good friction will do it,” she says.

        Hand sanitizing gels, lotions and wipes will kill the bacteria, but they won't clean any soil on the hands. But the sanitizers are handy to carry in diaper bags or in the car for quick clean-ups, Dr. Connelly says.

"Happy Birthday'
       
        Ms. Lordo has a simple way to determine how long to wash your hands.

        “We timed it. If you sing "Happy Birthday' at a reasonable pace, that's 10 seconds,” she says.

        Getting proper treatment for shigellosis is also important to keep the disease from spreading, Dr. Connelly says. There's no vaccine to prevent the disease. But antibiotics can clear up the infection. That's important, she says, because even after children stop having symptoms, the bacteria are still present in their feces and can be spread to others.

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