The Galveston County Health District (GCHD) encourages parents and educators to teach children the importance of good hand hygiene following an increase of the gastrointestinal illness shigellosis at area schools and daycares.


Shigellosis, caused by the bacteria shigella, is spread from person-to-person through hand-to-mouth contact with the stool of an infected person. This frequently occurs through direct contact with the unwashed hands of an infected person or through food or drink handled by an infected person.

Symptoms typically appear 1-3 days after exposure and include diarrhea, fever, vomiting, and stomach cramps. These symptoms typically go away by themselves in 4-7 days; however treatment with antibiotics may relieve symptoms or make them go away faster. Some people with shigellosis will have no symptoms but are still able to spread the infection to others.

“Shigellosis in schools and daycares is not uncommon and the most frequent cause is children not properly washing their hands after using the restroom,” said Dr. Abdul-Aziz Alhassan, interim Galveston County Local Health Authority. “Our epidemiology staff has determined improper handwashing as the most probable cause of the increased cases we’re investigating.”

The Centers for Disease Control and Prevention offers the following tips for proper handwashing:

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them.

According to the CDC, washing hands with soap and water is the best way to reduce the number of germs in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

“Although shigellosis is easily spread, it’s also easily preventable,” Dr. Alhassan continued. “That’s why it’s important for adults to talk to children about proper handwashing.”

GCHD has confirmed 82 shigellosis cases in the county since October, primarily affecting young children. The number of shigellosis cases reported to the Health District varies yearly with 12 cases reported last year, 84 in 2013, 5 in 2012, 6 in 2011, and 28 in 2010. The 2015 year-to-date total is 91.

Of the cases since October, 34 are related to outbreaks at a Texas City daycare and League City elementary school. Collectively, cases have been confirmed at 14 schools and eight daycares.

Control measures at the school and daycare with outbreaks have been implemented, including increased cleaning of frequently-touched surfaces including restroom fixtures, door knobs, water fountains, and keyboards. Hand sanitizer has also been made available in various areas. The Health District also provided information to be sent home to parents of the affected facilities. As is routine in such situations, an alert was sent to area medical providers encouraging them to test patients with symptoms of the illness.

“If your child has shigellosis symptoms, it’s important that you take them to a physician immediately to have them tested for the illness so that treatment can begin,” Dr. Alhassan continued. “Physicians report this information to our epidemiologists so they can investigate and address the sources.”