Shigellosis is another disease kids risk contracting in day care centers and passing on to their families.
In 1991 there was an outbreak of Shigella sonnei infection in Lexington-Fayette County, Kentucky, that involved 14 licensed day care centers, making a lot of people sick but, every cloud has a silver lining, giving researchers a chance to test some epidemiological hypotheses. They discovered some useful information.
Day care centers that had outbreaks were more likely to have a food handler who also changed diapers and provided transportation for children from their homes to the center. These centers also had a higher toddler-to-toilet ratio, so there were more kids using the same bathroom.
In most families with shigellosis, the first person with diarrhea was a child younger than six. And, perhaps most interesting, the community-wide promotion of hand washing was identified as the most likely factor in getting the outbreak under control.