Main scenarios for evaluation | Definition |
---|---|
I. Shigellosis exclusion policiesa | The patient can return to childcare if in compliance with the following requirements: |
Two consecutive tests: Culture | Two consecutive laboratory culture analyses of convalescentb stool samples yield negative results for Shigella |
Two consecutive tests: PCRc | Two consecutive laboratory PCR analyses of convalescentb stool samples yield negative results for Shigella |
One test: Culture | One laboratory culture analysis of convalescentb stool samples yields negative results for Shigella |
One test: PCR | One laboratory PCR analysis of convalescentb stool samples yields no Shigella |
14 days after onset | 14 days after symptom onset, with no tests performed during convalescence |
7 days after beginning treatment | Seven days after beginning antimicrobial treatment, with no tests performed during convalescence |
24 h symptom-free | 24 h symptom-free, with no tests performed during convalescence |
II. Treatment scenarios for each exclusion policyd | |
A. Immediate, effective treatment | Child visits healthcare provider and starts effective antimicrobial treatment without requiring any further diagnosis or test on the second day of illness |
B. Effective treatment after diagnosis | Child visits healthcare provider on the second day of illness, gets a stool culture with antimicrobial susceptibility testing, and starts effective treatment after results are availablee |
C. Ineffective treatment | Child visits healthcare provider and starts ineffective antimicrobial treatment on second to fourth day of illness |
D. No treatment | Child receives no antimicrobial treatmentf |