May 22,

Outbreaks

Outbreaks

Enteric line listing form

Outbreak Management Resources for Child Care Centres

  • How do I know if my facility is experiencing an outbreak?
  • Who do I call to report a suspect outbreak?
  • What is an outbreak case definition?
  • What information do I need to collect if I have an outbreak?
  • What steps can be taken to minimize the spread of an outbreak?
  • What should I tell parents of attendees?
  • Are there any special instructions for staff?
  • When will the outbreak be declared over?
  • Are there any links to resources to assist me?

How do I know if my facility is experiencing an outbreak?

An outbreak should be suspected when there is an increase in the expected number children or staff experiencing similar signs and/or symptoms of illness within a certain period of time and/or in a certain location.

Even if you are unsure, don’t hesitate to call Public Health at 705-743-1000 to discuss what is happening at your facility.

Early recognition and early reporting are important to help decrease the number of children and staff affected by the outbreak. It will also aid in shortening the duration of the outbreak. Daily observation and recording of symptoms will help to determine a baseline. When there is an increase above baseline of respiratory or gastrointestinal symptoms, an outbreak could be occurring.

If you notice an increase above your baseline, please call Public Health at 705-743-1000.

Who do I call to report a suspect outbreak?

Call Peterborough Public Health staff at 705-743-1000 to report a confirmed or suspected outbreak.

On the phone, the Public Health Inspector or Nurse will ask you for the following information:

  • name of the facility
  • location (address and phone number)
  • contact person at the above location to provide details on the outbreak
  • number of ill individuals (staff, volunteers and children)
  • number of individuals (staff, volunteers and children)  in the facility
  • signs/symptoms presented by ill individuals
  • onset dates of signs and symptoms of ill individuals
  • duration of illness (if known)
  • any common characteristics or connections of existing cases

The Public Health Inspector or Nurse will arrange a meeting with you at your facility to help you manage the outbreak and to answer your questions.  An outbreak number will be given to you to document on paperwork.

What is an outbreak case definition?

At the first meeting or on the phone, the Public Health Inspector or Nurse will prepare an outbreak case definition in consultation with you.  The case definition usually includes four components:

  • symptoms;
  • common characteristics about the people who are ill (i.e. specific gender, age groups, vaccination status, ate the same meal, etc.);
  • information about the location or place (i.e. classroom, area of building, etc.); and
  • a specification of time during which the outbreak occurred (i.e. date, etc.).

All of the staff or children who meet the established criteria are to be considered a case in the outbreak.

What information do I need to collect if I have an outbreak?

The Public Health Inspector or Nurse will provide you with a table to complete.  This table is also called a line list.  Use this table to record details on all of the individuals (staff, children, volunteers) who are ill and meet the case definition.  Depending on the symptoms presenting, a respiratory table or a gastrointestinal (enteric) table will be provided.  Forward a copy of the table to the Public Health Inspector or Nurse daily during the outbreak.

The table will be used to assist in controlling the outbreak.

What steps can be taken to minimize the spread of an outbreak?

The Public Health Inspector or Nurse will recommend measures to be taken to minimize the spread or control the outbreak.  The following are general steps that can be implemented:

  • Isolate ill children and arrange for prompt pick-up.
  • Provide written information to families advising them of the outbreak and to keep ill children at home.
  • Advise ill staff not to work in the facility and to return after no longer having symptoms for a predetermined number of days (the number of days will be determined by the Public Health Inspector or Nurse and will dependent on the outbreak/organism)
  • Do not accept new registrations or “short term” care during the outbreak period.
  • Post outbreak signs in prominent areas indicating to visitors, delivery services, families, etc. that the centre is experiencing an outbreak.
  • Review hand hygiene with staff.
  • Encourage hand hygiene for children, staff, and/or parents who enter centre and reinforce usual handwashing practices.
  • Ensure children and staff have access to warm running water, single use soap and paper towels in dispensers.
  • Cancel social outings including field trips for the duration of the outbreak period.
  • Suspend interactions between groups that have experienced the illness and groups that have not experienced the illness.
  • Dedicate staff to rooms.
  • Ensure staff assigned to preparing food are not assigned to diapering and/or toileting children.
  • Suspend the use of sensory play activities such as sand or water tables or play dough.
  • Clean and disinfect toys from outbreak affected areas on a daily basis.  (Toys handled by an ill child should be removed immediately until they have been cleaned and disinfected.)
  • Dress-up clothes, linens and re-usable mop heads should be washed in a hot cycle (>71°C for 25 minutes) with detergent and then hot air dried.
  • Increase cleaning and sanitizing of commonly-touched surfaces (i.e. door handles, handrails, sinks, toilet handles, etc.)

The Public Health Inspector or Nurse will provide you with a written list of recommended control measures.

What should I tell parents of attendees?

Provide information on the outbreak to parents/guardians of children by email, letter, phone calls, etc.  The information should include what symptoms are being seen, what activities you are doing to prevent further illness, a phone number to report illness, and what to do if their child has these symptoms.  If currently experiencing symptoms, specimens can be collected to determine the organism.

The Public Health Inspector or Nurse will assist in dropping off or picking up specimen kits.  This information should also be available on outbreak signs at the front door for parents, staff, and visitors to see.  If an organism for the outbreak is determined, you may want to provide more detailed information to the parent on how to prevent and/or manage the illness.

The Public Health Inspector and/or Nurse will help you prepare this information.

Are there any special instructions for staff?

  • Non-immunized staff should not work in the day care centre during an outbreak of a vaccine-preventable disease.
  • Any staff member who is ill should stay at home.
  • Pregnant women who are not immune should be excluded from working during an outbreak of chicken pox or shingles, fifth disease, and rubella as these diseases may harm the unborn child.

When will the outbreak be declared over? 

If the organism for the outbreak was determined, the date the outbreak is declared over is calculated as follows:

  • Date of onset of the last case +
  • The incubation period of the organism +
  • The number of days this person is communicable

The Public Health Inspector or Nurse will advise the facility of the date.

If the organism for the outbreak was not determined, the date the outbreak will be declared over will be determined by the Public Health Inspector or Nurse.

Are there any additional resources to assist me?

Yes.  Additional resources can be found at the following links:

Resources for Child Care Centres:
Managing Infections
Cleaning and Sanitizing Schedule

References:

Centers for Disease Control and Prevention . (2002, May). Guidelines for Laundry in Health Care Facilities. Retrieved from Office of Health and Safety:
Ontario Agency for Health Protection. (2009, December). Best Practices for Environmental Cleaning for Infection Prevention and Control in All Health Care Settings.

Simcoe Muskoka District Public Health. (2010, October). Outbreak Management.  Retrieved February 21, 2012, from Simcoe Muskoka District Public Health.

Last modified on Jul 05, 2017