Outbreaks in Child Care Centers

To report an outbreak during regular business hours, or for more information, call 613-580-2424 ext. 26325. Evenings, weekends or holidays, call 3-1-1 and ask to speak with the Public Health Inspector on-call.

It is important that child care centres collaborate with Ottawa Public Health (OPH) to ensure the prevention, early detection and control of infectious diseases. When a case or outbreak of an infectious disease occurs, OPH works closely with staff at your centre to implement appropriate infection control measures, to manage contacts, and to provide education and direction as needed. Prompt reporting of suspect or confirmed cases or outbreaks of infectious diseases is crucial to enable early implementation of control measures that can minimize the risk of further transmission or spread of the infection in child care centres.

To report an outbreak during normal business hours (Monday to Friday, 8:30 am to 4:30 pm), please call 613-580-2424 ext. 26325. To report a single case of a communicable disease during normal business hours please call 613-580-2424 ext. 24224. To report in the evening, on weekends or holidays, please call 3-1-1 and ask to speak with the public health inspector on-call.

Reporting outbreaks to Ottawa Public Health

A Child Care Centre should report an Outbreak of Illness to Ottawa Public Health (OPH)

When there are three or more cases of gastrointestinal (GI) illness (child and/or staff) within a program, group, or the entire centre in a three (3) day period, even if cases occurred at home
OR
If there are one or more case(s) of a reportable enteric disease in the centre (see below)
OR
If there is greater than 15% absenteeism due to illness within a program or entire centre on one day.

When an outbreak is suspected, implement outbreak control measures:

Clean and disinfect commonly touched surfaces and common areas
Post signs to alert staff and parents or guardians of increased absenteeism or outbreak
Clean and disinfect toys and play areas twice daily and when visibly soiled
Exclude ill children and staff
If possible, keep ill children in a separate supervised area until a parent or guardian takes them home
Be diligent to perform hand hygiene

Report to OPH

If an outbreak is suspected or you are uncertain if you have an outbreak, call OPH Outbreak Reporting Line at 613-580-6744 ext 26325, Monday to Friday from 8:30 am to 4:30 pm or 3-1-1 after hours.

If an outbreak is confirmed by OPH, fax the line listing to OPH at 613-580-9649 on a daily basis until the outbreak is declared over by OPH.

Do you have children absent with other illnesses?

Refer to the Guidelines for Communicable Disease and Other Childhood Health Issues for Schools and Child Care Centres.

Infection prevention and control measures during outbreaks

Schools follow infection control measures as part of their daily operations. During an outbreak, some measures may need to be adjusted or enhanced. These may include: 

1. Exclusion of Ill Students and/or Staff

Students and/or staff should stay at home when they have:

Symptoms of an enteric illness, including vomiting and/or diarrhea, and until their symptoms have been resolved for at least 48 hours
Symptoms of a respiratory illness, including fever, cough, sore throat, congestion, runny nose, or sneezing until they are fever-free and feeling better without the use of medication for 24 hours.
- To follow isolation instructions for specific illness such as COVID-19
- Other symptoms as described in the Guidelines for Communicable Diseases and Other Childhood Health Issues for Schools and Child Care Centres (2021, or as current).

During an outbreak, staff should be watchful in monitoring students for symptoms of illness. Students and staff are encouraged to self-screen for symptoms of illness before attending school. Students can return to school after they have completed their period of exclusion/isolation and should continue to follow public health measures when planning to resume regular activities.

2. Cohorting of Ill Students

If possible, ill students should be kept in a separate, supervised area that can be easily cleaned and disinfected, until a parent or guardian takes them home.

3. Cleaning and Disinfection

Routine cleaning and disinfection are essential to prevent the spread of germs. During outbreaks, you may need to take additional measures, including, but not limited to, the following:

Ensure that the disinfectant used during an outbreak is effective to kill Norovirus, a virus which often results in enteric outbreaks
Clean and disinfect high touch surfaces at least twice a day
Avoid sensory play during outbreaks (e.g. water or sand activities, use of play-dough)
Remove shared items such as toys that cannot be easily cleaned and disinfected for the duration of the outbreak
Additional Resources: Cleaning and Disinfection Checklist, Environment Cleaning and Disinfection in Child care centers and Schools, Cleaning and disinfection of toys

4. Hand Hygiene

Hand hygiene is essential for all staff and students to prevent the spread of germs. Young children should be supervised when performing hand hygiene to ensure it is done properly. Hand hygiene includes both hand washing and hand sanitizing and should be done more frequently during outbreaks.

You must ensure that:

Hands are washed with liquid soap and running water for at least 15 seconds if visibly soiled
Hands should be rubbed with 60-90% alcohol-based hand sanitizers for at least 15 seconds if not visibly soiled.

More information on how to perform hand hygiene for children and infants can be found on parentinginottawa.ca.

Printable hand hygiene resources by OPH are available below under “hand hygiene resources”.

Hand hygiene resources

Learn more about preventing the spread of germs in the below resources prepared by OPH.

The information below is available in other formats. Contact Ottawa Public Health at 613-580-6744 to request the document in an accessible format.

Hand Washing Poster only:

Hand Washing Poster and Factsheet:

Hand Sanitizing Poster only:

Hand Sanitizing Poster and Factsheet:

Cough Etiquette Poster only:

Cough Etiquette Poster and Factsheet:

Line listing for outbreaks

Outbreak line listing for child care centers and schools [PDF 160 kb]

Fax daily to: 613-580-9649

How to collect stool specimens

Kit contains two sterile containers:
Container Number	Colour of Cap	Transport Media	Test Required
#1	White cap	Empty vial	Virology
#2	Green cap	Red transport medium	Bacteriology

Collection

Check the expiration date on the sterile containers. DO NOT use expired kits
If blood or mucus is present in the stool, take the sample from this part of the stool
Stool specimens that have been in contact with water in the toilet are unacceptable

Collection Procedure:

*These first two steps are very important – if the label and/or form are missing information, illegible, or filled out incorrectly, the lab will not test the sample. 

Label the sample containers with the child’s name, health card number (ID number on the label), and the date/time the stool sample is collected.    
Complete all of the required sections of the “General Test Requisition” form
- Patient information section
- Public health unit outbreak number
- Date stool sample collected
- Date of symptom onset (date symptoms started)
Collect the stool sample 
- Adults and toilet trained children: Defecate into a clean container (i.e. a disposable plate). Stool that has been in contact with water is not acceptable. TIP: Urinate first if needed.
- Children who are not toilet trained: Collect the stool sample from the soiled diaper or directly from the child's training "potty."  
- Using the individual "scoop" attached to each of the caps, transfer stool into the corresponding sterile containers. Fill the white cap container first. 
- Fill to the line indicated on the container. Do not overfill.  
- Tighten the caps. Do not use excessive force to tighten the caps as the containers may crack and leak. 
- Place the containers in the inner pocket of the plastic biohazard bag and seal the zip-lock bag. 
- Place the General Test Requisition form in the small outer pocket of the plastic biohazard bag. Do not place the form in the inner pocket.        
- Place the biohazard bag into the brown paper bag and refrigerate the sample(s) immediately after collection. Stool samples should be placed on the bottom shelf of a fridge and food should not be stored in the same fridge as the stool samples. A cooler with ice or an ice pack can be used if a separate fridge is not available. DO NOT freeze the sample.
- Perform hand hygiene. If hands are visibly soiled, use soap and water.
- Call Ottawa Public Health at 613-580-2424, ext. 26325 for stool sample pick-up and delivery to the Public Health Laboratory located in Ottawa. Deadline for same day pick up is 15:30. Inform your child care and early years operator that a stool sample was collected.

Labelling

Label each container with the client's name, Date of Birth and date the stool sample was collected

Samples that are incorrectly filled out, or packaged improperly will be discarded by Public Health Lab

Enteric Outbreak Resources

Parent Stool Sample Information (pdf - 81 KB) (This document is currently not in an accessible format. An accessible document will be posted shortly.)
Child Care Enteric Outbreaks (pdf - 160 KB) (This document is currently not in an accessible format. An accessible document will be posted shortly.)

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