Outbreaks in Child Care Centers

To report an outbreak during regular business hours, please complete the Initial Notification of Increase of Illness online form or 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 settings 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 in your setting 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 settings.

Reporting outbreaks to Ottawa Public Health

A Child Care Setting should report an outbreak of illness to Ottawa Public Health (OPH)

When there are three or more cases (children or staff) of gastrointestinal illness (e.g. nausea, vomiting, diarrhea) within a program, group, or the entire setting in a three day period, even if cases occurred at home


When your child care setting absenteeism rate increases above what the setting would typically experience and the absences are not perceived to be linked to other factors such as holidays, the operator/owner should notify OPH.


If there are one or more case(s) of a reportable enteric disease in the setting as per the Guidelines for Communicable Disease and Other Childhood Health Issues for Schools and Child Care Centres.

When an outbreak is suspected, follow the guidance in the Infection prevention and control measures during outbreaks section below.

Reporting to OPH

If 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.

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 

Control Measures For Enteric and Respiratory Outbreaks

Ottawa Public Health aligns with provincial guidance for management of cases and contacts of COVID-19 in Ontario. 


Screening is encouraged for all staff, children, and visitors. Refer to the Ministry of Health’s COVID-19 school and childcare screening tool.

Management of symptomatic individuals

  • Individuals who have respiratory symptoms or a positive COVID-19 test must self-isolate immediately until symptoms have been improving for 24 hours and no fever present. Longer self-isolation is recommended in certain populations, such as those with severe illness, those who are immunocompromised, and those who live or work in a highest risk setting.
  • Individuals who have enteric/gastrointestinal symptoms including vomiting and/or diarrhea, should be excluded until symptoms have been resolved for at least 48 hours.
  • Follow exclusion criteria for other illness as described in the Guidelines for Communicable Diseases and Other Childhood Health Issues for Schools and Child Care Centres.

Management of household and non-household close contacts

  • For a total of 10 days after the last exposure to the COVID-19 positive case or individual with COVID-19 symptoms, the individual should:
    • Self-monitor for symptoms. They should self-isolate immediately if they develop any symptoms of COVID-19 and seek testing if eligible. 
    • Wear a well fitted mask in public settings including child care and school, unless under 2-year-old. Refer to page 13 in the guidance. 
      • Reasonable exceptions would include removal for essential activities like eating, while maintaining as much physical distance as possible. 
      • Participation in activities where masking can be maintained throughout may be resumed, but individuals should avoid activities where mask removal would be necessary (e.g., dining out; playing a wind instrument; high contact sports where masks cannot be safely worn); and 
      • Individuals who are unable to mask (e.g., children under two years of age, etc.) may return to public settings without masking.
    • Avoid non-essential visits to anyone who is immunocompromised or at higher risk of illness (e.g., seniors); and 
    • Avoid non-essential visits to highest risk settings such as hospitals and long-term care homes. Where essential visit cannot be avoided, close contacts should wear a medical mask, maintain physical distancing, and notify the highest risk setting (e.g., hospital) of their recent exposure

Management of ill Individuals Onsite

  • Limit movement of staff and children, as well as equipment used between cohorts where possible during outbreaks. 
  • Symptomatic staff/child procedure in place including isolation of ill individual; contacting family for pickup of ill child(ren); and sending ill individual home.
  • Ill children should be kept in a separate, supervised area that can be easily cleaned and disinfected, until a parent or guardian takes them home.
  • Appropriate PPE worn by all staff supervising ill children (medical mask, optional non-fit-tested N-95 mask, eye protection and gloves) and all ill children (medical mask if child is older than two and mask tolerated).

Personal Protective Equipment

Refer to Public Health Ontario – Refresher for Schools and Childcare for more details

  • Follow PPE guidance as per Provincial guidance for all close contacts
  • Sufficient stock of PPE (medical masks, non-medical masks) is always available for staff and children. PPE logs are recommended. 
  • PPE training for staff and children (donning and doffing). 
  • Gloves worn by staff if there is possibility of contact with bodily fluids (e.g., during diaper changes).  

Cleaning and Disinfection

Refer to OPH Webpage – Cleaning and Disinfection in Childcare and School Settings for more details.

  • Disinfectant contains a Drug Identification Number and is not expired.
  • Follow manufactures instructions for product’s use.
  • Remove sensory play during outbreaks (e.g., water or sand tables). 
  • Fabric furniture should be removed or covered with a nonabsorbent easy cleanable cover during outbreak.
  • Enhanced cleaning and disinfection of high touch surfaces, washrooms, toys/other shared objects minimum 2x/day; immediate cleaning & disinfection of items used by ill child or as needed (e.g., toys, blankets).
  • Clean and disinfect high-touch surfaces at least twice daily and as needed using an enhanced cleaner/disinfectant (e.g., doorknobs, water fountain knobs, light switches, toilet, and faucet handles).
  • Clean and disinfect linens, cots, and cribs at least once a week and immediately after use by a symptomatic child. 
  • Clean and disinfect diaper changing stations immediately after each use.
  • Personal items (e.g., sippy cups, soothers, utensils) are not shared.

Hand Hygiene

  • Train and encourage appropriate hand hygiene and respiratory etiquette for all staff, children, and visitors including the use of soap and water when hands are visibly soiled and alcohol-based hand rub (ABHR). Provide supervision/ assistance to children as needed. Ensure adequate supplies are available. 
  • Alcohol based hand rub (ABHR) with a minimum 70 per cent alcohol concentration must be available throughout the facility (including ideally at the entry point to each classroom) and/or plain liquid soap in dispensers, with sinks and paper towels in dispensers.
  • More information on how to perform hand hygiene for children and infants can be found on parentinginottawa.ca.
  • Printable hand hygiene resources.
Hand hygiene resources
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 NumberColour of CapTransport MediaTest Required
#1 White cap Empty vial Virology
#2 Green cap Red transport medium Bacteriology


  • 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 unable to be accepted due to contamination

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. 

  1. 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.     
  2. 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)
  3. 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 cannot be accepted. 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 3:30 pm. Inform your child care and early years operator that a stool sample was collected.  


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

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