School Illness Prevention and Response Toolkit

Proper hand hygiene is one of the most effective ways to reduce the spread of respiratory and gastrointestinal illnesses in schools. Encourage students and staff to wash their hands regularly using soap and water, especially:

• when hands are visibly soiled
• before/after eating
• after using the washroom
• after coughing, sneezing, or blowing their nose

Alcohol-based hand rub or hand sanitizer may be suitable when hands are visibly clean. If an alcohol-based hand rub is being used, ensure the alcohol concentration is at least 70% and the product is not expired.

Resources:

• Hand hygiene for children
• Hand hygiene resources and printables
• BAGS (Be a Germ Stopper) (lesson plans for JK to grade 3)

Respiratory etiquette helps reduce the spread of germs that can cause respiratory illnesses.

• Cover coughs and sneezes with a tissue or your elbow
• Dispose of used tissues immediately
• Wash hands after coughing, sneezing, or blowing your nose

Poster: Cover your Cough

Routine cleaning and disinfection help reduce the spread of illness, particularly on frequently touched surfaces and shared equipment. Enhanced cleaning and disinfection (minimum twice per day) should be implemented during increased periods of illness. Examples include high touch surfaces, washrooms and other shared objects.   

Consider:

• Following routine cleaning procedures
• Cleaning and disinfecting high-touch surfaces (e.g., light switches, desks, tables, chairs, lockers, etc.)
• Cleaning shared equipment according to school procedures (e.g., sports equipment, computers/tablets/mouse/keyboard, etc.)
• Using signage and posters to reinforce healthy behaviours
• Removing sensory materials (e.g., water tables, sand tables) during periods of gastrointestinal illness
  • Reviewing OPH’s IPAC control measures for schools and Environmental cleaning and disinfection in child care centres and schools

Recognizing Illness

Some students may not be able to clearly communicate symptoms or may show illness differently than older students.

Staff should watch for:

• Unusual tiredness or reduced participation
• Increased irritability or changes in behaviour
• Changes in appetite
• New coughing, sneezing, vomiting, or diarrhea
• Changes from the student's usual level of functioning

When concerns arise, communicate with parents or guardians and follow school illness procedures.

Supporting Hand Hygiene

Students may need reminders and supervision to perform hand hygiene effectively.

Consider:

• Establishing regular handwashing routines throughout the day
• Using visual supports, picture schedules, or social stories
• Providing hand-over-hand assistance or guided support when appropriate
• Allowing extra time for students to complete hand hygiene
• Reinforcing positive handwashing behaviours

Supporting Respiratory Etiquette

Teach and reinforce age-appropriate practices such as:

• Covering coughs and sneezes with a tissue or elbow
• Disposing of tissues promptly
• Cleaning hands after coughing, sneezing, or nose blowing

Visual reminders and regular practice can help students develop these habits.

Shared Materials and Sensory Items

Many kindergarten and special education classrooms use shared learning tools, sensory materials, and adaptive equipment.

Consider:

• Cleaning and disinfecting shared equipment according to school procedures
• Encouraging hand hygiene before and after use of shared items
• Removing items that cannot be cleaned when illness activity is increased
• Following manufacturer instructions for use (MIFUs) for cleaning specialized equipment

Resource:

• Environmental cleaning and disinfection in child care centres and schools

Communication with Families

Respiratory viruses can cause symptoms such as:

• Fever
• Cough
• Sore throat
• Runny nose
• Shortness of breath
• Muscle aches
• Fatigue
• Vomiting or diarrhea

Enteric illnesses ("stomach bugs") can cause:

• Vomiting
• Diarrhea
• Stomach pain

Students and staff should stay home when they are sick.

Return-to-school requirements vary depending on the illness. Families and staff should follow advice from their health care provider and/or any direction provided by Ottawa Public Health.

For many common respiratory and gastrointestinal illnesses, children and staff can return to school when:

• Symptoms are improving for at least 24 hours
• They are fever-free without fever-reducing medication
• They feel well enough to participate in regular activities
• At least 48 hours have passed since the last episode of vomiting or diarrhea

Some communicable diseases may require longer exclusion periods or additional public health follow-up. Follow guidance from a health care provider and Ottawa Public Health, where applicable.

•  Wash hands frequently
• Cover coughs and sneezes
• Avoid touching your face with unwashed hands
• Clean and disinfect high-touch surfaces
• Stay home when sick

Vaccination helps protect against serious illness and reduce the spread of disease.

• Annual flu and COVID-19 vaccines are recommended for everyone 6 months of age and older.
• Routine childhood vaccinations protect against illnesses such as measles and whooping cough.
• Parents should ensure their child's immunizations are up to date.

Resources from Ottawa Public Health

• Respiratory Virus Information
• Respiratory Illness Handout
• Where to Seek Care
• Child Immunization
• Poster: Keeping Your Sick Child Home [PDF]

When should schools contact Ottawa Public Health?

Schools should first consult the Guidelines for Schools and Child Care Centres on Infectious Diseases and Other Childhood Health Issues for support related to symptoms and/or suspected infections they may be seeing in schools.

Schools should contact Ottawa Public Health if they:

• Have further questions related to an infection or disease-specific guidance
• Have questions related to public health guidance for a specific communicable disease
• Are concerned about unusual illness activity and/or severe illness
• Are aware of a confirmed case of a reportable infection in the school
• Are suspecting food-borne illness

Schools do not need to contact OPH for routine illnesses that can be managed using the Guidelines for Schools and Child Care Centres on Infectious Diseases and Other Childhood Health Issues.

Does Ottawa Public Health declare outbreaks in schools?

Over the past few years, the approach to supporting schools in managing illness has continued to evolve. Rather than formal outbreak declarations, today, schools are supported through established communicable disease prevention practices, infection prevention and control measures, and ongoing collaboration with OPH when additional guidance or support is needed.

Schools should continue to follow the Guidelines for Schools and Child Care Centres on Infectious Diseases and Other Childhood Health Issues and contact OPH if they have concerns about illness activity, unusual patterns of illness, suspecting food-borne illness, or require assistance interpreting public health recommendations.

A parent tells us their child has a communicable disease. Do we need to notify the entire school community?

Notification of students, staff, and families is determined on a case-by-case basis and depends on the specific illness and whether public health action is required.

Schools should consult the Guidelines for Schools and Child Care Centres on Infectious Diseases and Other Childhood Health Issues to determine whether notification to Ottawa Public Health (OPH) is recommended.

It is important to distinguish between a suspected illness and a confirmed diagnosis. Families may report that a child has a specific illness before it has been confirmed by a health care provider. Schools should not assume a diagnosis has been confirmed based on symptoms alone or reports from families.

If a reportable infection diagnosis is confirmed, OPH will be notified directly by the diagnosing health care provider or laboratory, as required by law.  Where public health action is required, the Infectious Disease Program (IDP) will work with the school to determine any necessary follow-up, including communication with families or staff. 

Ottawa Public Health protects the privacy and confidentiality of students and staff involved in public health investigations and shares personal health information only when necessary to support public health actions.

If individuals may have been exposed to a reportable infection, OPH may work with the school and/or school board to obtain information required for public health follow-up and to support any necessary communications. Depending on the circumstances, OPH may contact affected individuals directly or provide communication materials for distribution by the school or school board.

Several students in a class have similar symptoms. Should we be concerned?

Respiratory and enteric illnesses commonly circulate in schools, particularly during the fall and winter months. It is not unusual for multiple students in a class or school to experience similar symptoms at the same time.

Schools should consider increasing their infection prevention practices and consult the IPAC control measures for schools when managing communicable diseases.

If schools have concerns about increased illness activity, unusual patterns of illness, severe illness, or suspected food-borne illness, they should contact OPH’s Infection Prevention and Control team.

What should schools do if a student or staff member vomits at school?

The individual should be separated from others, if appropriate, and arrangements should be made for them to return home as soon as possible.

Schools should have established procedures for responding to spills of blood and other body fluids. Any affected areas should be cleaned and disinfected promptly according to school procedures and in alignment with recommended infection prevention and control practices.

For additional guidance, refer to Public Health Ontario’s Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd edition – Appendix 23: Sample Procedure for Cleaning a Biological Spill.

Staff should encourage proper hand hygiene and monitor for additional illness among students or staff.

Individuals who are experiencing vomiting or diarrhea should stay home. For many gastrointestinal illnesses, a general recommendation is to remain home until at least 48 hours after the last episode of vomiting or diarrhea and symptoms are improving.

However, exclusion requirements may differ for some confirmed communicable diseases. Schools should consult the Guidelines for Schools and Child Care Centres on Infectious Diseases and Other Childhood Health Issues and seek Ottawa Public Health guidance when appropriate.

Do schools need to report increased absenteeism to Ottawa Public Health?

No. Beginning with the 2026-2027 school year, schools are no longer required to report increases in absenteeism to Ottawa Public Health (OPH).

Schools may still contact OPH’s Infection Prevention and Control (IPAC) team if they are concerned about unusual illness activity and/or severity of illness or require public health support.

What should schools do if they are unsure whether a disease is reportable?

As a first step, schools should consult the Guidelines for Schools and Child Care Centres on Infectious Diseases and Other Childhood Health Issues.

The guidelines identify diseases that require notification to Ottawa Public Health (OPH) and those that can be managed by the school and family without public health involvement. Schools can contact OPH if clarification is needed.

Some students are at higher risk of severe illness. Should schools take additional precautions?

Some students and staff may be at increased risk due to medical conditions, pregnancy, or weakened immune systems.

Schools should continue to encourage routine illness prevention practices such as staying home when sick, hand hygiene, respiratory etiquette, and keeping immunizations up to date. Individuals with specific health concerns should consult their health care provider regarding additional precautions.