Outbreaks

Public Health works with long-term care and retirement homes in managing their outbreaks, and provides guidance on infection control measures. If there is a suspect or confirmed outbreak at a home, call Public Health at 1-800-265-7293 ext. 4752 (during business hours) or 1-877-884-8653 (after hours, weekends, and holidays).

Gastroenteritis Outbreak definition

(MOHLTC Public Health Division, Control of Gastroenteritis Outbreaks in Long-Term Care Homes, October 2013)

  • Suspect: 2 suspected cases of infectious gastroenteritis in a specific area, such as a home, unit, or floor within 48 hours
  • Confirmed: 3 or more cases of infectious gastroenteritis in a specific area within a four -day period, or three or more units/floors having a case of infectious gastroenteritis within 48 hours. Note: This definition may be modified as the investigation proceeds.

Respiratory Outbreak definition

(MOHLTC, A Guide to the Control of Respiratory Infection in Long-Term Care Homes, November 2016)

  • Suspect Respiratory Outbreak: Two cases of acute respiratory infection (ARI) within 48 hours in a geographic area (e.g., unit, floor) OR more than one unit having a case of ARI within 48 hours
  • Suspect Influenza Outbreak: One laboratory-confirmed case of influenza OR two cases of ARI occurring within 48 hours in a geographic area (e.g., unit, floor) OR more than one unit having a case of ARI within 48 hours
  • Confirmed Respiratory Outbreak: Two cases of ARI within 48 hours, at least one of which must be laboratory-confirmed OR three cases of ARI (laboratory confirmation not necessary) occurring within 48 hours in a geographic area (e.g., unit, floor) OR more than two units having a case of ARI within 48 hours

To report a suspect or confirmed outbreak, call Public Health

  • During business hours: 1-800-265-7293 ext. 4752 
  • After hours, weekends, and holidays:1-877-884-8653

When reporting an outbreak, the following information needs to be provided to Public Health:

  • Number of ill residents and/or staff
  • Symptoms
  • Date of symptom onset
  • Affected unit, floor, wing
  • Hospitalizations/deaths

Once a suspect or confirmed outbreak is declared, homes will be directed to complete a daily line listing (specific to either respiratory or enteric) and line list summary fax cover sheet and fax it daily to Public Health at 1-855-934-5463. Public Health will monitor the outbreak, and provide direction on the following:

  • Specimen collection (Public Health will pick up specimens and arrange transfer to the Public Health Laboratory)
  • Antiviral protocol for residents and unimmunized staff (influenza outbreaks only)
  • Infection prevention and control measures:
    • Isolation of ill residents, cohorting of staff
    • Hand hygiene and personal protective equipment (PPE)
    • Increased environmental cleaning
    • Admissions, transfers, and appointments
    • Visitors
    • Communication of outbreak status and control measures

When there is a confirmed outbreak at a home, a bulletin is distributed to long-term care and retirement homes, hospitals and community partners, which contains the following information:

  • Outbreak number
  • Name and address of home
  • Type of outbreak (enteric or respiratory)
  • Date outbreak was declared and date declared over
  • If laboratory testing identifies a specific illness, the illness will be identified

Public Health has many resources that homes may request to help them manage their outbreaks. Some of the resources include:

  • Outbreak notification signs
  • Handwashing signs
  • Contact precautions signs
  • Specimen collection instructions (for both enteric and respiratory specimens)