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). To view a list of facilities in outbreak, refer to Public Health’s outbreak bulletin.

Gastroenteritis Outbreak definition

(MOHLTC, Recommendations for the Control of Gastroenteritis Outbreaks in Long-Term Care Homes, March 2018)

  • 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, Recommendations for the Control of Respiratory Infection in Long-Term Care Homes, March 2018)

  • 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 and fax it daily to Public Health’s confidential fax line at 1-855-934-5463. A blank respiratory or enteric line listing and line list summary fax cover sheet can be requested when the outbreak is reported. 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)