Enteric Outbreak Guidelines

Steps to take when you have a known or suspected outbreak:

1. Staff of camp will notify the health unit of a known or suspected outbreak.  It is the responsibility of the recreational camp, in consultation with SMDHU to decide if an outbreak is to be declared.  If an outbreak is declared, the SMDHU will generate an outbreak number.
2. Create a case definition (i.e. 2x vomiting with/or without diarrhea within 24 hours or bloody diarrhea with cramps and fever).
3. Start a separate line list for both staff and campers from the information on the line list instructional sheets.  See: “Filling out an Enteric Outbreak line lists for camper and for staff”
4. Review and implement outbreak management checklist. This document will guide you along as to what general infection control measures should be followed. See “Enteric Outbreak Management Checklist”
5. The recreational camp will fax the line list (both camper and staff) and signed outbreak management checklist to the SMDHU.

1. Collect stool samples from campers/staff with the most recent onset of enteric symptoms. Ensure that each specimen is appropriately labelled, and has a multiple specimen collection form included. All specimens need to be bagged in a brown paper bag prior to courier pick up.  See  “Stool Collection Technique” and “Labelling an Enteric Outbreak Kit”.
2. Once specimens are collected and bagged, contact your SMDHU investigator to arrange pick up and delivery to Orillia Public Health Lab. Your SMDHU investigator will contact you if a rapid test result is positive. Note: The only rapid test available for enteric diseases is for Rotavirus.
3. Continue to fax the updated line list to the SMDHU investigator in Barrie: (705) 733-7738, or in Gravenhurst: (705) 684-9959.

Note: Do not create a new line list each day. Once a person is no longer ill, do not remove their name from the line list or delete symptoms. It is only necessary to indicate their resolution date in the column on the line list.

1. Continue to monitor campers and staff and add the appropriate information to the line list for the duration of the outbreak.
2. Once the outbreak is declared over, complete summary reports with your SMDHU investigator.

Reference:

Ministry of Health and Long-Term Care/Mandatory Programs and Services/Public Health Branch. A guide to the control of enteric disease outbreaks in health care facilities. Ontario Ministry of Health; 1993.