Outbreak Management

The primary goal of outbreak management is to identify the cause of outbreaks within the institution and to implement infection control measures to reduce the risk of transmission. It's mandatory for institutional facilities to report outbreaks to the Health Unit.


What Is an Outbreak

An outbreak is an increase from the usual number of cases of disease or infection.

In the case of a respiratory outbreak, the outbreak should be suspected and reported when there are two cases of acute respiratory illness within 48 hours.

An enteric outbreak should be suspected and reported when there are two cases of gastrointestinal illness within 48 hours.


How to Report an Outbreak

Outbreaks should be reported as soon as they're suspected or identified.

They can be reported to the Health Unit by calling 613-933-1375 or 1 800 267-7120.

Completed daily line listings are to be sent to your Health Unit contact.


Staff Exclusions During an Influenza Outbreak

An outbreak is defined as the occurrence of 2 cases within 48 hours.

  1. If facility is experiencing a confirmed influenza outbreak:
    1. Employees who were immunized against influenza at least 2 weeks prior to the outbreak may continue to work at your facility, as they are protected.
    2. Non-immunized employees may either:
      • Be immunized immediately and start a course of an appropriate antiviral for the duration of the outbreak (until 8 days after the onset of symptoms in the last case), or 14 days after being immunized, whichever period is shorter;
        OR
      • Start a course of an appropriate antiviral agent to be taken for the duration of the outbreak and agree to report any influenza symptom immediately;
        OR
      • Be excluded from the facility for the duration of the outbreak.
  2. If another facility is experiencing a confirmed influenza outbreak and your employee works in that outbreak facility:
    1. Employees who were immunized against influenza at least 2 weeks prior to the outbreak may continue to work at your facility and at any other facility, provided the individual changes their uniform between facilities.
    2. Non-immunized employees may:
      • Be immunized immediately and start a course of an appropriate antiviral for the duration of the outbreak (until 8 days after the onset of symptoms in the last resident case), or 14 days after being immunized, whichever period is shorter;
        OR
      • Start a course of an appropriate antiviral agent to be taken for the duration of the outbreak and agree to report any influenza symptom immediately;
        OR
      • Be excluded from working in the outbreak facility for the duration of the outbreak. Non-immunized staff not receiving prophylactic therapy must wait one incubation period (3 days) from the last day they worked at the outbreak facility before working in non-outbreak facility. This is to ensure they are not incubating influenza.
  3. Employees, who have been diagnosed by a physician to have influenza, may return to work 5 days after the clinical onset, or until symptoms have resolved whichever is shortest.
  4. When an influenza outbreak is confirmed in your facility, the Health Unit employee assigned to the outbreak will require a list of all employees, contract staff, students doing placement work, volunteers and health professionals who have not been immunized against influenza at least 2 weeks previously and are not taking an appropriate antiviral agent. All such persons must be excluded from working in your facility immediately and until 8 days after onset of the last case of influenza in the outbreak or until the workers are considered protected (14 days after immunization or after start of an appropriate antiviral agent).
    Note: Additional control measures may be recommended depending on etiology of outbreak. It is imperative that specimens be obtained to facilitate identification of causative agent.
  5. In the event that someone continues to work when they should not, please notify the Health Unit immediately.

Resources


Links


Eastern Ontatio Health Unit / Bureau de santé de l'Ontario