Outbreak 

 Outbreak of Gastrointestinal Illness (TPH): An outbreak of enteric illness is defined as two or more
cases of illness with symptoms of gastroenteritis that are linked by time, exposure, and a common geographic
location or setting, such as a daycare center or school. An outbreak could also be defined as two or more cases with
similar symptoms occurring in the same classroom within a 48-hour time frame (City of Toronto, 2019). During a
suspected outbreak it is very important that staff respond quickly as control measures can be put into place to stop
the illness from spreading to other people.

Staff role during an outbreak


🔵Send the ill child or children home with their parents/guardian and send home any ill staff members.
🔵 Notify parents or emergency contacts as soon as possible.
🔵Create an illness line list including children and staff names, symptoms, date and time of onset, room number and
any other information required by Public Health.
🔵Increase hand hygiene, cleaning, and disinfection.
🔵Suspend water play and sensory activities as required by TPH or as part of the outbreak controls.
🔵Protect confidentiality when communicating with families.

Toronto Public Health role

Receive outbreak reports through the Communicable Disease Notification/Surveillance Unit.
🟠Review the information the center provided regarding the first case of illness, the most recent case of illness, the
number of ill children and staff, the rooms where the illness occurred and the symptoms of the illness.
🟠Assign an outbreak number for reporting purposes during an outbreak.
🟠Provide investigation support, control measures and guidance on specimens, communication and bringing an
outbreak under control.

Outbreak response timeline

First signs of illness: Children who are ill are given a health check by child care staff and go home with their parents.
Children who are ill are recorded by child care staff and their symptoms are written down.
Outbreak investigation and control measures: Put into place control measures as required, particularly if two or more
linked cases have occurred. A line list needs to be started for investigation and for TPH, cleaning needs to be
increased, and sensory play and water play should be suspended.
After an outbreak is declared: Continue to update the line list of illness cases and ensure all children and staff meet
the centre’s criteria for re-entry and TPH’s exclusion criteria. Follow all direction from TPH until the outbreak is over.
After no new cases: Confirm with TPH that the outbreak is over and follow their guidelines for final cleaning and
documentation. Return to regular center routines.
When calling Public Health in the event of an outbreak in your child care center, the following information will be
required: the date and time of the first case of illness in your center; the most recent case of illness in your center; the
total number of children and staff ill in your center; the rooms involved in the outbreak in your center; and the
symptoms of the illness (City of Toronto, 2025).