Illnesses and Outbreaks

• Diarrhea
• Vomiting
• Nausea
• Abdominal pain
• Fever or chills
• Rash
• Runny nose or nasal congestion
• Cough or difficulty in breathing
• Sore throat
• Headache (unusual or long lasting)
• Unusual behaviour
• Extreme Fatigue
• Muscle aches or joint pain
• Decreased or loss of taste or smell
• Decreased or no appetite in young children
• Pink eye

If an operator has knowledge of, or suspects that a child in their child care centre has a reportable disease listed on the Diseases of Public Health Significance list, the CDC program must be informed in accordance with the Health Protection and Promotion Act (R.S.O. 1990, c.H.7; part IV).

See our Infectious Diseases webpage for disease/illness specific information including exclusion guidelines.

An outbreak should be suspected when a greater number of children become ill with similar symptoms in a given period of time.

When a suspected outbreak is identified at your child care centre, notify the Communicable Disease Control (CDC) Program immediately at 705-474-1400 or toll free at 1-800-563-2808, ext. 5229 or by email at cdc@healthunit.ca. A CDC staff member will assist you in deciding if an outbreak exists and will recommend outbreak control measures to help bring the outbreak under control.

What questions should we expect to be asked?

• When did the children become ill?
• What symptoms are the ill children experiencing?
• When did the ill children last attend the centre?
• Are there any staff members with similar illness?
• What is the total population of children and staff and how are they distributed in the centre?
• Have there been any special events at the childcare centre or field trips?
• Have the children had any contact with animals?

What will happen next?

Recommendations will be provided by the CDC program to help limit the spread of the illness. An outbreak may be declared.

Gastroenteritis is an illness that affects the stomach and bowels. It can be caused by germs from unsafe food or water. It can also be spread by touching infected animals, surfaces, or people.

Symptoms of gastroenteritis include vomiting and/or diarrhea. It is also known as the "stomach flu". Gastroenteritis can be caused by several different viruses, including rotaviruses and noroviruses, bacteria, or parasites.

All enteric (gastroenteritis) outbreaks in child care centres are reportable to the CDC program (HPPA, R.S.O.1990, c.H.7) regardless of whether they are caused by:

• A reportable agent
• A non-reportable agent
•  An unknown cause

The CDC program can be reached at 705-474-1400 or toll free at 1-800-563-2808, ext. 5229.

Outbreak and case definition

An enteric outbreak exists when there are two or more cases meeting the case definition with a common epidemiological link (i.e., toddler room, same caregiver) with an initial onset within a 48-hour period. To be considered a case, at least one of the following must be met:

• Two or more unexplained episodes of diarrhea (i.e., loose/watery bowel movements) within a 24-hour period.

OR

• Two or more unexplained episodes of vomiting within a 24-hour period.

OR

• One or more episodes of diarrhea and one or more episodes of vomiting within a 24-hour period, not explained by another cause.

Symptoms of respiratory illness may include fever, headache, cough, sore throat, runny nose, sore muscles, or tiredness. Children can have as many as 8 to 10 colds per year. Illness is typically mild and often caused by a virus.

Since children are exposed to many viral illnesses circulating in the community and within families, increased respiratory illness at a childcare centre does not necessarily result in an outbreak being declared. However, infection prevention and control (IPAC) measures should be put in place to limit the spread of illness at the centre.

Please call the CDC program if there are a large number of children and/or staff affected with respiratory symptoms, they are experiencing severe illness (i.e., hospitalizations), or unusual symptoms. Some diseases (i.e., measles) should be treated like an outbreak even if there is only one case. Please call the CDC program to report any cases of a disease of public health significance.

Chickenpox illness must be reported by a child care centre. Use the online Chickenpox reporting form to report new cases of chickenpox (varicella).

See our Infectious Diseases webpage for disease/illness specific information including exclusion guidelines.

See our list of Diseases of Public Health Significance (DOPHS) as well as our DOPHS reporting form.

Respiratory outbreak related forms:

• Childcare Centre Respiratory Outbreak Line Listing
• Childcare Centre Increased Respiratory Illness - Outbreak Control Measures

Enteric outbreak related forms:

• Childcare Centre Enteric Outbreak Line Listing
• Childcare Centre Enteric Outbreak Control Measures

See our Hand Hygiene Resource Manual for Child Care Centres.

This document supports child care professionals, children, and their families to learn about the importance of proper hand washing. This resource provides lesson plans, activities, and materials for educators to use to teach children about germs, how they are spread, and how to prevent the spread of germs through proper hand washing.

See our Hand hygiene page for additional information.