Quick Reference for Detecting Outbreaks
Suspect an outbreak when:
| Respiratory (including COVID-19) | Enteric |
| Two patient/resident cases* of acute respiratory infection (ARI) with symptom onset within 48 hours with an epidemiologic link (e.g. same unit/floor/service area) suggestive of transmission in the setting and testing is not available or all negative | There are more cases** than normal, based on surveillance data |
Outbreak confirmed when:
| Respiratory (including COVID-19) | Enteric |
|
Two or more patient/resident cases of test-confirmed ARI with symptom onset within 48 hours and an epidemiological link (e.g. same unit/floor/service area) suggestive of transmission within the setting. OR Three or more patient/resident cases of ARI with symptom onset within 48 hours and an epidemiological link suggestive of transmission within the setting AND testing is not available or all negative. |
There are two or more cases** with an epidemiological link (e.g., unit or floor within 48 hours). |
*Respiratory case: a resident/staff with two or more respiratory symptoms (e.g., runny nose, cough, fever, sore throat, etc.) that are new/worsening and cannot be explained by other causes (e.g., allergies).
**Enteric case: a resident/staff with two or more episodes of vomiting and/or diarrhea in a 24-hour period that cannot be explained by other causes (e.g., medication side effects, laxatives, diet or prior medical condition).
Note: See MOH's Infectious Disease Protocol, Appendix 1 for additional details. Outbreaks are declared in consultation with public health and the affected facility.
Next Steps:
1. DON'T WAIT, ISOLATE! Follow routine practices in addition to:
| Respiratory (including COVID-19) | Enteric |
| Contact/Droplet precautions (gowns, gloves, eye protection, and N95 or surgical mask). | Contact precautions (gown, gloves). Droplet precautions as needed (splashes). |
Continue precautions until...
| Respiratory | COVID-19 | Enteric |
| 5 days after the onset of symptoms or until symptoms resolve, whichever is shorter. | Clients/patients/residents who are positive for COVID-19 should self-isolate on Additional Precautions for at least 5 days from symptom onset.* | Until symptoms have resolved for at least 48 hours. |
*Additional criteria must be met to end isolation after at least 5 days. COVID-19 positive residents of LTCH/RH/CLS who are not able to independently/consistently wear a mask should remain on Additional Precautions for 10 days from symptom onset. See the Recommendations for Outbreak Prevention and Control in Institutions and Congregate Living Settings for additional information.
Note: Cases who are hospitalized for COVID-19 related illness can be removed from Droplet/Contact precautions in hospital based on consultation with an infectious diseases specialist and/or hospital infection prevention and control (IPAC). Individuals with severe illness may be infectious for longer durations (e.g., 10 days or more), and even longer (e.g., 20 days or more) for those requiring ICU level of care for COVID-19. (MOH, Oct 2024: Infectious Diseases Protocol, Appendix 1).
2. Start a line listing. Use a separate page for each affected unit and a separate page for staff.
3. Contact the Communicable Disease Control (CDC) program at the Health Unit.
- Business hours: contact the staff assigned to your facility or 705-474-1400 or toll free at 1-800-563-2808, ext. 5229.
- After hours: contact 705-474-1400 or toll free at 1-800-563-2808, then press "0" for the Answering Service.
When contacting the CDC program, be prepared to answer the following questions:
- The symptoms that residents/patients are experiencing.
- Date of onset of symptoms for each resident/patient.
- The number of residents and staff within the facility and on the unit where an outbreak is suspected.
Last updated: Nov 2025, by CDC