Reporting & Managing Increased Illness

Public Health helps child care centres manage instances of increased illness in their centres by providing best practice recommendations and resources on infection control measures to minimize the spread of gastrointestinal illness.

Reporting increased illness

When your child care centre has an increase in the number of children absent due to gastrointestinal illness, above what you would expect, start a line list and phone Public Health at 1-800-265-7293 ext. 4753.

Case definition for illness: 2 or more episodes of diarrhea/watery stool or vomiting within a 24-hour period OR 1 episode of diarrhea/watery stool and 1 episode of vomiting with a 24-hour period

Public Health will review your reported illnesses, and advise you on maintaining surveillance, exclusion of ill children, increased cleaning and disinfection, and communication with staff and parents. We will email resources to you to help you manage the increased illnesses at your child care centre to prevent further spread. 

The following documents will be provided:

  1. Gastroenteritis Illness Checklist for Child Care Centres - for a summary of all infection control measures that should be put in place immediately to control the spread of gastrointestinal illness.
  2. Enteric Illness Line Listing - use this document to keep track of all cases (children and staff) of gastrointestinal illness at the centre. This line listing is for your own internal use and does not need to submitted to WDGPH unless it is specifically requested.

  3. Increased Illness in Child Care Centres (Letter to Parents) - send this letter to parents, staff and volunteers to inform them of the increase in gastrointestinal illness at the centre.

Exclusion of ill children

Ill children that meet the case definition should be excluded from the child care centre until at least 48 hours symptom-free. 

Parents can have their ill child assessed by their family physician. The physician will determine whether a stool sample should be collected.


Keep staff and parents updated about the increased illness in the child care centre, either verbally, electronically, or by posting a notice.

Visitors such as parents, housekeeping staff or support workers (e.g., speech language pathologist) should be advised by the child care centre of the increased illness in the child care centre. Encourage visitors to visit only one room or child and to perform hand hygiene before entering and after leaving.

Hand hygiene and personal protective equipment (PPE)

During periods of increased illness, hand hygiene should be increased, especially after toileting or diapering, after playing outside, and before and after eating or drinking.

Staff cleaning up body fluids such as vomit and diarrhea should wear single use non-latex gloves and a mask. 

Cleaning and disinfection

Increase cleaning and disinfection in the centre using a product that is effective against norovirus (e.g., Virox 5, Percept, Accel TB, 1:10 bleach and water solution).

Routinely touched surfaces, washrooms, common areas and toys must be cleaned and disinfected at least once a day while there is an increase in illness in the centre.

Any toys that cannot be cleaned and disinfected (e.g., cardboard, unsealed wood or wicker) should be removed from the classroom during the period of increased illness and for at least 2 weeks after.

Water table and sensory use should be discontinued until illness levels decrease to normal levels.