Waterborne Outbreak Investigation

Policy

Category: Control of Infectious Diseases
Subject: Waterborne Outbreak Investigation
Division: Health Protection
Policy Number: CA.82.01.107
Effective Date: February 26, 2016

POLICY STATEMENT

It is the policy of Wellington-Dufferin-Guelph Public Health (WDGPH) to respond immediately to the notification of a suspected waterborne outbreak of a reportable disease.

SCOPE

This policy applies to all Control of Infectious Diseases (CID) team members – Public Health Inspectors (PHIs), Public Health Nurses (PHNs), Program Manager, and Supervisor – who may be required to respond to a notification implicating a suspected waterborne outbreak.

DEFINITIONS

Waterborne Outbreak – When two or more persons experience the same illness (organism) after ingesting the same water from the same source and epidemiological evidence implicates the water as the source of the illness

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Procedure:  CA.82.02.107 Waterborne Outbreak Investigation
CA.50.01/02.101 Documentation Practices
CA.83.01/02.105 Small Drinking Water Systems Response to Adverse
CA.83.01/02.107 Municipal Systems Bacteriologically Unsafe, Regulated 170/03
CID Excelicare Desktop Reference
Infectious Diseases Protocol (disease specific, as current)
Procedures to Investigate Waterborne Illness, 2nd edition (IAMFES)

CONTACT FOR INQUIRIES

Manager, Control of Infectious Diseases

APPROVED BY

Director, Health Protection 


Procedure

Category: Control of Infectious Diseases
Subject: Waterborne Outbreak Investigation
Division: Health Protection
Procedure Number: CA.82.02.107
Effective Date: February 26, 2016

PROCEDURE

  1. Upon notification of a suspected waterborne outbreak with a confirmed organism, the Control of Infectious Diseases (CID) team member will begin an outbreak investigation file in Excelicare using the established naming convention. The information will be analyzed and a decision will be made by the Manager to declare an outbreak.
  2. The CID team member will notify the CID Manager and Director, Health Protection, who in turn will notify the Medical Officer of Health (MOH) and all HPD Managers of the situation. The CID Manager will alert the CID team and Communication Manager. The MOH will designate the media spokesperson for the outbreak.
  3. If a Boil Water Advisory is needed, refer to CA.83.01.105 Small Drinking Water Systems Response to Adverse and CA.83.01.107 Municipal Systems Bacteriologically Unsafe Regulated Systems 170/03 for instructions, and consult with the Water Safety Manager.
  4. The CID team member will refer to the Procedures to Investigate Waterborne Illness – 2nd Edition (IAMFES) book, located in each office, to investigate the outbreak and implement control measures.
  5. If the causative agent is identified as cryptosporidium/giardia, the CID team member will refer to the Infectious Diseases Protocol (as current) for cryptosporidiosis and/or giardiasis to guide outbreak management.
  6. The CID Manager will notify PHO and MOHLTC partners and prepare a posting for PH Alert. The HPD Managers and Communications Manager will work together to prepare outbreak communications.
  7. The assigned CID team member will notify the Public Health Lab using the Outbreak Information Sheet and will arrange for delivery of samples to the lab. http://www.health.gov.on.ca/english/providers/pub/labs/specimen.html
  8. The outbreak may be declared by the MOH. It may be declared over when no new cases develop after a period of time equivalent to one incubation period plus one infectious period for the causative organism or a set time period.

RESPONSIBILITIES

Management will:

  • Consult with the MOH and Director, Health Protection;
  • Direct outbreak investigation;
  • ​Liaise with Health Protection management pertaining to water sampling and results;
  • Advise team and Manager, Communications; and
  • Prepare any advisory/media needed with assistance from Communications.

Staff will:

  • Assist with delivery, pick up, and submission of stool kits to the Public Health Lab;
  • Assist with interviews of suspect, probable, and confirmed cases;
  • Assist with public inquiries related to illness or perceived illness due to the suspected outbreak;
  • Man hotlines (as needed);
  • Assist with development of educational materials pertaining to any illness associated with the suspect    outbreak;
  • Assist with cataloguing and interpretation of stool sample results; and
  • Assist all institutions affected by the outbreak with their management of cases and infection control practices.

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Policy CA.82.01.107 Waterborne Outbreak Investigation
CA.50.01/02.101 Documentation Practices
CA.83.01/02.105 Small Drinking Water Systems Response to Adverse
CA.83.01/02.107 Municipal Systems Bacteriologically Unsafe, Regulated 170/03
CID Excelicare Desktop Reference
Infectious Diseases Protocol (disease specific, as current)
Procedures to Investigate Waterborne Illness, 2nd edition (IAMFES)

CONTACT FOR INQUIRIES

Manager, Control of Infectious Diseases

APPROVED BY

Director, Health Protection