Public Health works with long-term care, retirement homes and acute care settings in managing respiratory and enteric outbreaks, and provides guidance on infection control measures. Public Health also works with higher risk congregate settings in managing COVID-19 outbreaks but will also provide guidance and support on infection control measures for increased illness in these facilities. If there is a suspect or confirmed outbreak at a facility, call Public Health at 1-800-265-7293 ext. 4752 (during business hours) or 1-877-884-8653 (after hours, weekends, and holidays). To view a list of facilities in outbreak, refer to Public Health’s outbreak bulletin.

Gastroenteritis Outbreak definition

(MOHLTC, Recommendations for the Control of Gastroenteritis Outbreaks in Long-Term Care Homes, March 2018)

  • Suspect: Two suspected cases of infectious gastroenteritis in a specific area, such as a home, unit, or floor within 48 hours
  • Confirmed: Three or more cases of infectious gastroenteritis in a specific area within a four -day period, OR three or more units/floors having a case of infectious gastroenteritis within 48 hours. Note: This definition may be modified as the investigation proceeds.

Respiratory Outbreak definition

(MOHLTC, Control of Respiratory Infection Outbreaks in Long-Term Care Homes, November 2018) and  COVID-19 Guidance for Public Health Units: Long-term Care Homes, Retirement Homes and Other Congregate Living Settings, June 2023)

  • Suspect Respiratory Outbreak: Two cases of acute respiratory infection (ARI) within 48 hours in a geographic area (e.g., unit, floor) OR more than one unit having a case of ARI within 48 hours
  • Suspect Influenza Outbreak: One laboratory-confirmed case of influenza OR two cases of ARI occurring within 48 hours in a geographic area (e.g., unit, floor) OR more than one unit having a case of ARI within 48 hours
  • Suspect COVID-19 Outbreak: One positive PCR OR rapid molecular test OR rapid antigen test in a resident who has reasonably acquired their infection from that setting.
  • Confirmed Respiratory Outbreak: Two cases of ARI within 48 hours, at least one of which must be laboratory-confirmed OR three cases of ARI (laboratory confirmation not necessary) occurring within 48 hours in a geographic area (e.g., unit, floor) OR more than two units having a case of ARI within 48 hours
  • Confirmed COVID-19 Outbreak: Two or more residents with a common epidemiological link (e.g., within a specified area/unit/floor/ward), each with positive results from a polymerase chain reaction (PCR) test OR rapid molecular test OR rapid antigen test within a seven-day period where both cases could have reasonably acquired their infection in the setting.

To report a suspect or confirmed outbreak, call Public Health

  • During business hours: 1-800-265-7293 ext. 4752 
  • After hours, weekends, and holidays:1-877-884-8653

When reporting an outbreak, the following information needs to be provided to Public Health:

  • Number of ill residents and/or staff
  • Symptoms
  • Date of symptom onset
  • Affected unit, floor or wing
  • Hospitalizations/deaths

Once a suspect or confirmed outbreak is declared, homes will receive a suspect or confirmed outbreak email with an attached electronic line listing and outbreak number. The line listing will be encrypted with a password which will be provided in a second email. Homes will be directed to complete the line listing and email it daily to Public Health’s congregate setting’s email: congregatesettingsteam@wdgpublichealth.ca Public Health will monitor the outbreak, and provide direction on the following:

  • Specimen collection 
  • Antiviral protocol for residents and unimmunized staff (influenza outbreaks only)
  • Infection prevention and control measures:
    • Isolation of ill residents
    • Cohorting of staff and residents
    • Hand hygiene and personal protective equipment (PPE)
    • Increased environmental cleaning
    • Admissions, transfers, and appointments
    • Visitors
    • IPAC auditing
    • Communication of outbreak status and control measures
    • Outbreak meetings

When there is a confirmed outbreak at a home, a bulletin is distributed to long-term care and retirement homes, hospitals and community partners, which contains the following information:

  • Outbreak number
  • Name and address of home
  • Type of outbreak (enteric or respiratory)
  • Date outbreak was declared and date declared over
  • If laboratory testing identifies a specific illness, the illness will be identified

Public Health has many resources that homes may request to help them manage their outbreaks. Some of the resources include:

  • Outbreak notification signs
  • Handwashing signs
  • Additional precautions signs
  • Specimen collection instructions (for both enteric and respiratory specimens)
  • Sample test requisitions
  • PPE donning and doffing resources
  • Point of Care Risk Assessment (PCRA) resources