Outbreak Management

What is an Outbreak?

An outbreak is generally a sudden increase in the number of cases of an infection which exceeds what would normally be expected for that setting.

If you suspect an outbreak, break the chain of transmission, and implement outbreak controls.

The Ontario Ministry of Health and Long-Term Care have set case definition criteria for outbreaks:

COVID-19 Other Acute Respiratory Infections
Influenza Enteric

Provincial Guidelines

Our role is to provide effective support and assistance in the identification, prevention, and management of outbreaks as mandated by the Ministry of Health and Long-Term Care.

It is the responsibility of the facility to manage the outbreak as mandated by the Ministry of Health and Long-Term Care in cooperation with the WECHU. Every facility should create an Outbreak Management Team (OMT) to collaborate with the WECHU.

The OMT works in collaboration with external and internal partners to investigate, manage, and control a suspect or confirmed outbreak. To provide a comprehensive approach to outbreak management, each facility should strive to have a representative from all departments in addition to the IPAC Lead as a member of the OMT.

The OMT is encouraged to meet daily during an outbreak to ensure the following:

  1. Line listings are accurate and updated daily.
  2. Cases added to the line list(s) meet outbreak definition.
  3. Surveillance is being conducted.
  4. Outbreak control measures are being implemented and maintained.
  5. Provide adequate coverage for staff absences (i.e., designate an alternate person who is knowledgeable of the outbreak process to fax inline listings).
  6. Communicate effectively with staff, residents, families, and volunteers.

Prompt reporting of an outbreak results in a rapid response in the initiation of infection prevention and control (IPAC) measures. This can help to decrease the length and severity of the outbreak.

Healthcare facilities and institutions are legally required to report outbreaks. If you suspect an outbreak, fax a completed initial Comprehensive Line List to WECHU at 519-977-5097.

Contact the Infectious Disease Prevention (IDP) Hotline to discuss outbreak management and control measures with a member of the IPAC Hub Team.

Regular Business Hours

Monday to Friday 8:30am to 4:30pm

 After hours, weekends and holidays
519-258-2146 ext. 1420 519-973-4510

Track and monitor client and staff cases on line listing forms. Fax the Comprehensive Line Listbefore 10:00 AM daily; including on holidays and weekends to 519-977-5097.

ONLY add clients and staff to line listing that meet the WECHU-provided case definition.

Fax in a “No New Cases” line listing if all clients and/or staff are removed, or no symptomatic clients and/or staff are identified during the outbreak.

Notify the WECHU of all line listed clients and staff who are hospitalized.

Notify the WECHU of all line listed client or staff deaths.

Notify the WECHU of all line listed clients and staff with chest x-ray confirmed cases of pneumonia.

Outbreak Control Measures

Each facility should evaluate and update their outbreak policies and procedures regularly in accordance with evidence-based practices and ensure staff, volunteers, and students are educated on outbreak management and control.

Lab Testing Guidelines

The Outbreak Number (2268 - YYYY - _______) provided by the WECHU for suspect and confirmed outbreaks is required on all lab requisitions and WECHU Forms.

Complete all lab requisitions in its entirety with your facility address. Two matching patient identifiers are required on both the sample and Lab Requisitions.

You can order specimen containers and supplies through the Public Health Ontario website.

You can order specimen containers and supplies through the Public Health Ontario website.

RESCINDING AN OUTBREAK

Rescinding COVID-19 Outbreak:

The outbreak may be declared over and rescinded after 8 days from the last potential exposure to a resident case in the facility.

Rescinding Respiratory Outbreak:

Varies depending on the causative agent.

  • Viral respiratory outbreaks may be declared over and rescinded after 8 days from onset of symptoms of the last resident/client case.
  • The 8-day rule is based on the period of communicability (5 days) plus the incubation period (3 days) for influenza.

Rescinding Enteric Outbreak:

The outbreak is rescinded on a case-by-case basis and can vary depending on the organism.

  • 5 days from last symptom onset,

OR

  • Cases are 48 hours symptom free.

The WECHU will notify the facility when outbreak meets conditions for the outbreak to be declared over.

A formal Rescind Notification Advisory will be forwarded to your facility.

Fax in the Final Respiratory Outbreak Report for all respiratory outbreaks.

  • Final Respiratory Outbreak Report (insert link for pdf form)

Additional Resources:

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