Outbreaks in Long-Term Care Homes and Retirement Homes
Early recognition of outbreaks, rapid initiation of control measures and effective communication are critical for minimizing the extent of outbreaks in Long-Term Care Homes (LTCHs) and Retirement Homes (RHs).
What is an outbreak?
An outbreak is generally an increase in the number of infections above the number normally expected in a particular health care setting over a defined period of time.
The Ontario Ministry of Health and Long-Term Care has specific outbreak definitions:
- Confirmed Outbreak: 3 or more cases within a 48 hrs in a specific area OR more than 2 units having a case within 48 hours OR 2 cases with one being lab confirmed
- Suspect Outbreak: 2 cases within 48 hours in a specific area OR more than one unit having a case within 48 hours
- Confirmed Outbreak: 3 or more cases within a 4 day period in a specific area OR 3 or more units or floors having a case within 48 hours
- Suspect Outbreak: 2 cases in a specific area within 48 hours
What are outbreak case definitions?
- A resident or staff with 2 or more new respiratory symptoms such as fever, cough, runny nose, nasal congestion, sore throat/hoarseness. The respiratory case definitions should be developed for each outbreak as symptoms will vary based on the pathogen involved.
- A resident or staff with 2 or more episodes of vomiting and/or diarrhea or a combination of vomiting and diarrhea within 24 hours or lab confirmation of a pathogen with one symptom.
Every LTCH should:
- Evaluate and update their outbreak policies and procedures annual in accordance with evidence-based practices or prevailing practices.
- Ensure staff are educated about outbreak management and control.
- Refer to ESTPH’s Pre-Season Influenza Season Planning and Prevention Checklist
Notify the Health Unit
If you suspect your facility is in outbreak, contact the Health Unit to discuss outbreak management and control.
- Call 519-631-9900 ext. 1232 (Mon-Fri 8:30 am – 4:30 pm) to speak with a member of the Communicable Disease Team.
- Call 519-631-9900 and press 0 if calling after hours, on the weekend or a holiday.
Implement Outbreak Control Measures
- Respiratory Outbreak Control Measures Checklist
- Enteric Outbreak Control Measures Checklist
- Resident Transfers During Outbreaks
Monitor and Track Cases Using Line Listing Forms
- Respiratory Outbreak Line List for Residents
- Respiratory Outbreak Line List for Staff
- Enteric Outbreak Line List for Residents
- Enteric Outbreak Line List for Staff