Germ Illustration

Managing Outbreaks of Respiratory Illness in Child Care Centres

Respiratory illnesses are emerging infectious diseases and are caused by a number of bacteria and viruses. Child care centres are at an elevated risk for spread of respiratory illnesses due to the large amount of children sharing rooms, toys, activities, eating spaces and bathrooms.

How to Identify A Respiratory Outbreak in Your Child Care Centre

Generally an outbreak is defined as a cluster of respiratory illness in groups with related symptoms.

Signs and symptoms must include at least two of the following:

  • fever
  • cough
  • runny nose or sneezing
  • sore throat or hoarseness or difficulty swallowing
  • tiredness
  • muscle aches
  • loss of appetite
  • headache
  • chills
  • irritability

Steps to Managing an Outbreak

  1. Isolate ill children with two or more of the above symptoms and arrange for prompt pick-up.
  2. Information on respiratory illnesses should be provided to families of affected children with encouragement to seek medical treatment.
  3. Notify the health unit.

Establish Control Measures

  • Consult with the Huron County Health Unit’s Infectious Diseases team to determine the exclusion time for ill children and staff from child care centres.
  • There should be no new registrations or “short-term” care during the outbreak period.
  • Notices should be posted indicating to visitors, delivery services, families etc. that the centre is experiencing an increase in illness.

Outbreak Control Measures

  1. Communicate with Parents
  • It is essential that parents are kept informed of the status of the illness in the centre. It is also important they understand the policy surrounding exclusion and understand why ill children are not to be present in the child care centre.
  1. Reduce Interactions
  • Do not accept new children in your child care centre.
  • Exclude ill children and staff from child care until symptoms have stopped. This recommendation may change during an outbreak on direction from the Medical Officer of Health.
  • Suspend interactions between groups that have experienced illness and groups that have not experienced illness. Staff should be dedicated to assigned rooms and not move between rooms. Breaks should be covered off by a supervisor if possible. Staff responsible for diapering should not be preparing or handling food.
  • Assess the risk of social outings, including field trips, to determine if there is a need to cancel outings for the duration of the outbreak period.
  • Stop sensory play activities such as water tables, sand tables etc.
  1. Increase Cleaning
  • Ensure surfaces contaminated by feces or vomit are immediately cleaned and disinfected using a high level disinfectant. Gloves, mask and water resistant gown will reduce the risk of infection to the staff cleaning and disinfecting.
  • Increase cleaning and disinfection of common touch surfaces such as door handles, handrails, sink/toilet handles etc.
  • Clean and disinfect toys in outbreak affected areas at least on a daily basis and more frequently than the routine cleaning schedule. All plush toys, if not dedicated per child, should be removed during the duration of the outbreak. Toys handled by a child who has become ill while in care should be immediately removed from circulation until they have been washed and disinfected. “Mouthed” toys should always be dedicated per child and continue to be one-time use items, being cleaned and disinfected after each use.
  • Contaminated clothing should be put into a plastic bag and sent home with parents for hot water washing. Play clothing/costumes, re-usable mop heads, and all linens including cot liners should be washed on a hot cycle (>71°C for 25 minutes) with a detergent and hot air dried.
  • Soft furnishings or carpets should be thoroughly cleaned with detergent and hot water.
  • Hard surfaces (including common high touch surfaces and toys) should be thoroughly cleaned with detergent, hot water and a single use cloth then wiped down or immersed with a high level disinfectant and allowed to air dry. It is critical to ensure the appropriate contact time is used for the disinfectant.
  1. Hand Washing
  • Review hand hygiene with staff. Increased hand washing is strongly recommended during an outbreak for children and staff. Operators must ensure there is access to warm running water, single use soap and paper towels in dispensers. Do not share towels.
  • Wash children’s hands upon arrival at child care centre, in addition to usual hand washing practices.
  • Alcohol-based hand rubs (ABHRs), may be used when hands are not visibly soiled. ABHRs should have at minimum 60% alcohol concentration, kept out of reach of children and only used with children under direct supervision.

Complete documentation (General Line Listing Form (PDF)) on a daily basis and fax to the Huron Perth Public Health. The confidential fax number is 1.844.935.1327.

Declaring a Respiratory Outbreak Over

A respiratory outbreak in a child care centre is declared over in consultation with the Huron Perth Public Health.

Generally outbreak is declared over five days after the last episode of illness at the centre. This may change depending on the agent causing the outbreak and upon consultation with the Medical Officer of Health.

Last modified: February 19, 2020