What are viral gastroenteritis outbreaks?

A gastroenteritis outbreak occurs when two or more people have sudden onset of vomiting or diarrhoea at the same time in the same institution. In childcare centres and schools, you should suspect viral gastroenteritis if two or more children or staff have vomiting or diarrhoea within a two day period.

Viral gastroenteritis is highly infectious and outbreaks are very common and can be difficult to control. Outbreaks often occur in institutional settings such as nursing homes, hospitals, child care centres and schools. There are several things you can do to help reduce the spread of infection.

How do I prevent the spread of infection?

Hand washing

Good hand hygiene is the most effective way of preventing the spread of infection.

• Make sure that hand washing facilities and alcohol hand rub are available for staff, residents, children and visitors.
• Alert staff, residents, children and visitors to the outbreak and the need for thorough and frequent hand washing, and post hand washing signs in toilet and care areas.
• Staff and visitors should wash their hands thoroughly with soap and running water for 30 seconds and dry their hands with disposable paper towels, even if they have been wearing gloves:
• if hands are visibly dirty
• after using the toilet
• after changing nappies
• before eating/preparing food.
• There are body fluids (e.g. blood, urine, faeces) on your hands.

Alcohol hand rub can be used to clean your hands for other situations.

Isolation and restriction

The following precautions should be taken to restrict the spread of gastroenteritis:

• Children and/or staff with vomiting or diarrhoea should be separated from the rest of the group as soon as symptoms appear. This may involve dedicating a room to the sick children before they can be sent home.
• Cases that reside in an institution (such as in a boarding school) should also be separated from non-infected individuals where possible. This includes separate facilities for hand washing, toilet and bathroom.
• Sick children and staff should be excluded from attending the facility for at least 48 hours after their symptoms have ceased.
• Visitors should be discouraged from attending the premises while the outbreak is occurring.
• If the outbreak continues and new enrolments are considered to be at risk of infection, consider closing the facility to new enrolments.

Cleaning

• Surfaces or objects that have been exposed to vomit or faeces must be thoroughly cleaned as soon as possible.
• Wear disposable gloves when cleaning up. Mask, goggles and impermeable protective clothing offer additional protection if available.
• Use disposable towels to remove faeces and vomitus, and seal in a plastic bag before disposing of them (in a clinical waste bin, if available).
• Wash the surface or object with hot water and a neutral detergent.
• Where possible, disinfect hard surfaces and objects with freshly prepared sodium hypochlorite (bleach) 0.1 per cent solution. Leave the bleach on the surface for at least 10 minutes before rinsing with cold water, and allowing to dry thoroughly.
• Allow objects to dry thoroughly after they have been cleaned.
• Wash your hands after you have removed gloves and protective clothing.

Gastro Pack for Childcare Centres.

Who should I contact?

Managers of facilities where an outbreak of viral gastroenteritis is occurring or suspected should:

• report the outbreak to their local Public Health Unit
• document the number of cases, dates of onset, duration of symptoms and report to your Public Health Unit.

Call 1300 066 055 (within NSW) to be directed to your local public health unit.

How can the public health unit help?

Public health unit staff have expertise in managing infectious disease outbreaks. Your local public health unit can provide advice and assistance on controlling further spread of the outbreak, samples that should be collected, and the type of testing that should be carried out.

Further information

• Viral gastroenteritis
• Norovirus
• Rotavirus

For further information please call your local Public Health Unit on 1300 066 055.