Childhood Diseases and Illnesses
Gastrointestinal Illnesses and Outbreaks (diarrhea/vomiting)
- What are the signs and symptoms?
- How is the illness spread?
- Instructions for schools
- When should a school exclude ill students?
- What should a school do if a food services staff member is ill?
- What can the school do to control an outbreak of diarrhea/vomiting?
- Further information and resources
Gastrointestinal (enteric) illnesses are caused when a person eats a food, water or item contaminated with pathogens (harmful bacteria, viruses, or parasites) such as:
- E-coli (pathogenic)
- Hepatitis A
- Typhoid Fever
- Paratyphoid Fever
For more information on the pathogens listed above, see the Guide to Common Gastrointestinal Illnesses chart (21 KB, 4 pages).
For a complete list of designated reportable communicable diseases, consult the List of Reportable Diseases (PDF 85 KB)
What are the signs and symptoms?
- The onset of illness varies for each communicable disease from a few hours to several days or even weeks, depending on the type of pathogen.
- Symptoms vary but generally include nausea, vomiting, diarrhea, fever, chills, or stomach cramps
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How is the illness spread?
- Foodborne illness can also be transmitted from person to person. This can happen when an ill person does not wash their hands after using the toilet. The pathogens on their hands can be transmitted to food or items that another person will put in their mouth.
- Viral enteric illnesses or "stomach flu" such as Norovirus can often be responsible for outbreaks of vomiting and/or diarrhea in institutions and schools. The disease is transmitted easily from person to person, or by exposure to food, water, or surfaces contaminated by an infected person.
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Instructions for Schools
- Report unusual increases in absenteeism due to gastrointestinal illness (diarrhea/vomiting) immediately to Peel Public Health at 905-799-7700.
- Consult the provided flow chart (PDF 41 KB) for assistance in determining whether you have an outbreak of enteric illness at your school.
- In addition to calling Peel Public Health, you may complete a Daily Screening Report for Students with Gastrointestinal Symptoms (PDF 26KB)
A Public Health Inspector may contact the school for further investigation and consultation, as needed.
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When should a school exclude ill students?
School children with a diagnosed communicable disease may not need to be excluded from school provided they feel well enough to participate in school activities and are capable of practicing good hand washing.
- Norovirus illnesses and outbreaks may require additional sanitation measures. See the section below for information on controlling an outbreak.
- Refer to the Guide to Common Gastrointestinal Illnesses chart (PDF 21 KB, 4 pages) for further details on suggested exclusions and readmissions for each communicable disease.
Remember to protect the confidentiality of the student by not disclosing a diagnosis to concerned parents and/or colleagues. If follow up is required Peel Public Health will contact those who are at risk.
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What should a school do if a food services staff member is ill?
Foodhandlers with vomiting or diarrhea can transmit their illness to others through contact with food and utensils. They should not handle food or touch clean dishes/utensils until they are symptom-free for at least 24 hours.
- In the case of E. coli, Shigella, Typhoid Fever, or Paratyphoid Fever infections, food handlers will be excluded from work by Peel Public Health and may be required to submit stool specimens before they are allowed to return to work.
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What can the school do to control an outbreak of diarrhea/ vomiting?
- Hand hygiene and washing thoroughly with soap and water is the single most effective strategy for both preventing infection in the school and stopping its spread once an infection is present.
- Reduce the risk of transmission of infections during periods of increased absenteeism by encouraging preventive practices such as:
- Isolating and/or excluding sick students as per the Guide to Common Gastrointestinal Illnesses chart (PDF 21 KB, 4 pages)
- Limiting or reducing common activities between different groups of students
- Discouraging students from sharing food or drinks. For example, common water bottles for sports teams.
- Not using sensory, water play tables and sandboxes for class activity
- Checking the operation and water flow of drinking water fountains
- Practice proper cleaning and disinfection of the school. Increased cleaning and disinfection of high touch surfaces with effective sanitizers is recommended. Disinfecting solutions using household bleach (PDF 121KB)
- Report illnesses and keep track of any students ill with diarrhea/vomiting on a Daily Screening Report for Students with Gastrointestinal Symptoms (PDF 23KB)
- You may also choose to communicate to the students/parents/public using:
- If applicable, special needs feeding, personal care, and diapering procedures should be reviewed
- Practice safe food preparation - clean, separate, cook, chill. Food handlers are encouraged to attend a Food Handler Certification Course. Call Peel Health at 905-799-7700 for course details and registration.
For further information about this or other communicable disease questions you may have, contact Peel Public Health at 905-799-7700.
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Resources and Related Links:
- Guide to Common Gastrointestinal Illnesses chart (PDF 21 KB, 4 pages)
- School Health Reference Guide: Handling and reporting communicable diseases
- Notification of Disease in Schools (PDF 171KB, 2 Pages)
- Preventing Infections in Schools
- Health Protection and Promotion Act – Communicable Diseases
- Information on Norovirus
- CDC – Norovirus Outbreak Management (www.cdc.gov)
Resources for Gastrointestinal Illness Outbreaks:
- Reporting Increase in Absences – flow chart (PDF 41 KB)
- Daily Screening Report for Students with Gastrointestinal Illness (PDF 51 KB)
- School Checklist During a Gastrointestinal Illness Outbreak (PDF 10 KB)
- Disinfecting solutions using household bleach (PDF 121 KB, 2 pages)
- Downloadable resource materials for infection control
- Signage indicating outbreak (PDF 24 KB)
- Sample letter to parents (PDF 29 KB)
- Hand washing signs/posters
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