Outbreak Resources for Long-Term Care and Retirement Homes

Outbreaks can spread quickly in long-term care and retirement homes. Knowing how to recognize, manage, and report them can help keep residents and staff safe. This page gives you the tools and information you need.

What is an outbreak?

What are the case definitions for outbreaks?

A case definition helps you decide who should be considered part of an outbreak. This definition is made by looking at:

• Symptoms

• Time

• Place

• Person

Each type of outbreak has a different case definition. Here’s a quick guide to help you understand them.

Respiratory, influenza, and COVID-19 outbreaks

Case definitions for these outbreaks can change depending on the situation. Here’s what to know:

1. Use the Infectious Diseases Protocol to help create your case definition

2. For COVID-19 outbreaks in high-risk settings (like long-term care homes), check the novel coronavirus appendix for specific guidance.

3. Case definitions should:

• Fit the type of illness and outbreak situation

• Be updated as the outbreak changes to make sure most cases are included

Helpful resources:

• Surveillance definitions for infections in Canadian long-term care homes

• Recommendations for Outbreak Prevention & Control in Institutions & Congregate Living Settings, 2024

• Appendix 1: Respiratory Outbreak Definitions

Enteric outbreaks

For enteric outbreaks, symptoms can’t be explained by something else (like medicine or diet). A case meets the definition if:

• Two or more episodes of diarrhea in 24 hours, OR

• Two or more episodes of vomiting in 24 hours, OR

• One episode of diarrhea and one episode of vomiting in 24 hours.

Helpful resources:

• Appendix 1: Enteric Outbreak Definitions, Ministry of Health

How do you report an outbreak? 

If you suspect an outbreak, contact Southwestern Public Health (SWPH) to discuss next steps.

• St. Thomas Site: 1-800-922-0096 ext. 3500

• Woodstock Site: 1-800-922-0096 ext. 3500

• After Hours, Weekends & Holidays: 1-800-922-0096 ext. 0

How do we control an outbreak?

Each LTCH should annually review outbreak policies and ensure staff are trained. Resources to help you manage include:

• Summary of Outbreak Control Measures for LTCH's, RH's and CLS's
• Quick Reference to Outbreak Control and Management for LTCH's and RHs 
• Outbreak Control Measures - Congregate Living Settings
• Management of Residents with Respiratory Symptoms
• Management of Residents with Enteric Symptoms
• Management of Symptomatic Staff in LTCH/RH

Line Lists

Monitor and track cases using the following line listing forms:

• Facility Outbreak Line List (print and fill version)

• Facility Outbreak Line List (fillable version)

Lab testing during an outbreak

Lab testing is key to confirming and managing outbreaks. Call SWPH to discuss specimen collection and order kits:

• Respiratory Viruses (including influenza)

• Ordering testing kits

• Gastroenteritis –Stool Viruses

• To order additional enteric outbreak kits, please call SWPH at 1-800-922-0096 and ask to speak to a member of the Infectious Diseases Team 

Test requisitions

• COVID-19 & Respiratory Virus Test Requisition (respiratory outbreaks)

• General Test Requisition (enteric outbreaks)