Gastroenteritis

What is gastroenteritis?

You will hear gastroenteritis illness called different names, such as gastro, tummy bug, rotavirus and norovirus, however the symptoms are the same. These symptoms are nausea, vomiting and or diarrhoea.

When a person is sick with vomiting and/or diarrhoea it can cause the body to lose more fluid than is taken in, this can lead to dehydration. Young children are more likely to get dehydrated when sick with a gastro illness as they can lose fluid more quickly. This can lead to hospitalisation.

When should a centre be concerned?

When you have three or more children and/or staff with similar symptoms within seven days. Put into action the 10 top tips for outbreaks and then follow the below advice. If you have any further questions please give our public health advisors a call on 027 807 8544.

IMPORTANT! If you experience any of the below situations, please contact a health protection officer by email on healthprotection@huttvalleydhb.org.nz or phone on 04 570 9002:

If the number of people sick reaches 15% or more of the total centre roll (incl staff)
(to calculate % of people sick: Number of people sick (children & staff) ÷ total centre roll x 100 = % of people sick)
The children and/or staff all got sick at the same time or after a particular event (e.g. a party, event held at the centre, petting zoo visit).
The number of ill children and/or staff doubles in a short timeframe (i.e. within a week)
Children and/or staff have bloody diarrhoea.

Useful resources

Click on the below links to download:

What else can be done to manage the spread of illness in your centre during an outbreak?

Exclusion

Sick children and staff members need to stay away for at least 48 hours after the last symptoms of diarrhoea and/or vomiting. This is a minimum time period. If the 48 hour exclusion period has past but a child is observably still not well (i.e. has fever, lethargic and unable to participate), they should not be at the centre.
A child who is sick at the centre should be collected by their parents and taken home as soon as possible.
If a parent is sick and has come to collect their child, have the child taken to them by some one else so the sick parent does not walk through the centre.

Communication

In an outbreak situation communication with parents is important.

Provide information about the outbreak to parents; signs on the door, on your notice board, your website and/or by email.

Hand washing

All parents, staff and children need to wash and dry their hands on arrival to, and leaving the centre (parents and staff can use alcohol based hand gel).
All staff and children wash and dry their hands after going to the toilet, before preparing and eating food, after eating and after changing nappies.
Wash children’s hands after nappy changing with soap and water.
Supervise children when they are washing their hands.

Cleaning

Tell your cleaners about the current outbreak in the centre and advise to use bleach for disinfection.
Make a plan for the increased centre cleaning; set a date when all the cleaning will be done by. Try to get them complete in one to two days.
Replace cleaning products with bleach/chlorine products. Make a new bleach solution daily using either of the following formulas:
- Make a bleach solution at 1:10 ratio (1 part bleach and 9 parts water) or,
  - To make 1 litre = 50ml of bleach and add water to make 1 litre or, ¼ cup of bleach and add 4 cups of water
  - To make 10 litres = 500ml (2 cups) of bleach and add water to make 10 litres
When using bleach it needs to be sprayed and left on surfaces for 30 minutes before being removed in order to be effective or leave on surface if appropriate.
Identify areas that children play in a lot, these areas is high risk areas and should be cleaned first.
Look at cleaning from a child height not an adult height for example backs and sides of chairs where little hands go, taps, and door handles.
Increase cleaning in bathrooms.
Increase the cleaning of soft furnishings i.e. couches, cushions and chair covers. Steam clean these when there has been a vomiting or diarrhoea accident on them.
Increase washing of sleeping linen (sheets and pillow cases). If this is normally once a week it will need to be increased to twice a week or as required.
Rotate toys on a roster so not all toys are out at once and clean toys can be used. Especially important for under twos as they put toys in their mouth.
It is recommended to clean all toys with hot soapy water and then a bleach solution.
If practicable, the dishwasher and washing machine can be used for washing toys.
Remove and wash soft toys and puppets.
Remove play dough, painting and water play until the outbreak has stopped.
Remove any containers that children access regularly that cannot be wiped down such as cane baskets.
Wipe down cots with diluted bleach, especially where children hold or bite.
Send all comforters (dummies, sleep toys, blankets) home to be washed. Children should not bring comforters to the centre during the time of illness.

Cleaning up vomiting and diarrhoea

Have a spill kit ready and train staff how to use this. Click here to download washdown guidelines that includes a list of spill kit items.
Staff should use Personal Protective Equipment (PPE) when cleaning any sick or soiled children and handling contaminated clothing during an outbreak situation. PPE includes gloves, masks and disposable aprons.
All clothing, nappies and disposable equipment including cloths and wipes should be double bagged. Care should be taken to ensure that air that could carry viral particles is not released form the bag.
Please make sure that a safe and hygienic process is in place for the storage of soiled clothing such as a bucket with a lid in the laundry area.

Record keeping and communication with Public Health

Complete your illness register daily for children and staff illness and absences.
Call parents to ask if the absent child is unwell with diarrhoea, vomiting or flu-like illness (high temperature, sore throat, cough).
Inform Public Health of any new cases (child or staff) who report being unwell with diarrhoea or vomiting and send through the updated illness log daily.

Food

Do not share food. If providing any food, have staff serve food onto individual plates for each child with utensils.
Stop baking activities.

How do you know when to go back to normal operating?

When there has been seven days with no children or staff sick with a gastro illness.