Managing a gastro outbreak in your service

There has been a flood of media reports about gastro outbreaks in school and early childhood centres in the last few months. In fact, Queensland's Courier Mail reports a fourfold increase in gastro outbreaks in child care centres with almost 200 children affected since June.

In early childhood services a gastro 'outbreak' is defined as two or more people with diarrhoea and/or vomiting in an early childhood service at one time. This includes children as well as educators and support people working in a centre.

What is gastro and how is it spread?

Gastroenteritis, or gastro as it is known, is usually caused by viruses or bacteria that infect the bowel and in children often begins as vomiting. Many children then go on to develop stomach pain, diarrhoea and sometimes fever. In children, a bout of gastro usually lasts from two to four days, however it can take a week or more before a child’s poo returns to normal.

Gastro is easily spread in early childhood education and care settings, if children or staff touch objects contaminated with the virus they can become infected. The virus can also be spread through skin contact and if someone with the virus on their hand touches another person they too can become infected.

This makes it very important to remind families about your exclusion policies when there is a gastro outbreak and to remind parents about the signs and symptoms of gastro so they can be on the watch.

Can gastro be prevented?

The truth is no, not really; gastro can easily be brought into early childhood settings from outside environments, no matter how strict a service’s health and hygiene policies are.

The most effective way to minimise the impact of gastro in an early childhood service is to enforce good hygiene practices, this includes:

• regular cleaning of communal surfaces with warm water and detergent, this includes toilet seats, door handles, taps, tables and chairs
• thorough hand washing before and after preparing meals, toileting and nappy changes
• limiting access to toys/objects which cannot be cleaned easily, such as play dough and soft toys
• reminding children about the importance of hand washing, showing them how to clean their hands properly using soap and water
• using disposable gloves to handle clothes which have been soiled
• reduce the risk of bacterial causes of gastro by storing food correctly and throwing out food and water which may be contaminated
• educating parents about the signs and symptoms of gastro and explaining why your service strictly enforces exclusion policies during outbreaks

Gastro caused by Rotavirus can be prevented by immunisation. This vaccine is usually given in two doses before a child reaches 24 weeks old.

How should a service respond to gastro?

Treatment for gastro is bed rest and fluids, which are best administered under parental supervision at home. Children who contract gastro should stay at home and not return to care for at least 24 hours after the last episode of vomiting and/or diarrhoea.

Staff should also be reminded of the exclusion policies and according to NSW Department of Health guidelines should remain home for 48 hours after their symptoms cease.

When gastro is going around in a service staff should be especially vigilant in their support of children and toileting. Children should be supervised when necessary and encouraged to be careful about washing their hands.

In the case of an outbreak, services should contact their local public health unit who can provide resources and support when necessary. It's also helpful to send notices home and to put a poster up in the foyer so visitors to the service are aware of the situation.

---

References:

Gastro Pack for Child Care Centres