Managing a gastroenteritis outbreak in early childhood education and care settings  

• Begin gastro outbreak cleaning
• Post signs on the front door advising that an outbreak is in progress
• Throw away playdough in affected rooms
• Stop using sandpits & water play in affected areas
• Declutter nappy change areas
• Bring out easy to clean toys (e.g. plastic toys)
• Remove hard to clean toys (e.g. soft toys)
• Stop family grouping between rooms
• Encourage regular handwashing, particularly before eating and drinking.

When there is a gastro outbreak, it’s very important to clean carefully and follow infection control steps right away. This helps stop the illness from spreading. 

Follow the steps below during every outbreak. If we think food or water might be the cause, extra steps will be needed — we will let you know if this happens. 

For more detailed cleaning instructions please read the sections in the Victorian Department of Health – A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres.

The centre manager must make sure all staff:

• know where to find these documents, and
• understand how to use them.

Victorian Department of Health resources

• A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres 
• Appendix 1A Chlorine dilutions quick guide 
• Appendix 1B Environmental cleaning quick guide 

Norovirus is the most common cause of gastro outbreaks in children’s centres. It spreads very easily and can live on surfaces for up to 28 days.

During a gastro outbreak, use a chlorine-based disinfectant, like a plain, unscented household bleach. Other disinfectants don’t kill norovirus or other viruses that cause gastro. 

Your local council Environmental Health Officer (EHO) will visit your centre and can give advice on cleaning and disinfection. They can help you with the correct mixing of solutions and safe cleaning practices. 

Appendix 1A Chlorine dilutions quick guide 

This guide shows how to use disinfectants safely and effectively. It includes:

• commercial-grade disinfectants 
• how to mix solutions correctly 
• instructions for safe use.  

This easy-to-use Chlorine Dilutions Calculator tells you how much chlorine-based (sodium hypochlorite) sanitiser/disinfectant to dilute with water to get the desired concentration (parts per million) of chlorine solution.

Appendix 1B Environmental cleaning quick guide 

This guide shows how to use chlorine-based cleaning in different areas:

• kitchen – food contact surfaces (Plates, bowls, cups, trays and utensils, etc.) 
• kitchen – non-food surfaces (benches, shelving, doors, storage areas, sinks, etc.) 
• all other areas.

During a gastro outbreak, all areas should be cleaned and disinfected at least twice every day.  

Pay extra attention to surfaces people touch a lot (“frequently touched surfaces”), such as:

• toys 
• light switches 
• cupboard and door handles 
• tables and benches  
• chairs, highchairs and booster seats 
• cots 
• taps 
• toilets, toilet seats, flush handles 
• change tables (clean after every use).

Other areas, including children’s rooms, staff rooms, outdoor play equipment, and shared spaces, should also be cleaned and disinfected often during an outbreak. 

Change tables must be cleaned and disinfected after every nappy change. 

WPHU’s 3-Step Cleaning Guide gives easy instructions for cleaning specific items, including all the surfaces listed above.

Bathroom and kitchen areas

Download

Indoor learning areas

Download

Outdoor areas

Download

After a vomit or diarrhoea incident

When someone vomits, tiny virus particles can spread through the air and land on nearby food or surfaces.

If a child vomits in a shared area:

• move everyone away for at least one hour
• clean and disinfect the area immediately
• throw out any uncovered food nearby.

Use paper towels to soak up the excess vomit and poo. Put the waste in a closed plastic bag and then clean and disinfect the area thoroughly.

Staff cleaning vomit or poo should wear disposable personal protective equipment (PPE), including:

• gloves
• apron
• mask.

Staff who work with food should not clean up vomit or poo and should not be changing nappies.

For more information, see section 3.1 of A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres.

Washing hands well with soap and water is the best way to stop gastro spreading.

Alcohol-based hand sanitisers do not work against gastro.

Hands can spread infection if they touch:

• vomit or poo
• food
• toys or equipment.

This is how hands can spread infection:

Sourced from: Staying Healthy: Preventing infectious diseases in early childhood education and care services (6th edition)

Know how and when to wash your hands

For step-by-step instructions on washing your hands correctly, see the downloadable resources below

Download

Download

Hand washing quick guide

For a quick reference on when children, educators, and other staff should wash their hands, see the table below.

Important: hand wash basins must only be used for washing hands. Do not use hand wash basins to prepare food or wash equipment.

Sourced from: Staying Healthy: Preventing infectious diseases in early childhood education and care services (6th edition)

For more information on hand hygiene and alcohol-based hand sanitisers, see section 3.2 of A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres.

• Stop cookery activities.
• Stop activities that mix children from different rooms or age groups, including family grouping.

For more details, see section 3.5 of A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres.

• Children and staff must stay home until 48 hours after their last vomiting or diarrhoea.
• Do not allow a child to return earlier, even if a doctor writes a note.
• If unsure, contact WPHU on 1800 497 111 for advice.
• Follow these rules carefully to protect other children, staff and families.

• Tell all parents, guardians, and staff:
  • when an outbreak starts
  • what symptoms to watch for
  • how long staff or children must stay away (exclusion)
  • how to collect poo samples.
• WPHU can provide a letter for staff and families.
• Put up posters and signs in your centre at the start of an outbreak.
• Put handwashing posters above sinks in toilets, bathrooms, and kitchens.

Download: Appendix 5 Signage – Children’s services centre visitors and staff

For more information, see section 8.0 of A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres

Testing poo samples from children or staff who are sick helps us find the cause of an outbreak and prevents more people from getting sick.

Collect up to 5 poo samples during an outbreak. Samples can be collected up to 7 days after their diarrhoea has stopped.

Two ways to collect samples

1. Using a council kit:

• the council will give you kits when they come to visit
• families and staff can collect samples at home or at the centre, for example from a soiled nappy if a child has diarrhoea at the centre OR,
• return the samples to the centre for council pick-up.

2. Through a GP:

• your GP will give you a poo sample kit
• return the sample to your GP or local pathology centre after collecting it
• ask your staff and families to tell the centre if they used their GP, so the information can be shared with WPHU and council.

How to collect a poo sample

Step-by-step instructions

Download

For more information, see section 5.0 of A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres

Update your list of people who are sick

• Update your list of sick people and send it to WPHU and council at least twice a week.
• Continue doing this until the outbreak is over, or if WPHU asks you to.

Regular contact and support

• WPHU will stay in touch with you during the outbreak, usually every 2–3 days by phone or email.
• Your local council will also make contact and will visit your centre.
• During a visit, council may collect menus, food or environmental samples.

Declaring an outbreak is over

• WPHU usually declares an outbreak over if 48 hours have passed since the sick persons symptoms – vomit or diarrhoea have stopped and there are no new sick people.

Once WPHU confirms the outbreak over:

• do a final clean and disinfect of the whole centre
• send a final list of sick people to WPHU and council. Include the last day the person was sick (vomited or had diarrhoea).

For more information, see section 6.0 of A Guide to the Management and Control of Gastroenteritis Outbreaks in Children’s Centres