Department of Health

Increase in gastroenteritis outbreaks in childcare

Health advisory

Status:
Resolved
Advisory number:
210309
Date issued:
08 Mar 2021 - -(Update to Advisory issued 26 November 2020)
Issued by:
Adjunct Clinical Professor Brett Sutton, Chief Health Officer
Issued to:
Childcare providers, parents with children in early childhood education, the Victorian community.

Key messages

  • Parents and carers are urged to keep young children at home if they are sick amid a rapid rise in outbreaks of viral gastroenteritis in Victorian childcare centres.
  • Viral gastroenteritis is highly infectious. Symptoms include nausea, vomiting, diarrhoea, fever, abdominal pain, headache and muscle aches, with more severe outcomes in the elderly and very young. Symptoms can take up to three days to develop and usually last between one or two days, sometimes longer.
  • Washing hands with soap and water is one of the most effective ways of preventing the spread of infection. Alcohol-based hand sanitisers are not effective against many common viruses that cause gastroenteritis.
  • Infants or children in childcare or school, as well as staff, who develop vomiting or diarrhoea should stay at home until at least 48 hours after their symptoms have stopped, since they will still be infectious. If symptoms are severe or they persist, or you are concerned, see a GP for advice and possible testing.
  • Staff and parents should be vigilant for symptoms of gastroenteritis in children and reinforce basic hygiene measures.
  • Cleaning and sanitising are also important infection control measures and facilities should follow relevant Department of Health guidelines.
  • Anyone recovering from gastroenteritis should avoid visiting hospitals, childcare centres and aged care facilities to avoid spreading the infection to those most vulnerable. Any person living in a household with someone who has gastroenteritis should refrain from visiting these high-risk facilities until at least 48 hours after the last person in the household has recovered.

What is the issue?

As children return to school and childcare in Victoria, more outbreaks of gastroenteritis are being reported, up fourfold from the five-year average. Most of the current outbreaks are suspected or confirmed to be caused by norovirus with a person-to-person transmission.  

Gastroenteritis is highly infectious and is caused by viruses, bacteria or parasites. In each case, infection occurs when the 'bug’ is ingested. This usually happens in childcare settings when unwashed hands are placed directly in mouths or touch food or drinks, or indirectly – by touching contaminated surfaces such as taps, toilet flush handles, children’s toys and nappies. Airborne droplets may be formed when a person vomits or has diarrhoea. These droplets can also contaminate surfaces with viral particles.

Who is at risk?

Viral gastroenteritis can affect people of all ages. Those most at risk of complications include the elderly and the very young.

Symptoms and transmission

Symptoms of viral gastroenteritis include nausea, vomiting, diarrhoea, fever, abdominal pain, headache and muscle aches. They can take up to three days to develop and usually last between one or two days, sometimes longer. 

The main complication of gastroenteritis is dehydration, but this can be prevented if the fluid lost in vomit and diarrhoea is replaced, ideally with electrolyte solutions or ice blocks (Hydrolyte/Gastrolyte). 

Gastroenteritis is highly infectious and may spread rapidly. The virus is present in the vomit and faeces of an infected person and can spread either: from close contact with infected persons; contact with contaminated surfaces; or consuming contaminated food or drink. Viruses are often spread from person-to-person, and to objects and food via unwashed hands. 

Recommendations

The best defence against the spread of these viruses is to wash your hands thoroughly with soap and running water for at least 20 seconds before and after handling and eating food, after using the toilet, changing nappies, or assisting someone who has vomiting or diarrhoea. Alcohol hand rub, while effective against some viruses (such as coronavirus), is not sufficiently effective for preventing viral gastroenteritis.

Infants or children in childcare or school who develop vomiting or diarrhoea must stay at home until at least 48 hours after their symptoms have stopped, as should staff members and anyone whose work involves handling food or looking after children, the elderly or patients.

Anyone recovering from gastroenteritis must avoid visiting hospitals, childcare centres and aged care facilities to avoid spreading the infection to those most vulnerable. Any person living in a household with someone who has gastroenteritis should refrain from visiting these high-risk facilities until at least 48 hours after the last person in the household has recovered.

Childcare centres are encouraged to reinforce basic hygiene measures, such as regular hand washing (paying particular attention to hand washing after attending to nappy changes), cleaning all hard surfaces, and providing education to help prevent the spread of infections. Staff should supervise and assist young children to wash hands properly. Staff should also wear gloves and a mask when cleaning up bodily fluids, including vomit, when symptoms commence at the centre. Disinfect surfaces with a freshly made sodium hypochlorite (bleach) solution.

Anyone concerned about their symptoms should consult their doctor for advice.

More information

Clinical information

Guidelines for the investigation of gastroenteritis

Consumer information

Letter from the Chief Health Officer - Gastroenteritis in childcare

Better Health Channel - Gastroenteritis

Better Health Channel - Gastroenteritis in children

Better Health Channel - Be a Soapy Hero!

Contacts

For more information, please contact the Communicable Disease Prevention and Control section at the Department of Health on 1300 651 160 (24 hours).

Reviewed 22 November 2021

Health.vic

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