Recently some schools have been slow in reporting possible outbreaks of gastroenteritis (diarrhoea and vomiting), only seeking advice when over 20 children and several staff had been affected.

A report of an 'outbreak' should be made "as soon as two or more apparently linked cases occur at around the same time" to the local Environmental Health Officer (EHO).br/>
Gastroenteritis in Children's Services Establishments

Gastroenteritis (diarrhoea and vomiting) may readily spread in the school/setting environment, leading to possible outbreaks (two or more linked cases). Outbreaks can be due to a point source such as a food poisoning incident, or the spread of viruses or bacteria from person to person. These two types of outbreak may initially be difficult to distinguish from each other and the investigation and control management are quite different.

Most forms of gastroenteritis are highly infectious. It is therefore very important to practise good hygiene, such as washing hands after going to the toilet, and before preparing food.

Noroviruses are part of a group of viruses that are the most common cause of gastroenteritis (stomach bugs) in the UK. They are also called the 'winter vomiting disease' because people tend to get them during the winter months. However, they can occur at any time of the year. The norovirus spreads very easily from person to person and the virus can survive for several days in a contaminated area.

Management Actions

If you suspect that an outbreak of gastroenteritis is occurring in your school/setting, the following key actions should be taken as soon as possible:

	Inform your local Environmental Health Department (EHD) immediately. Record the names and addresses of affected cases, dates of onset of illness, their school class and whether or not they eat food provided by the school. (This information should be given to the responsible EHO.)
	Affected cases (children and staff) should not attend school until 72 hours after recovery with normal (for them) stools unless otherwise advised by the Norfolk, Suffolk and Cambridge Health Protection Unit or your local EHD.
	Body fluid spillages should be dealt with promptly, using an appropriate disinfectant.
	Strict attention should be paid to hand hygiene. This may involve active reinforcement at occasions such as school assemblies etc.
	Cleaning regimens should be increased, particularly in higher risk areas such as lavatories and food preparation areas. Particular emphasis should be placed on touch points in lavatories, including taps and door handles and lavatory seats and handles etc, which may become contaminated.

Providing Personal Information

Following a report of an outbreak, it is quite likely that an Environmental Health Officer will visit the school to check the situation.

They might want to look around the school to check on the hygiene arrangements in toilet and kitchen areas and make recommendations for improvements, either long or short term. They will probably ask for details of the people who have been ill as this allows them to visit families to follow up contacts outside the school. Schools should cooperate with such requests.
Sometimes schools have been reluctant to provide this information, but there is a clear responsibility to provide it 'for the protection of health.' This should be done as soon as possible. The sooner that the cases are diagnosed and any common links established, the sooner the outbreak can be controlled.

Return to School

Affected cases (children and staff) should not attend school until 72 hours after recovery with normal (for them) stools unless otherwise advised.