Outbreak control measures, such as closing health care and long term care facilities to visitors, are common during fall and winter and this year has been no exception. One of the most recent in Sun Country Health Region is that at Willowdale Lodge in Kipling, which has been closed to visitors since Jan.16.

Dr. Shauna Hudson, medical health officer for Sun Country, notes that there has been an increasing number of instances where such actions have been taken in recent years.

“There were more than 30 outbreaks (in facilities within the region) in 2006, slightly more than in 2005, and more in 2005 than in 2004,” says Hudson.

There can be a number of reasons for this other than its simply being an upward trend. Increased reporting of suspected outbreaks, along with the cyclical nature of some infectious organisms can also play a part.

“It could reflect an increased awareness of the impact of outbreaks within a facility and a community,” she says. “Concern about possible pandemics has heightened in recent years.” She cites the SARS outbreak in Toronto some time back as an occurrence which increased public awareness.

Typically at this time of year, a variety of illnesses surface throughout the province and can find their way into acute and long term care facilities.

The Norwalk virus is one which has been making the rounds in many regions. There are in fact several virus strains which can produce Norwalk-like symptoms and are often grouped as Nor-virus or Norwalk.

Late in 2006, three people were admitted to Kipling Memorial Health Centre with Norwalk symptoms. This resulted in that facility having been closed to visitors from Dec.30 to Jan.2.

Another seasonal contagious illness is influenza, whose strain varies year-to-year, and for which immunization is made available each fall.

Then there is parainfluenza, which while usually somewhat milder than influenza, is often accompanied by the respiratory syncytial virus (RSV), an upper respiratory tract infection.

It is this illness which has led to the current closure to visitors of Willowdale Lodge. There has been one confirmed case of parainfluenza and RSV at Willowdale and 10, or slightly more than one-third of residents, were or had been symptomatic up to Wednesday.

The closures and other outbreak control measures can be in effect for some time, depending upon the incubation period for an illness. For example, influenza has an incubation period of one to three days and can be spread by an infected person the day before symptoms develop. Thus, each time symptoms are noted adds three days to the time that control measures are in place.

In the case of Norwalk viruses, relapses are possible, so often control measures are kept in place for two incubation periods of 48-72 hours each.

With parainfluenza, a concern is that RSV can lead to a secondary bacterial pneumonia.

When an outbreak is suspected, a number of infection precautions are taken in addition to those most obvious to the public, Hudson says.

Sick individuals are most often isolated until symptoms pass.

Depending on what the illness is, staff will be directed to wear gloves or masks, or both, when coming in contact with the patient.

Staff will also not be allowed to go from one facility to another, which at times requires rescheduling of shifts.

All measures are designed to prevent the transmission of the illness.

Staff are also excluded from working if they themselves are ill.

Cleaning procedures, too, are often modified, as some cleaning products are specific to (eliminating) certain organisms.

An increased frequency of cleaning is also often undertaken.

“There are a host of different tools that we use to deal with illness,” says Hudson

“There is a lot of hard work done on the front lines when dealing with outbreaks.”

There are also dietary precautions implemented and when possible, antiviral medications are administered to residents and non-immunized staff.

Closures are instituted to prevent transmission from the facility to the community and vice-versa

Thus, the restriction applies to volunteers and to others who provide services in some way, such as entertainers.

Many precautions are ongoing says Hudson, since prevention is more desirable than outbreak control.

Hand washing is a key element in preventing an illness from spreading, and hand disinfectant is provided in all care facilities in Sun Country region.

” It is important that visitors use it upon entering and leaving a facility,” Hudson says.

“It should also be used when going from one room to another.”

Some aspects of prevention are just common sense, such as not visiting acute care or long term care facilities while you are ill.

Flu shots are also recommended, especially for those who will have frequent contact with those who are more susceptible to influenza.

In other news in the past week, Sun Country’s first incidence of influenza A this year, a confirmed case at Kipling, has been detected.