• Rabies

• Salmonellosis

• Campylobacteriosis

• Lyme disease

• Leptospirosis

• Toxoplasmosis

• Was anyone bitten, scratched, or had direct contact with the bat?

• How many people were in the house?

• Were there very young children, sleeping individuals, or others unable to reliably report contact?

• Does anyone have unexplained bites, scratches, or wounds?

• Were any pets or domestic animals in contact with the bat?

• Where is the bat now (alive, dead, contained, escaped)?

• Caller contact information

• Transmission of communicable diseases

• Skin infections from contaminated tools or poor hygiene

• Blood exposure from nicks, cuts, or sharps near the skin

• Head lice or other parasitic concerns

• Poor cleaning and disinfection of reusable equipment

If they also perform piercings:

• Increased risk of bloodborne infections (e.g., Hepatitis B, Hepatitis C, HIV)

• Improper sterilization of instruments

• Unsafe handling and disposal of sharps

• Higher risk of local skin and soft tissue infections

• Contact the patient

• Obtain a 3-day food history

• Determine symptoms and symptom onset

• Determine if anyone else is ill

• Attempt to identify the likely source of infection

• Determine the patient’s drinking water source

• Risk of botulism from Clostridium botulinum spores

• Greatest concern for infants under 1 year of age

• Infants have lower stomach acidity and immature intestinal flora, allowing spores to survive and produce toxin

• Water chemistry is out of balance

• High pH may reduce the effectiveness of the chemical sanitizer

• Close the pool

• Evacuate bathers

• Issue a verbal and/or written order

• Post closure notices

• Instruct the operator to adjust the water chemistry

• Educate the operator

• Re-inspect to confirm correction

• Notify manager

• Kitchen equipment

• Kitchen supplies

• Maximum occupancy and bed spacing

• Furniture

• Washroom equipment

• Ventilation

• Overall condition and cleanliness

• Lighting

• Hot and cold potable water

• Pest control and window screens

• Laundry facilities

• Waste disposal

• Safety equipment

• Primary disinfection is used to kill or inactivate pathogens (bacteria, viruses, protozoa) during water treatment

• It is the main treatment step to make the water safe to drink

• Common methods include chlorine, UV, or ozone

• Secondary disinfection is used to maintain a disinfectant residual throughout the distribution system

• Its purpose is to prevent microbial regrowth and protect water as it travels through pipes to the consumer

• Most commonly done using chlorine or chloramine

• Isolate ill residents

• Cohort staff to specific resident groups

• Ensure staff are not working at multiple homes

• Post warning notices

• Limit visitors

• Cancel group activities and social events

• Ensure appropriate PPE for staff

• Increase cleaning and disinfection

• Retain food samples and/or submit stool samples if indicated

• Monitor other residents for symptoms

• Reinforce enhanced hand hygiene

• Hand wash facilities

• Proper disinfectants

• IPAC policies and procedures

• Separate diaper change area

• Safe storage of personal items

• Beds and nap area

• Washrooms

• Laundry procedures

• Potable water supply

• Poultry (especially chicken and turkey)

• Eggs and raw egg products

• Raw or undercooked meat

• Unpasteurized milk and dairy products

• Raw sprouts

• Melons (especially cantaloupe)

• Peanut butter

• Fresh produce contaminated during handling (e.g., tomatoes, leafy greens)

• Foodborne infection occurs when a person eats food containing live pathogenic microorganisms that grow in the body and cause illness

• Examples: Salmonella, Campylobacter, Listeria, E. coli

• Foodborne intoxication occurs when a person eats food containing toxins that were already produced in the food before it was eaten

• The organism may no longer be present, but the toxin causes illness

• Examples: Staphylococcus aureus, Bacillus cereus, Clostridium botulinum

• Giardia

• Cryptosporidiosis

• E. coli infection

• Campylobacteriosis

• Hepatitis A

• Building sewer / connecting pipe

• Septic tank

• Distribution pipes / header pipe

• Leaching bed (tile bed)

• Final grading and soil cover

• To receive and hold sewage from the building

• To allow solids to settle to the bottom as sludge

• To allow fats, oils, and grease to float to the top as scum

• To provide partial breakdown of waste by anaerobic bacteria

• To allow clarified liquid effluent to flow to the leaching bed for further treatment

• Sewage backing up into sinks, toilets, or drains

• Wet, soggy, or unusually green areas over the leaching bed

• Sewage odors around the septic tank or leaching bed

• Slow draining fixtures in the home

• Surface ponding of sewage or effluent near the system

• Contaminated well water or nearby surface water concerns

• Confirm the product is unpasteurized milk being offered for sale

• Advise the operator that the sale of unpasteurized milk is prohibited

• Order the product removed from sale immediately

• Seize and/or detain product

• Educate the operator on the legal requirements and public health risks

• Document all actions taken

• Notify manager and market organizer

• E. coli

• Salmonella

• Listeria monocytogenes

• Campylobacter

• Brucella

• Mycobacterium bovis