A Boil Water Advisory has been issued by the North Bay Parry Sound District Health Unit (NBPSDHU). The boil water advisory remains in effect until it is lifted by the NBPSDHU.
The guidelines below are provided to operators of child care facilities in response to the boil water advisory issued.
During A Boil Water Advisory
Water for Drinking
- Use only boiled or commercially bottled water. All water used for drinking or for use as an ingredient in other prepared foods must be commercially bottled or boiled for one minute (rolling boil) then stored in clean and disinfected covered containers until served.
- Post signs advising not to drink the tap water at all sinks. Fountains should be turned off or made inaccessible.
Food Preparation
- Discard all foods and beverages made with untreated or potentially contaminated water
- All water that is used to wash, rinse or soak foods (i.e. fruits and vegetables) must be commercially bottled or boiled for one minute. Children and staff should not consume raw foods rinsed with water that has not been disinfected.
- Commercial dishwashers that can provide a sanitizing rinse temperature of 71°C at the plate are satisfactory. If dishwasing occurs by the manual method, follow procedures as specified in section 72 (b), 73, 74, and 75 of Ontario Regulation 562 (Food Premises).
Exclusion with Diarrhea
- Exclude all children or staff reporting diarrhea until symptoms have subsided for at least 48 hours.
- Report all illness linked to a community outbreak to the Acting Medical Officer of Health
Handwashing guidelines during a boil water advisory
Wash your hands as you normally do, using warm running water and soap. If the boil water advisory has been issued because of a waterborne outbreak of illness, wash hands under warm running water and soap or use alcohol-based hand disinfectants containing a minimum concentration of 60% alcohol. These products are widely used in health care settings after washing or in situations when water is not available
Teethbrushing
- Ensure availability of potable water for teeth brushing and ensure that supervision of this activity occurs.
Diapering
- Use disposable gloves, alcohol/gel rinses and disposable moistened towelettes when diapering children.
- Use disposable paper to cover diaper-changing areas
- Clean children’s hands with the gel after diapering and ensure staff wash hands after each diaper change.
- If face cloths are used, ensure they are moistened with non-contaminated water then laundered after each use.
- Use overclothes or diapers capable of retaining liquid feces.
- Disinfect diaper areas after each child has been changed with a chlorine solution of 100 parts per million (or a solution of equivalent disinfection capability).
- Ensure clear separation of diapering and food-handling areas and responsibilities
- Ensure separation of diaper changing areas from children’s play areas.
Water Play Stations
- Stop the use of water play tables during this time. Drain all water play tables or or play areas containing water.
- Discourage activities/crafts which utilize water and where there is a risk that children may consume a product (eg. handpainting, baking, pasting with glue made from flour and water).
Washing Toys
- Wash cloth toys or dress up clothes in a washing machine and heat dry them in a clothes dryer for 30 minutes.
- Disinfect toys in a disinfectant solution ensuring adequate contact time. Dishwasher-safe toys may also be cleaned in a dishwasher providing that the machine uses a hot water wash at 60° C (or 140° F) with a hot water sanitizing rinse of 82° C (or 180° F) for ten seconds.
Laundry
- Launder dishcloths, bedding, bibs and facecloths in a standard washing machine provided that a sanitizing rinse or hot rinse cycle is used. Items should be dried in a standard dryer for a minimum of 30 minutes.
Communication to Parents
- Inform parents of the boil water advisory, symptoms of enteric illness, need for exclusion, reporting requirements, risk of severe illness in immunocompromised persons, and necessary control measures.
Upon Rescinding a Boil Water Advisory
Once the BWA has been lifted, all water-using fixtures or pieces of equipment should be re-started, flushed and sanitized in accordance with the manufacturer's specifications. This may vary from fixture to fixture. Water filters, softeners and treatment devices may need to be completely replaced. The facilities engineer and/or the fixture manufacture should be consulted for specific guidance when re-starting equipment.
Additional Measures to Be Effected:
- Run cold faucets for one minute before using the water.
- Run drinking fountains for one minute before using the water.
- Backwash pool filters and change media or water as warranted.
- Drain and refill hot water heaters set below 45° C (113 ° F).
- Drain and refill all water play stations.
For more information, call the Health Unit as (705) 474-1400 or 1-800-563-2808 or visit www.healthunit.biz
Adapted from Guidelines contained in the Protocol for the Investigation and Control of Cryptosporidium and Giardia Waterborne Outbreaks (Public Health Branch, August 1997) and Cryptosporidium and Water: A Public Health Handbook (1997).
Updated: July 2009
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