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NC Division of Public Health
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Diseases & Topics

Public Health Management of Enteric Illnesses

Many enteric, or gastrointestinal, illnesses are highly contagious and easily transmitted from person to person in group settings. Local health directors are responsible for receiving and investigating reports of communicable disease outbreaks, including food-borne, water-borne and other enteric illnesses, within the community. While an outbreak or suspected outbreak is being investigated, there are measures which should be immediately implemented to prevent the spread of illness to others, particularly in group settings involving children. School administrators, employers, child care facility operators and administrators of public or private institutions, hospitals or jails are key partners in containing outbreaks and minimizing impact to the public's health.

In group settings, the most effective measures available to end transmission of enteric illnesses are to:

  • Exclude symptomatic persons when possible.
  • Thoroughly disinfect all premises where vomiting or diarrheal episodes have occurred.
  • Maintain strict adherence to proper handwashing techniques.

Food handlers, health care workers, and child care providers should be excluded from work if they are ill with any symptoms of gastroenteritis. Children who are ill with vomiting or diarrhea need to be kept out of school or daycare while having those symptoms.

In situations where home isolation is not possible or additional measures are needed, your local health department may recommend cohorting, or grouping children and staff who display similar signs and symptoms of disease together into one room. This practice effectively separates children and adults recovering from the disease from well children and staff, decreasing the likelihood of disease transmission. Used correctly, cohorting may allow a facility to remain open during an outbreak. It also allows asymptomatic children and staff to return to the facility and parents to return to work. Child care facilities should consult their local health department and their licensing consultant for guidance in designing and implementing an effective cohorting practice.

NC DHHS Guidelines for specific settings

Recognizing food-borne illnesses

CDC investigations

Multi-state outbreaks of food-borne, water-borne, and other enteric (intestinal) illnesses are investigated by the U.S. Centers for Disease Control and Prevention (CDC). When a potential multi-state outbreak is detected, CDC serves as lead coordinator between federal, state and local public health partners to monitor the outbreak, define its size and extent, identify the source and ensure rapid response. CDC also provides assistance in the field to any state requesting it. Learn more about CDC's role in investigating multistate foodborne outbreaks. External link