Outbreak Information

Antibiotic Resistant Organisms (AROs)
Antibiotic-Resistant Organisms (AROs)
CHICA Canada
Management of Multidrug-Resistant Organisms In Healthcare Settings
Jane D. Siegel, MD; Emily Rhinehart, RN MPH CIC; Marguerite Jackson, PhD; Linda Chiarello, RN MS; the Healthcare Infection Control Practices Advisory Committee
Biofilm Testing Report
MBEC Biofilm Technologies Inc.
Multidisciplinary research teams find solutions to industrially relevant biofilm problems, as well as beneficial uses for microbial biofilms at the Montana State University Center for Biofilm Engineering (CBE).
BIOFILMS: Friend or Foe? Portable Document Format (1.49 MB)
Nicole Kenny, Virox Technologies Inc.
Excerpt:“It is interesting to note, that more than 99 per cent of all bacteria in the world exists as part of a biofilm community although, historically, microbiologists have only studied free-floating (planktonic) bacteria.” pg. 7
Biofilms: Microbial Life on Surfaces
Rodney M. Donlan, CDC
Excerpt:“Microorganisms attach to surfaces and develop biofilms. Biofilm-associated cells can be differentiated from their suspended counterparts by generation of an extracellular polymeric substance (EPS) matrix, reduced growth rates, and the up- and down- regulation of specific genes. Attachment is a complex process regulated by diverse characteristics of the growth medium, substratum, and cell surface. ”
Biofilms: Microbial Life on Surfaces
Affinity Laboratory Technologies
Excerpt:“Microorganisms attach to surfaces and develop biofilms. Biofilm-associated cells can be differentiated from their suspended counterparts by generation of an extracellular polymeric substance (EPS) matrix, reduced growth rates, and the up- and down- regulation of specific genes. Attachment is a complex process regulated by diverse characteristics of the growth medium, substratum, and cell surface. ”
Center For Biofilm Engineering
The war against invasive bacteria that stick to surfaces
Agriculture and Agri-Food Canada
Excerpt:“For the food industry, the world of microbes might be compared to a minuscule battlefield, where its allies and its enemies are engaged in a deadly struggle on a microscopic scale. Pathogens and micro-organisms that cause spoilage are particularly formidable adversaries, as they give rise to many economic problems and threats to human health. One major source of contamination is surfaces. Bacteria tend to stick tightly to surfaces, even surfaces that have been meticulously disinfected ”
Clostridium difficile (C.diff)

Protocols/Product Use Instructions - click here

Clostridium difficile (C.diff)
AJIC: American Journal of Infection Control. 33(6):320-325, August 2005. Perez, Justo PhD; Springthorpe, V. Susan MSc; Sattar, Syed A. PhD
Excerpt:“Clostridium difficile is an increasingly common nosocomial pathogen, and its spores are resistant to common environmental surface disinfectants. Many high-level disinfectants (eg, aldehydes) are unsuitable for environmental decontamination because they need several hours of contact to be sporicidal. This study tested the potential of selected oxidative microbicides to inactivate C difficile spores on hard surfaces in relatively short contact times at room temperature. ”
C.Diff - A Sporadic Reservoir?  Portable Document Format (83 KB)
Carla Feltrin RN, BA, CNCC(C), Subhash K. Patel MD, FRCPC, FCAP, Tracey Davey RN, BScN, CPHQ
Clostridium difficile Fact Sheet for Patients
Ministry of Health and Long Term Care
Clostridium Difficile Infectious Diarrhea (431 KB)
Infection Prevention and Control Services Vancouver Island Health Authority
Clostridium difficile Information
Canadian Centre for Occupational Health & Safety(CCOHS)
Excerpt:“"Clostridium difficile (also known as C.difficile) is a bacterium associated with diarrhea and intestinal inflammation among patients or residents in health care facilities."”
Disinfection of Clostridium difficile Spores, AOAC…  Portable Document Format (226 KB)
V. Susan Springthorpe, Justo Perez & Syed A. Sattar
Eliminating Chlostridium difficile from the Health Care Environment
CSSA, Dr. Michelle Alfa
Guidance for the Efficacy Evaluation of Products with Sporicidal Claims against Clostridium difficile Portable Document Format (65 KB)
U.S. Environmental Protection Agency
Unlike US test requirements, Canadian Sporicidal surface disinfectants are tested on a soil challenged surface to more accurately determine their efficacy in an environment more representative of reality. Soiled surfaces present the potential for inactivating certain disinfectant chemistries (ie bleach) and therefore testing with a soil load instils confidence that disinfection can be achieved, even if suboptimal cleaning occurs.
Improved eradication of Clostridium difficile spores from toilets of hospitalized patients using an accelerated hydrogen peroxide as the cleaning agent. Portable Document Format (301 KB)
BMC Infectious Diseases September 2010: Michelle J Alfa, Evelyn Lo, Alana Wald, Christine Dueck, Pat DeGagne and Godfrey KM Harding
C. difficle spores in the environment of patients with C. difficile associated disease (CDAD) are difficult to eliminate. Bleach (5000 ppm) has been advocated as an effective disinfectant for the environmental surfaces of patients with CDAD. Few alternatives to bleach for non-outbreak conditions have been evaluated in controlled healthcare studies.
Excerpt:“Our data indicate that the AHP formulation evaluated that has some sporicidal activity was significantly better than the currently used SHP formulation. This AHP formulation provides a one-step process that significantly lowers the C. difficile spore level in toilets during non-outbreak conditions without the workplace safety concerns associated with 5000 ppm bleach.”
Infection control practices related to Clostridium difficile infection in acute care hospitals in Canada Portable Document Format (2.71 MB)
AJIC Vol. 37, No. 1, February 2009, pg. 9-14 Gravel D, Gardam M, Taylor G, Miller M, Simor A, McGeer A, Hutchinson J, Moore D, Kelly S, Mulvey M; Canadian Nosocomial Infection Surveillance Program.
We carried out a survey to identify the infection prevention and control practices in place in Canadian hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP).
Excerpt:“Although the hospitals used contact precautions quite uniformly, considerable variation was seen among hospitals in terms of testing strategies, cleaning and disinfection protocols and products, and isolation practices. The timing for the initiation of infection control precautions is important to prevent secondary transmission of CDI. Most of the hospitals implemented precautions while waiting for the toxin assay results. ”
Information Factsheet: Questions and answers  Portable Document Format (25 KB)
The Canadian Journal of Infection Control SPRING 2000
Ontario Best Practice Manual for Prevention and Control of Transmission of Clostridium difficile within Healthcare Facilities
Ontario Ministry of Health & Long-Term
This document deals with the prevention and control of the transmission of Clostridium difficile (C.difficile) in acute and non-acute health care settings.
Public Reporting of C. difficile
Ministry of Health and Long Term Care
Excerpt:“Healthcare associated infections are an unwelcome reality in modern health care settings across the globe. Prevention and control of these infections in hospitals is a priority for Ontario and is key to keeping patients safe. The government of Ontario has developed this site to keep the public informed on patient safety related issues at the province's hospitals”
Ebola Virus Disease (EVD)
Free Ebola Resources
Click below for a list of resources on the Ebola virus West Africa outbreak and download our free Virox resources including fact sheets, cleaning and disinfection protocols and Ebola presentations.
Enterovirus D68
Free Enterovirus D68 Resources
Click below for a list of Enterovirus resources including fact sheets, an enterovirus presentation and cleaning and disinfection protocols.
Extended Spectrum Beta Lactamase (ESBL)
Ambler Class A Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella spp. in Canadian Hospitals
American Society for Microbiology
This report describes a study carried out to gain baseline information on the molecular characteristics of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. in Canada.
Emergence of Enterobacteriaceae producing extended-spectrum b-lactamases (ESBLs) in the community
Journal of Antimicrobial Chemotherapy Advance Access published May 25, 2005
This review indicates that ESBL-producing bacteria, especially E. coli producing CTX-M types, from community sources, have become widely prevalent in certain areas of the world and that they are most probably imported into the hospital setting.
Influx of Extended-Spectrum b-Lactamase– Producing Enterobacteriaceae into the Hospital
Chicago Journals
Excerpt:“"The prevalence of infections caused by extended-spectrum b-lactamase (ESBL)–producing Enterobacteriaceae is increasing worldwide. The influx of these bacteria into hospitals has major implications for infection-control and empirical treatment strategies." ”
Outbreaks of Multi-Drug Resistant Escherichia Coli in Long-Term Care Facilities in the Durham, York and Toronto Regions of Ontario, 2000 - 2002
Canada Communicable Disease Report - July 15, 2002 Volume 28 No. 14
This report describes the initial findings of an on-going investigation of related outbreaks of a clone of multi-drug resistant (MDR), extended spectrum beta-lactamase (ESBL)-producing Escherichia coli in long term care facilities in (LTCFs) in the Durham, York and Toronto Regions of Ontario. The purpose of this investigation is to determine the extent and cause of the outbreaks, identify contributing factors, institute control measures and evaluate their impact.
Risk Factors for Colonization with Extended-Spectrum β-Lactamase–producing Bacteria and Intensive Care Unit Admission
Emerging Infectious Diseases - Volume 13, Number 8–August 2007
Excerpt:“"In this study, we identified risk factors for ESBL-producing bacterial colonization among ICU patients. These data may be useful for identifying which patients may warrant empiric ESBL-targeted antimicrobial drug therapy. We also demonstrate that subsequent infections with ESBL-producing bacteria develop in a large percentage of ICU patients colonized with ESBL-producing bacteria." ”
H1N1 Influenza



Free Influenza Resources
Download our free Virox Influenza resources including fact sheets and cleaning and disinfection protocols.
Canada: http://info.virox.com/influenza-outbreak-resources-canada
USA: http://info.virox.com/influenza-outbreak-resources-us
Technical Bulletin – H1N1 Flu (Swine Flu)
Breaking the chain:  Routine cleaning and disinfection of the patients surroundings should be done daily to reduce the risk of transmission using an EPA or DIN registered Hospital Grade Disinfectant with special consideration taken for cleaning and disinfection of hand contact surfaces and non-critical equipment.  For “Comfort and Confidence” a disinfectant technology with the highest level of virucidal activity (meaning can inactivate the gold standard tough to kill non-enveloped viruses such as Norwalk, Rotavirus, Polio and Parvovirus) has obvious advantages.
2009 H1N1 Flu ("Swine Flu") and You
CDC - Centers for Disease Control and Prevention
2009 H1N1 (sometimes called “swine flu”) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) signaled that a pandemic of 2009 H1N1 flu was underway.
Excerpt:“Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including... hydrogen peroxide... are effective against human influenza viruses if used in proper concentration for a sufficient length of time. ”
ASHES Member Advisory: Swine Influenza Portable Document Format (52 KB)
American Society for Healthcare Environmental Services (ASHES)
On April 26, 2009, the CDC issued Key Facts About Swine Influenza as well as Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting.
Environmental Cleaning and Disinfection in the School Environment
Leeds, Grenville & Lanark District Health Unit
Influenza viruses including the pH1N1 (pandemic) strain can survive between 8 to 48 hours on environmental surfaces including hard toys, countertops, door knobs, hand rails, phones, computer keyboards* etc. While these viruses can be inactivated by routine cleaning with commercially available cleaning products, the use of certain disinfectants are also very effective.
Public Health Agency of Canada (PHAC)
All strains of influenza can be dangerous; however, good infection prevention measures can help protect you and others if this virus begins to spread rapidly in Canada. Wash your hands often and thoroughly in warm, soapy water or use hand sanitizer Cough and sneeze in your arm, not your hand Keep common surfaces and items clean and disinfected Stay home if you’re sick, unless directed to seek medical care
Green Cleaning in the Era of H1N1: One School Building Manager's Experience
Healthy Schools Campaign
Bill Thompson, Director of Facilities for Lockport Township High School discusses how schools can work against the spread of H1N1 using green cleaning.
Excerpt:“We began disinfecting desks every other day (Tuesdays and Thursdays) and then on Mondays, Wednesdays and Fridays we use an accelerated hydrogen peroxide cleaner, which has sanitizing properties. ”
H1N1 Decision Chart Portable Document Format (44 KB)
Health Link Alberta
IF YOU HAVE FLU SYMPTOMS: Use the guidelines in this table to help make the best decision for you and your loved ones.
H1N1 Flu Clinical and Public Health Guidance
CDC (Centers for Disease Control and Prevention)
Information regarding guidance for the H1N1 Influneza
Human Cases of Swine Influenza A (H1N1) - Interim Guidance: Infection prevention and control measures for Health Care Workers in Acute Care Facilities  Portable Document Format (151 KB)
Public Health Agency of Canada
This fact sheet has been developed to provide interim guidance to health care workers (HCWs) in the infection prevention and control management of suspect cases with Swine Influenza A H1N1 (swine flu) virus. This infection prevention and control guidance is for HCWs caring for patients with Influenza-like Illness (ILI) suspected to be due to the novel Swine Influenza A H1N1 influenza virus.
Interim Clinical Guidance for Pregnant and Breastfeeding Women with Influenza-Like Illness in the context of the Pandemic H1N1 2009 Virus Portable Document Format (88 KB)
Public Health Agency of Canada (PHAC)
This guidance has been developed by the Public Health Agency of Canada for clinicians to manage pregnant and breastfeeding patients presenting with cough and fever in the context of the pandemic (H1N1) 2009 virus (H1N1 2009).
Interim Guidance for Ambulatory Care of Influenza-Like Illness in the context of H1N1 influenza virus  Portable Document Format (101 KB)
Public Health Agency of Canada (PHAC)
This guidance has been developed for clinicians to manage patients presenting with cough and fever in the context of pandemic H1N1 and other respiratory pathogens. These guidelines highlight the need for infection prevention and control measures, targeted assessment and laboratory testing, and ongoing collaboration with public health.
Interim Guidance for emergency use of oseltamivir (Tamiflu®) In children under one year of age in the context of 2009 (H1N1) pandemic  Portable Document Format (105 KB)
Public Health Agency of Canada (PHAC)
This guidance document has been prepared by the Public Health Agency of Canada to assist clinicians in the management of children under one year of age presenting with Influenza-like-illness (ILI) in the context of the (H1N1) 2009 pandemic.
Interim Guidance for the Management of pandemic H1N1 2009 outbreaks in closed facilities  Portable Document Format (104 KB)
Public Health Agency of Canada (PHAC)
This guidance document has been prepared by the Public Health Agency of Canada to provide guidance to clinicians and public health professionals on the management of pandemic H1N1 outbreaks in closed facilities in which high risk persons reside.
Interim Guidance: Infection Prevention and Control Measures for Prehospital Care
Public Health Agency of Canada (PHAC)
This guidance document is being provided by the Public Health Agency of Canada in response to the Pandemic (H1N1) 2009 outbreak. This guidance is based on current, available scientific evidence about this emerging disease, and is subject to review and change as new information becomes available.
Novel Influenza A (H1N1) Virus - Resources for Dental Professionals Portable Document Format (86 KB)
Organization for Safety and Asepsis Procedures (OSAP)
Excerpt:“As more details emerge, the CDC will be updating the dental profession on recommendations for dental facilities. In the interim, if patients are feeling ill, they should delay dental treatment until they are feeling better. If patients present with flu-like symptoms, they should be referred to a physician for testing. Dental personnel should follow CDC's suggested work restrictions, in the absence of state and local regulations, if they feel they have been exposed to or infected.”
Pandemic (H1N1) 2009 Virus - Links and Resources
CHICA-Canada, Links and Resources
Excerpt:“Confirmed cases of Swine Influenza A/H1N1 have now occurred in Mexico, the U.S., Canada (British Columbia, Nova Scotia), the U.K. (Scotland) and Spain, triggering a global alert for severe respiratory illnesses (SRI) surveillance and control. Officials in Mexico, the U.S. and Canada have been liaising with the World Health Organization to better understand the risk which these SRI events pose.”
Preparing for the second wave: lessons from current outbreaks
World Health Organization (WHO)
Monitoring of outbreaks from different parts of the world provides sufficient information to make some tentative conclusions about how the influenza pandemic might evolve in the coming months.
Routine Cleaning and Disinfection of Commonly Touched Surfaces During Influenza Season
Center for Disease Control (CDC)
Influenza viruses, such as the pH1N1 strain, can be transmitted through hand contact and by contamination of commonly touched items and environmental surfaces such as door knobs, taps, hand rails, phones, computer keyboards, elevator buttons, shared musical instruments, sports equipment, toys, countertops, and so on.
Serious Respiratory Illness is Swine Flu
Fraser Health, BC
Testing has shown that the Serious Respiratory Illness (SRI) in Mexico is a novel reassorted H1N1 swine influenza with gene segments from North American swine and avian influenza, human influenza, and a Eurasian swine influenza. Sequencing is incomplete, but so far is identical to that in 8 California/Texas cases with milder disease. Mexico has increased influenza outbreak control to include closing schools/universities and museums. WHO has activated its strategic health operations centre, in
Swine Flu – General Information
Public Health Agency of Canada (PHAC)
Excerpt:“Human swine influenza has been reported in Canada, Mexico and the United States. The Public Health Agency of Canada (PHAC) is working collaboratively with Mexican and American officials to further investigate this situation. PHAC continues to work with federal, provincial and international governments to address this situation, and will share more information with Canadians as it becomes available.”
Swine Influenza (Flu)
Centers for Disease Control and Prevention (CDC)
Excerpt:“WHO is coordinating the global response to human cases of swine influenza A (H1N1) and monitoring the corresponding threat of an influenza pandemic. Information on this page tracks the evolving situation and provides access to both technical guidelines and information useful for the general public.”
Methicillin-Resistant Staphylococcus aureus (MRSA)
For Protocols, click here
Community-Associated Methicillin Resistant Staphylococcus aureus (CA-MRSA)
Centers for Disease Control and Prevention, October 2007
Drug Resistant Organisms
The Society for Healthcare Epidemiology of America
Facts About Antibiotic Resistance
US Food & Drug Administration
Facts About Antibiotic Resistance
Infectious Diseases Society of America
Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States
Invasive Methicillin-Resistant Staphylococus aureus Infections in the United States
American Medical Association, October 2007
Excerpt:“"Invasive MRSA infection affects certain populations disproportionately. It is a major public health problem primarily related to health care but no longer confined to intensive care units, acute care hospitals, or any health care institution." ”
Management of Multidrug-Resistant Organisms In Healthcare Settings
Jane D. Siegel, MD; Emily Rhinehart, RN MPH CIC; Marguerite Jackson, PhD; Linda Chiarello, RN MS; the Healthcare Infection Control Practices Advisory Committee
More companies focus on preventing staph infections
USA Today
Excerpt:“"The number of people developing a serious MRSA infection in 2005 was about 94,360, according to the CDC. About 14% of all the infections occurred in people without obvious exposure to health care facilities" ”
MRSA and the Workplace
Centers for Disease Control and Prevention, October 2007
MRSA in the Ambulance
Emergency Medicine
Excerpt:“Nearly half of 21 ambulances in a single fleet tested positive for MRSA ”
MRSA in the Dental Office
OSAP, December 2006
MRSA Information
Medline Plus
MRSA: Methicillin-resistant Staphylococcus aureus in Healthcare Settings
Centers for Disease Control and Prevention, October 2007
Multiple Drug–Resistant Bacteria Prevention and Control  Portable Document Format (380 KB)
Association for Professionals in Infection Control and Epidemiology
Overview of Healthcare-associated MRSA
Centers for Disease Control and Prevention, October 2007
Questions and Answers about Methicillin-Resistant Staphylococcus aureus (MRSA) in Schools
Centers for Disease Control and Prevention, October 2007
Swabs in Hand, Hospital Cuts Deadly Infections
Kevin Sack, July 2007
Excerpt:“"MRSA can be brought into hospitals by patients who show no symptoms, and it then thrives in settings where immune systems are weakened and where incisions provide inviting ports of entry. It now accounts for 63 percent of hospital staphylococcus infections, up from 22 percent in 1995." ”
Free Norovirus Resources
Download our free Virox Norovirus resources including fact sheets, cleaning and disinfection protocols, and newsletters.
Canada: http://info.virox.com/norovirus-outbreak-resources
USA: http://info.virox.com/norovirus-outbreak-disinfection

Picture of cruise ship with the AHP logo

A Guide to the Laboratory Investigation of Gastrointestinal Disease Outbreaks Portable Document Format (273 KB)
BCCDC Laboratory Services
The purpose of the guide is to ensure efficient coordination of outbreak laboratoryi investigation. It includes ready reference guidelines for public health officials in the event of gastrointestinal GI) disease outbreaks. It defines roles of the BCCDC Laboratory Services and of the Health Units and Health Care Workers in thei nvestigation an outbreak.
A Norwalk Nightmare Portable Document Format (298 KB)
Sanitation Canada
AHP successful against Norwalk outbreak on cruise ships  Portable Document Format (51 KB)
Virox Technologies Inc.
Excerpt:“In August Health Canada approved the use of AHP as an alternative for the decontamination of surfaces in a Norwalk virus outbreak. This allowed the ship’s staff to decontaminate surfaces safely that would have been otherwise damaged by using a bleach solution. ”
All Hands off Deck! A Hands-On Guide to Fighting a Shipboard Norovirus
Excerpt:“"ship will be undergoing a daily cleaning regimen with a special hydrogen peroxide-based product called Virox 5, that kills germs"”
Bug Fighter Battles Back Portable Document Format (87 KB)
Toronto Star
Cleaning up after Norovirus
Chris Hamlyn
Excerpt:“Cleaners have been busy at Nanaimo Regional General Hospital, trying to keep ahead of an outbreak of Norovirus ”
Cruise Ships are Proactively Fighting the Norovirus War Portable Document Format (162 KB)
Cruise Trade, April 2007
Even though the cruise industry has a far lower incidence of the norovirus than land-based facilities, such as schools and nursing homes, the media and the public still persist in calling the disease “the cruise ship virus.” This is mainly because ships are required to report illness affecting even only 2% of the people on board — something hotels and resorts aren’t required to do — which has brought cruising undeserved notoriety.
Excerpt:“Several cruise lines swear by Virox, an accelerated hydrogen peroxide base formulation. Hart Sugarman, Holland America Line corporate executive housekeeper, said the line has been using Virox 5 since 2001.”
Gastrointestinal Illness Surveillance System  Portable Document Format (273 KB)
Centers for Disease Control and Prevention (CDC)
The following forms are provided as guides to standardize the collection of information required to assess the patterns of gastrointestinal illnesses and monitor for outbreaks aboard vessels. These forms are downloadable at the Vessel Sanitation Program website: http://www.cdc.gov/nceh/vsp
Management of a Norwalk-Like Virus Outbreak Portable Document Format (442 KB)
Dr. Michael Gardam, Director, Infection Prevention and Control, University Health Network
Excerpt:“AHP brings has a 4Log reduction against Feline Calicivirus with a 5 minute contact time" ” pg. 2, Slide 9
Brett Mitchell, Masters Adv.Practice (Infection Control); Dip.Tropical Nursing; "Bachelor of Nursing; Post.Grad.Dip.Mod.Teaching & Assessing; Cert.Healthcare Management" Senior Nurse Manager Infection Control, North Glamorgan NHS Trust, Prince Charles Hospital, Merthyr Tydfil, Wales
Excerpt:“Norovirus is a highly infectious virus which causes gastroenteritis in humans. The high infectivity rate causes rapid spread within the population and particularly in close environments such as hospitals.”
Norwalk-Like Viruses Decontamination Guidelines for Environmental Services  Portable Document Format (157 KB)
Virox Technologies Inc.
This document has been developed in accordance with current applicable infection control and regulatory guidelines. It is intended for use as a guideline only.
Schools latest casualty of fast-moving virus Portable Document Format (68 KB)
Toronto Star
Scientific Solutions To The Norwalk Problem  Portable Document Format (516 KB)
Syed A. Sattar, Ph.D. Professor of Microbiology Centre for Research in Environmental Microbiology (CREM) Faculty of Medicine, University of Ottawa.
Excerpt:“AHP named as an effective disinfectant against the Feline Calicivirus ” pg. 8 slide 2
Some Disinfectants Effective Against Feline Calicivirus (as a surrogate for Norovirus) Portable Document Format (34 KB)
Syed A. Sattar, Ph.D. Professor of Microbiology Centre for Research in Environmental Microbiology (CREM) and Robert E. Wheeler, MD, FACEP
Excerpt:“A Log10 reduction of 4 (99.99%) or greater is considered adequate for FCV/Norovirus disinfection. Products listed as non-toxic may still cause mild eye and/or skin irritation in some people. Some compounds may leave a surfactant residue on various surfaces. When selecting a disinfectant, it’s important to consider the product’s entire formulation since there may be significant disinfectant action synergism produced by the specific combination of ingredients.”
Strategies for Norovirus Infection Control Aboard Cruise Ships - Power Point Presentation  Portable Document Format (1.26 MB)
Robert E. Wheeler, MD, FACEP
Excerpt:“"AHP named as a disinfectant with proven efficacy against Norovirus" slides 35&37 ” pg. 6, Slide 35 & 37
The Centers for Disease Control and Prevention (CDC) lists AHP for use against Norwalk Virus"
The Centers for Disease Control and Prevention
This report describes five of the norovirus outbreaks that occurred during July 1--December 2, 2002, on cruise ships.
Updated Infection Control Measures for the Prevention and Control of Influenza in Health-Care Facilities
Centers for Disease Control and Prevention
This document provides general guidance for prevention and control of influenza transmission in acute care facilities. Links to recommendations for the 2007-08 influenza season are provided.
Vessel Sanitation Inspection Report  Portable Document Format (72 KB)
Viral Gastroenteritis Outbreak Guidelines For Community Living Facilities (PDF doc)  Portable Document Format (586 KB)
Washoe County District Health Department
Washed Away? Not Yet.  Portable Document Format (1.20 MB)
Anne Kalosh
Excerpt:“Personally, he favours Accelerated Hydrogen Peroxide because ‘it meets all criteria I look for, is versatile, priced affordably and safe to use. ‘Widely used shoreside in Canada, AHP is highly effective against norovirus and is expected to gain approval as a disinfectant by the US Environmental Protection Agency in 2005.” pg. 2
Porcine Epidemic Diarrhea Virus (PEDV)
Free Porcine Epidemic Diarrhea (PEDV) Resources
Click below for a list of PEDV resources
Severe Acute Respiratory Syndrome (SARS)
Chapter Two: Infection Control  Portable Document Format (184 KB)
The Walker Report
Excerpt:“The SARS outbreak highlighted a problem that has received far too little attention in the past decade, despite being raised as far back as December 1994 at the Lac Tremblant Declaration.1 The problem is infectious disease control. Prior to the outbreak, many people within different parts of the healthcare sector, as well as the Ministry of Health and Long-Term Care, had a false sense of security with respect to infectious disease control. ”
Classes of Microorganisms Ranked in Descending Order from Least to Most Susceptible to Chemical Disinfectants  Portable Document Format (118 KB)
Laboratory Centre for Disease Control, Health Canada
The article highlights which level of disinfection should be used against spores, mycobacteria, fungi, vegetative bacteria, and enveloped viruses
Directive to all Ontario Non-Acute Care Facilities Under Outbreak Conditions Portable Document Format (151 KB)
Ministry of Health and Long-Term Care
This document practices directs non-acute care facilities to undertake the following practices in the event of an outbreak of SARS. It applies to health care workers and settings that provide direct clinical services to patients or clients in non-acute care facilities. Non-acute care facilities include: Complex Continuing Care Hospitals, Rehabilitation Hospitals, Long-Term Care Facilities, Private Hospitals, Specialty Hospitals, Psychiatric Hospitals, Children’s Treatment Centres and indepe
Excerpt:“Hospital grade disinfectants that may be used include stabilized accelerated hydrogen peroxide products...”
FACT SHEET - Basic Information About SARS
Centers for Disease Control and Prevention (CDC)
Frequently Asked Questions from Paramedics  Portable Document Format (73 KB)
Toronto Works & Emergency Services
Health Canada’s Preparedness for and Response to Respiratory Infections Season and the Possible Re-emergence of SAR, Fall/Winter 2003-04 as of Nov 19/03  Portable Document Format (100 KB)
Health Canada
Excerpt:“The importance of sustained commitment to effectively managing infectious diseases that threaten the health of populations is clear. Events of the past 12 months have reinforced some of the well-established public health frameworks within the federal as well as provincial and territorial systems but have also served to strengthen the resolve of public health administrators and front line workers to keep watch, act quickly and stay in touch with each other, especially in the face of emerging respiratory infections. ”
Infection control and anesthesia: lessons learned from the Toronto SARS outbreak
Canadian Journal of Anesthesia
Protocols and Guidelines - Severe Acute Respiratory Syndrome (SARS)
Mount Sinai Hospital
Public Health Management of Cases and Clusters of Severe Respiratory Illness (SRI) in the SARS Post- Outbreak Period, Version 1: November 6, 2003  Portable Document Format (128 KB)
Health Canada
The purpose of this document is to provide baseline national recommendations for the public health management of specific scenarios or "alerts" identified through enhanced surveillance for severe respiratory illness (SRI) in the SARS post-outbreak period (See "Surveillance for Severe or Emerging Respiratory Infection in the SARS Post-Outbreak Period" http://www.sars.gc.ca/ ). If SARS re-emerges then it is expected that the guidelines referring to the SARS "outbreak period" will become the approp
S.A.R.S. - Questions and Answers (June 20, 2003)  Portable Document Format (79 KB)
Ministry of Health and Long-Term Care
SARS (Severe Acute Respiratory Syndrome) Outbreak Period  Portable Document Format (77 KB)
Health Canada
SARS Infection Control and Exposure Management
Centers for Disease Control and Prevention (CDC)
SARS outbreak in the Greater Toronto Area: the emergency department experience  Portable Document Format (71 KB)
Canadian Medical Association
Excerpt:“We outline the process successfully followed by 4 Toronto emergency departments (at Mount Sinai Hospital, North York General Hospital, Sunnybrook and Women’s College Health Sciences Centre and the Hospital for Sick Children) involved in the assessment and treatment of 276 suspect and probable SARS cases... ”
SARS Update for March 25, 2003  Portable Document Format (57 KB)
Peter Macintyre, Manager, Community Safeguard Services
Excerpt:“There are now three Toronto paramedics in hospital being treated for what appears to be SARS. Only one of them is considered to be a probable case. The other two are suspected cases only. At the request of the family of one of the involved medics, we can state that he is feeling much better, his fever has broken, and despite rumours to the contrary, has not been intubated, nor has he suffered a cardiac arrest. Our thoughts are with all three paramedics and their families. ”
Studies of SARS Virus Survival  Portable Document Format (128 KB)
World Health Organization (WHO)
Scientists in the WHO network of collaborating laboratories yesterday reported results of the first scientific studies designed to determine the survival time of the SARS virus in different environmental media
Surveillance for Severe or Emerging Respiratory Infections in the SARS Post-Outbreak Period, Revised November 19, 2003  Portable Document Format (123 KB)
Health Canada
On 14 August 2003, the World Health Organization (WHO) developed guidelines for Alert, verification and public health management of Severe Acute Respiratory Syndrome (SARS) in the SARS post-outbreak period (see http://www.who.int/csr/sars/postoutbreak/en/). On 10 and 11 September 2003, Health Canada hosted an international meeting of experts to discuss enhanced surveillance and case definitions. At the meeting it was agreed that individual countries, particularly developed countries, need to ada
The Significance of a General Virucide Claim Based Upon the Efficacy Against the Polio Virus Portable Document Format (44 KB)
Therapeutics Products Programme Guidelines: Disinfectant Drugs
Excerpt:“If you do not demonstrate performance against the Polio Virus it is then required that you test and demonstrate performance against specific pathogens (product sold under Virox 5, Percept, Accel, Peroxigard).” pg. 2
Toronto's Dance With SARS  Portable Document Format (60 KB)
Paul Webber
Excerpt:“Several days after her Continental Airlines flight from Hong Kong touched down in Toronto, family matriarch Kwan Sui-Chu died quietly from flu-like symptoms at her suburban home. She had not been to a hospital, and once symptomatic, she had not circulated in the general population - her cause of death was listed as "heart attack." "Nobody knew about SARS at the time; her death did not trigger anything in the coroner’s mind," said Dr. Jim Cairns, Ontario’s deputy chief coroner. If SARS had been limited to Sui-Chu, Toronto’s first SARS outbreak might never have happened. Unfortunately, it wasn’t limited, and through a series of events, it was about to get legs. ”
Training Bulletin, Issue Number 103, Version 1.1 Severe Acute Respiratory Syndrome (SARS) Portable Document Format (479 KB)
Ministry of Health and Long-Term Care
Excerpt:“Following the transport of a patient with suspected SARS, EMA's and Paramedics must decontaminate the vehicle, stretcher and any equipment used during the call. It is recommended that Virox-5™, an accelerated hydrogen peroxide base formulation, be used as the disinfectant of choice for this purpose. Studies have concluded that Virox-5™ is over 99% effective in disinfecting surfaces when used according to manufactures specifications. The product is therefore suitable for use as a high level disinfectant and is safer than many other broad-spectrum germicides.” pg. 6
Vessel Sanitation Inspection Report  Portable Document Format (72 KB)
Virucidal Effectiveness Test: Coronavirus Portable Document Format (467 KB)
M. Khalid Ijaz, DVM, Ph.D.
Excerpt:“AHP (products sold under Virox 5, Percept, Accel, Peroxigard) passed the Virucidal Effectiveness Test when Coronavirus was exposed to the test material for 5 minutes” pg. 10
Other Emerging Outbreaks
Zika Virus Fact Sheet  Portable Document Format (72 KB)
Virox Technologies Inc. 
Excerpt:“The rapid spread of Zika virus through the Americas, together with the possible association of the infection with microcephaly and the Guillain-Barré syndrome have propelled this previously ignored virus into the limelight."
Ebola Resorces Page 
Virox Technologies Inc.