Respiratory Illness and Gastrointestinal Illness Outbreak Reporting

This survey is intended for:

K-12 schools to report respiratory illness outbreaks (e.g., COVID-19, influenza, RSV) and/or gastrointestinal illness outbreaks (e.g., vomiting, diarrhea) to the Minnesota Department of Health.

Child cares (e.g., licensed, certified, family/home) to request technical assistance regarding respiratory illness (e.g., COVID-19, influenza) from the Minnesota Department of Health and/or report gastrointestinal illness outbreaks (e.g., vomiting, diarrhea) to the Minnesota Department of Health.

For other school and child care infectious disease reporting (e.g., chicken pox, measles, pertussis), please visit the Minnesota Department of Health website: Methods of Reporting Disease

Institues of higher education should report gastrointestinal illness outbreaks (e.g., vomiting, diarrhea) to the Minnesota Department of Health by phone or email using the contact information found on the Minnesota Department of Health website: Reporting Suspected Foodborne and Waterborne Illness

Today's Date

M-D-Y

Reporter's Name

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Reporter's Email

* must provide value

Reporter's Phone Number

* must provide value

Facility Type

* must provide value

School (public, private/independent, charter)

Child Care (licensed, certified, family)

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School Name

* must provide value

If Other, please enter school name

* must provide value

School district number

Total student enrollment

* must provide value

Type of Child Care

* must provide value

Child care center

Family (in-home) childcare

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Child Care Name

* must provide value

If Other, please enter child care name

* must provide value

Child Care Name

* must provide value

DHS License Number

* must provide value

City

* must provide value

Total staff in building

* must provide value

County

* must provide value

What category of illness would you like to report?

* must provide value

Respiratory Illness (e.g., COVID-19, influenza)

Gastrointestinal Illness (e.g., norovirus, vomiting/diarrhea, stomach bug)

Both Respiratory AND Gastrointestinal Illness

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Please select the category of illness you are experiencing in your childcare.

* must provide value

Respiratory illness (e.g., COVID-19, influenza, RSV)

Gastrointestinal illness (e.g., norovirus, vomiting/diarrhea, stomach bug)

Both respiratory AND gastrointestinal illness

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Respiratory Illness Alert and Technical Assistance Request

Certified child care centers, licensed child care centers, and licensed family child cares are no longer required to report cases of COVID-19 as of August 1, 2023.

If you have questions about respiratory illness (e.g., COVID-19, influenza, RSV) in your child care and would like technical assistance from MDH, please use the form below to describe your situation and mark the type of follow up you would prefer.

Please describe the respiratory illness trends that you are experiencing in your child care (e.g., ill children in same room, children experiencing similar symptoms, etc.)

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Would you like follow up from MDH regarding COVID-19?

Selecting "Yes" will alert MDH staff to follow up with you as soon as possible; MDH may follow up with you at a later date even if "No" is selected.

* must provide value

Yes

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Would you like follow up from MDH regarding influenza?

Selecting "Yes" will alert MDH staff to follow up with you as soon as possible; MDH may follow up with you at a later date even if "No" is selected.

* must provide value

Yes

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Would you like follow up from MDH regarding other respiratory illness (other than COVID-19 and/or influenza)?

Selecting "Yes" will alert MDH staff to follow up with you as soon as possible; MDH may follow up with you at a later date even if "No" is selected.

* must provide value

Yes

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If Other, please describe the respiratory illness for which you are requesting follow up

Respiratory Illness Reporting Threshold

Student Threshold:

10% of total student enrollment in a school building out with respiratory illness on a given day - this includes any students out sick or sent home sick with either or both of the following:

A confirmed respiratory illness diagnosis of COVID-19, influenza, RSV, etc.
Any respiratory symptoms such as cough, sore throat, runny nose/congestion (these respiratory symptoms may or may not be accompanied by fever, headaches, muscle aches).

For the purposes of meeting the reporting threshold, if symptom or diagnosis information is unavailable for some ill or absent students, you can assume that they DO have respiratory symptoms.

Staff Threshold:

When the 10% student threshold is met, please also report the total number of staff out with respiratory illness on that day.

First Date Threshold Met

* must provide value

M-D-Y

Number of students absent with respiratory illness

* must provide value

Percentage of students out with respiratory illness

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Number of staff absent with respiratory illness

Percentage of staff out with respiratory illness

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If known, please enter the number of students and/or staff with a known respiratory illness diagnosis. For reporting purposes, a test result (e.g., home test, point-of-care test) or a healthcare provider diagnosis may be considered a confirmed diagnosis.

	Students	Staff
COVID-19
Influenza
RSV
Strep Throat
Other

If Other, please describe respiratory symptoms and/or respiratory illness diagnosis(es)

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Please provide additional details about any trends that you have observed among students and/or staff with respiratory illness (e.g., students/staff in the same classroom, students/staff participating in the same extracurricular activity, students/staff that attended the same event).

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Would you like MDH to follow up with you regarding the respiratory illness at your school?

Selecting "Yes" will alert MDH staff to follow up with you as soon as possible; MDH may follow up with you at a later date even if "No" is selected.

* must provide value

Yes

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Thank you for reporting the respiratory illness outbreak at your school. You will receive a follow up survey in seven days to provide updates on the status of this outbreak.

You do not need to submit additional respiratory illness outbreak reports using this form if the 10% student threshold is met within the next 14 days.

If you would like technical assistance from MDH in the interim, please contact us via email at health.schools.covid19@state.mn.us and/or health.vpd.report@state.mn.us.

If you would like to order additional COVID-19 test kits for your school, please submit a request via REDCap: https://redcap.health.state.mn.us/redcap/surveys/?s=3J8TDDC7E4HJPNNM

Click here for additional respiratory illness resources for schools and child cares.

Infectious Disease Information

Hennepin County Infectious Disease Manual
- Infectious diseases | Hennepin County

Gastrointestinal Illness Reporting

Gastrointestinal illness may include: norovirus, vomiting/diarrhea, a stomach bug, or other (e.g., Salmonella, E. coli)

By Minnesota state law (Minn. Rules part 4605.7050), "any pattern of cases, suspected cases, or increased incidence of any illness beyond the expected number of cases in a given period" shall be reported immediately to MDH. This includes suspected outbreaks, increases in gastrointestinal illnesses, or unusual disease activity at your school. Examples of when to report include:

Illnesses above established baseline (i.e., more than what you normally see): Determine what the baseline incidence of gastrointestinal illness is in your school based on daily absence records. Report to MDH when the number or percent of illnesses rises above your baseline (e.g., double the number of absences due to vomiting or diarrhea).
Multiple cases in one classroom or group (e.g., sports or other activity groups)
More staff calling in sick with gastrointestinal symptoms than usual

Type of School

Select all that apply

Elementary School

Middle School

High School

Other

If Other, please describe type of school

Date of earliest gastrointestinal illness onset (i.e., when did the first person get sick)

* must provide value

M-D-Y

How many students and staff are sick with gastrointestinal illness (vomiting/diarrhea)?

	Total Number	Number Sick
Students	______
Staff	______

How many attendees and staff do you have in total?

How many are sick with gastrointestinal illness (vomiting/diarrhea)?

	Total Number	Number Sick
Attendees/Kids
Staff

Percentage of students with gastrointestinal illness

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Are any of the ill staff food service/dietary staff?

* must provide value

Yes

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Number of food service/dietary staff out with gastrointestinal illness

* must provide value

Date of earliest gastrointestinal illness onset among food service/dietary staff

* must provide value

M-D-Y

Percentage of staff with gastrointestinal illness

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Please select all the symptom(s) that any of the ill individuals are experiencing

* must provide value

Diarrhea

Vomiting

Fever

Other

If Other, please describe symptoms

* must provide value

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Has anyone (attendee and/or staff) had a gastrointestinal illness diagnosis OR had a stool sample tested?

* must provide value

Yes

Unknown

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Please provide additional details on the diagnosis and/or stool sample results

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Please provide additional details about any trends that you have observed among attendees and/or staff with gastrointestinal illness

(e.g., individuals in the same classroom, individuals participating in the same activity, individuals that attended the same event)

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Would you like MDH to follow up with you regarding the gastrointestinal illness at your school?

Selecting "Yes" will alert MDH staff to follow up with you as soon as possible. MDH may follow up with you at a later date even if "No" is selected.

* must provide value

Yes

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Thank you for reporting the gastrointestinal illness outbreak at your school. Next, please complete the steps below:

Follow the checklist in this toolkit to prevent the spread of illness: 2020-2021 Norovirus Information for Schools (state.mn.us)
Complete the Student Gastrointestinal Illness Log and the Staff Gastrointestinal Illness Log and send via email to health.foodill@state.mn.us

If you have any questions or concerns, call us at 1-877-FOOD-ILL (877-366-3455) or email us at health.foodill@state.mn.us.

Additional gastrointestinal illness information can be found on the Minnesota Department of Health website:

Outbreaks at Schools, Child Care, and Long-term Care Facilities - MN Dept. of Health (state.mn.us)

Thank you for reporting the gastrointestinal illness at your child care. MDH will review your report and will follow up with you right away, if necessary.

If you have any questions or concerns, call us at 1-877-FOOD-ILL (877-366-3455) or email us at health.foodill@state.mn.us

Additional gastrointestinal illness information can be found on the Minnesota Department of Health website:

Child Care Provider Information on Diarrheal Illness

MMWR Week

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Respiratory Illness and Gastrointestinal Illness Outbreak Reporting

Infectious Disease Information

COVID-19 Information

Influenza Information

RSV Information

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