Outbreak Information, Guidance and Education
This page provides information and guidance to help prepare for, and support people, with common illnesses which can be linked to outbreaks.
You will find information on prevention, testing and control of illnesses, including, respiratory and gastrointestinal infections and scabies. Some of these illnessess tend to happen during the Winter months and may be referred to as Winter illnesses or bugs.
Winter preparedness will be posted on this page September/October 2025.
**Please note**
All documents and links on this page are reviewed (at least) annually, usually in the run up to Winter, please always check that you are using the most up to date version of any document.
The most up to date national information and guidance can be can be found online within Care Home Infection Prevention and Control Manual (CH IPCM) .
Video: Overview of common illnesses and related measures
This short video has kindly been shared by East Region Health Protection Service and covers common respiratory and gastrointestinal illnesses. These are most common during Winter although they may occur at other times of the year. This video includes:
- How to identify and interventions to limit transmission of illness and outbreaks.
- Testing processes and infection outbreak management
General Infection Control – includes PPE
Personal Protective Equipment:
Personal protective equipment such as gloves and aprons are vital everyday equipment for assisting with personal care.
At times of infections in individuals or outbreak situations additional PPE may be required to play a vital role in helping prevent or lessen the chance of outbreak – protecting staff and other residents from illness and infection.
For current information on what PPE to use, storage of PPE and other related infection prevention and control information please see the national guidance Care Home Infection Prevention and Control Manual (CH IPCM); additionally there is also the Health Improvement Scotland (HIS) Infection, Prevention and Control Standards
It is vital that personal protective equipment is used correctly, this includes the putting on (donning) and taking off (doffing) of equipment such as gloves and aprons. The resources below are provided to demonstrate the correct process.
Video
The correct order for putting on, removing and disposing of PPE.
Care Home Infection Prevention and Control Manual (CH IPCM)
Gastrointestinal Illness – includes Norovirus
Gastrointestinal Illnesses, in particular norovirus, are more prevalent in the Winter months but can happen at other times of the year; they can affect people living in Care Homes, relatives and staff.
Below is a selection of guidance to help support care homes support the management of suspected and confirmed cases of Gastro-intestinal illness of an infectious nature amongst residents
National Guidance:
The most up to date information regarding care home Gastro-intestinal illness and infection prevention and control, can be found in the resource developed by ARHAI Scotland.
Care Home Infection Prevention and Control (IPC) Resource for Gastro-intestinal illness
It is recommended that you access the information online through the link to ensure the most up to date information and guidance is accessed.
Respiratory Illness – Including testing
Respiratory Illnesses are most common in the winter months but can happen all year round, affecting people living in care homes, relative and staff.
Below is a selection of guidance to help support care homes support the management of suspected and confirmed cases of respiratory illness of an infectious nature amongst residents
National Guidance:
The most up to date information regarding care home respiratory illness and infection prevention and control, can be found in the resource developed by ARHAI Scotland and Public Health Scotland
Care Home Infection Prevention and Control (IPC) Resource for Respiratory illness
It is recommended that you access the information online through the link to ensure the most up to date information and guidance is accessed.
Respiratory Infection and Testing – RESIDENTS
Respiratory Testing and PCR: Residents
In February 2023 a local policy was agreed re the testing and management of respiratory illnesses (including Covid-19). This policy is still in place, please see below for more details.
Summary of Testing Pathway
Please see the documents below for full details
- A Care Home will notify the Health Protection Team (HPT) if two or more residents have respiratory symptoms
- Where HPT suspect an outbreak they will advise the Care Home to carry out PCR testing on up to 5 symptomatic residents
- Staff will carry out testing on identified residents and manage the samples as detailed in the documents below
- The Care Home calls HPT for the results of testing
**Please Note**
- The Care Home Programme team have sent out 10 PCR testing kits to each Care Home for winter respiratory testing for suspected outbreaks
- PCR testing should not be carried out for a suspected outbreak unless HPT have advised this
- PCR testing requested by other health professionals, such as a GP or ANP, should be carried out by the clinician requesting the test and the PCR tests should also be supplied by them – PCR test kits for outbreak management should only be used for outbreak management testing
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Respiratory Infection and Testing – STAFF
This poster has been devised as a quick guide to aid staff and managers on the latest guidance to respiratory testing for staff and guidance on symptoms in relation to attendance at work.
**Please note ** although this is titled “Winder Guidance” it is relvant all year round.
Scabies
This infectious mite skin condition can can be found in many areas, including, Care Homes and schools.
Please find below a link to a Webinar available in the National Infection Prevention and Control manual (NIPCM) with a comprehensive update on Scabies.
Care Home Outbreak Box
How the boxes originated, information, feedback and questions
The Care Home Outbreak Box was initially suggested by the Midlothian Care Home Support Team (CHST) during Winter preparedness discussions and how we may be able to assist Care Homes with outbreaks or suspected outbreaks in a way useful to them.
The opportunity for a box was then discussed at NHS Lothians weekly Operational Group Meeting, which has representatives from NHS Lothian, the four HSCPs, Care Inspectorate and Scottish Care.
It was suggested that we asked the Care Homes if they thought this type of box would be useful and 99% of respondents agreed that it would be a good resource to have access to.
100 boxes were created and offered to all Care Homes in Lothian, in December 2024 these were distibuted by the Care Home Support Team (CHST) in each local authority area. The uptake was very encouraging with the majority of Care Homes accepting a box.
After the initial supply of an outbreak box Care Homes are required to keep information up to date themselves with assistance as required from their CHST. Relevant documents will also be placed on this webpage to assist with updating materials.
The team behind the the Care Home Outbreak Box has been collating information to gain feedback on the boxes; what worked well and what didn’t work so well in relation to the boxes during an outbreak or suspected outbreak – so that we can ensure they meet the needs of Care Homes.
If you wish to give feedback on the Care Home Outbreak Box , ask questions or gain more information please do not hesitate to email NHS Lothian Quality Improvement Team for Care Homes and Primary Care Settings or contact your local CHST.
What is a Care Home Outbreak Box?
Although it is recognised Care Homes manage outbreaks of infection well, the idea of the Care Home Outbreak Box is to have outbreak information and resources available in one central point within the Care Home.
The Care Homes outbreak box aims to contain information required during an outbreak and contains guidance and posters on various aspects from PPE to sampling procedures.
It is entirely voluntary if a Care Home chooses to have or use an outbreak box although the East Region Health Protection Service (formerly Health Protection Team (HPT)) do encourage their use during outbreaks or suspected outbreaks.
We do not have any physical outbreak boxes remaining, however, you can download all the materials below.
What is in a Care Home Outbreak Box?
The Care Homes Outbreak Box consists of a label for the box, contents list, a red folder (gastrointestinal illness), a blue folder (respiratory illness) and additional information, such as, posters for outbreaks and posters with QR codes to take people to relevant guidance.
**Please note** All items below will open in this window, to return to this page please press the back button on your browser. Alternatively, you can right click on your mouse and select “open link in a new tab”.
Red Folder
Gastrointestinal Illness
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Blue Folder
Respiratory Illness
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Additional Information
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Updated June 2025 HS
Vaccinations
As vaccination schedules change frequently the best place to find information about vaccines for people over the age of 65 is the immunisations page on NHS Inform.
Staff vaccinations will be communicated nearer the time on the latest news section of this website.
