Toilet isolation lifted this morning

There have been no new reports of residents being unwell with diarrhoea and vomiting for over 36 hours.

This morning, as each toilet block is cleaned, the yellow triangle and green tick signs will be removed and all bathrooms will be back in normal use for everyone except:

• on the first floor, the single toilet next to room 128; and
• on the second floor, the single toilet next to room 228.

These two toilets will be for the exclusive use of people who have had any diarrhoea and/or vomiting within the last 48 hours.

If you have had diarrhoea and/or vomiting within the last 48 hours, we ask that you please only use one of these two toilets, until you have been free from symptoms for 48 hours.

We should be able to return these two toilets to normal use tomorrow or Wednesday, provided no one else becomes unwell.

Food poisoning investigation

The pattern of cases of diarrhoea & vomiting so far is more suggestive of person-to-person spread than of food poisoning, but we always conduct a full investigation into food safety whenever there is an outbreak of this type of illness in Hall.

The catering team will send food samples for analysis if there is any food left from Thursday night, which is when most people became unwell. 

It is also really helpful if anyone who is unwell sees their GP and has a stool sample sent for analysis. This is the only sure way to determine what the cause of this illness is.

Finally, we ask that everyone who has been affected completes this form and sends it to info.connaught@london.ac.uk or hands a printed copy to the Hall Manager on Monday morning:

connaught-hall.org.uk/documents/AllegedFoodPoisoningReport.doc

D&V: Fewer notifications in last 24 hours

Only two new notifications of people being unwell with diarrhoea and vomiting have come through in the last 24 hours. If there are no more notifications overnight tonight, we may be able to reduce the number of toilets reserved for sick people on Sunday morning.

It is extremely important that if you are unwell with diarrhoea and vomiting today - or if you have been in the last two days, but haven't told us yet - that you tell us by email. If we don't have accurate numbers and locations of those who are sick, we cannot make a proper assessment of when to relax the isolation precautions, and we cannot help you individually if we don't know you're unwell!

We need you to tell us by email: not in person, telephone, Facebook, or any other means. This helps us to keep an accurate log and ensures that everyone who needs to know does know in a timely manner. 

So if you are or have been unwell in the last two days, please send an email to both wardens.team@connaught-hall.org.uk and info.connaught@london.ac.uk. Please send an email even if you have already told a member of staff verbally or by some other means.

In your email, please mention:

• your name and room number;
• what are your symptoms? (e.g. diarrhoea, vomiting, fever?);
• when did your symptoms first start?;
• did you eat in the dining hall at Connaught Hall on Thursday night, and if so, what did you eat?
• do you need any practical help from us right now?

There is lots of information about this outbreak, and tips on how to look after yourself if you are diarrhoea and/or vomiting, at connaught-hall.org.uk/vomiting.html. 

Updates are being posted here on my blog. You can see them all at connaughthall.blogspot.co.uk/search/label/vomiting%20February%202014.

Getting food from the dining hall if you are unwell

If you are currently unwell with diarrhoea and/or vomiting, or have been within the last 48 hours, please try to limit the number of visitors you have and don't eat in the dining hall.

We have asked the kitchen to let your friends collect food for you over the weekend, and bring it to your room. Please get in touch with a friend and ask them to collect your meals for you.

If we stop the spread of this illness promptly now, it will be much easier to contain. We all have a part to play but isolating ourselves if we are sick, helping friends, and making sure we all wash our hands with soap and water frequently.

Handwashing

Washing your hands with soap & water is the most important thing you can do to prevent the spread of illnesses like flu and norovirus.

It is really important that you wash your hands with soap and water frequently, and ALWAYS:

• after using the bathroom;
• after coughing, sneezing, or vomiting;
• after contact with someone who is unwell;
• before eating or preparing food.

Full information about self-care and handwashing, etc, at http://www.connaught-hall.org.uk/vomiting.html.

Separate toilets for people with diarrhoea & vomiting

We now have 9 residents who have told us they are unwell with diarrhoea and/or vomiting. The true number is likely to be higher and some may have already contracted the illness but not developed symptoms yet.

To help prevent the spread of infection, s

ome bathrooms have been designated for the exclusive use of people who are unwell, and some for the exclusive use of people who have not been unwell for at least 48 hours. 

If you're unwell (or have been within 48 hours), only use bathrooms with a yellow triangle. 

If you are well (and haven't been unwell in the last 48 hours), only use bathrooms with a green tick.

And always... wash your hands!

Full information about self-care and handwashing, etc, at http://www.connaught-hall.org.uk/vomiting.html.

Have you been unwell in the last 24 hours?

We are aware of a number of cases of diarrhoea and vomiting in the Hall. It is vital that we establish how many people are affected, so we can put infection control precautions in place if necessary.

If you've been unwell with diarrhoea and/or vomiting in the last 24 hours, please email us ASAP at wardens.team@connaught-hall.org.uk and info.connaught@london.ac.uk. We need to know:

a) your name and room number;

b) what are your symptoms? (e.g. diarrhoea, vomiting, fever?);

c) when did your symptoms first start?;

d) did you eat in the dining hall at Connaught Hall on Thursday night, and if so, what did you eat?

e) do you need any practical help from us right now?

We will use your email to keep a list of everyone affected, and a member of staff will check that you're OK within 8 hours of receipt. If you need help more urgently, contact reception (extension 8200) and ask for the Duty Senior Member, available 24 hours a day over the weekend. If lots of people are affected, we may need to set up separate toilets for those who are ill, so as to avoid spreading their illness to others. We always notify our caterers of any outbreak of diarrhoeal illness in Hall, so they can commence an investigation into any possible allegations of food poisoning, although a viral illness such as Norovirus is more likely.

If you are ill with diarrhoea and vomiting, please visit your GP today if possible, tell them several residents have been unwell with the same symptoms, and ask if they will send a stool sample for you. This will help us work out which bug has caused people to be unwell, and maybe where ...it came from.

Remember to drink plenty of clear fluids, use paracetamol to relieve pain and/or fever, and let a friend know that you're unwell. Please observe strict hygiene in the bathrooms to avoid passing any bugs to others! There is more advice about self-treatment of diarrhoea and vomiting here: nhs.uk/Conditions/Diarrhoea/Pages/Treatment.aspx.

If you are not affected by any symptoms, please remember to wash your hands thoroughly with soap and water after using the bathroom or visiting anyone who is unwell. This will help ensure you don't catch anything.

I have put up more information on a dedicated page on our website: connaught-hall.org.uk/vomiting.html. 

Visit this link for blog updates on the situation: connaughthall.blogspot.co.uk/search/label/vomiting%20February%202014 

Sickness absence

EDIT - THURSDAY 8th NOVEMBER - I have now resumed full and normal duties in my role as Warden at Connaught Hall.

I will be away from my normal Warden duties due to sickness for the next few days.

If you need help urgently, please contact the Hall Office (Mon-Fri, 8-6) or the Duty Senior Member (all other times). They are authorised to contact the Warden of another intercollegiate hall for advice if necessary in an emergency.

For routine matters, please email wardens.team@connaught-hall.org.uk. The Senior Members will deal with straightforward issues; I will take up the more complex, but non-urgent, matters when I return to work.

I expect to continue as planned with my scheduled open office sessions: http://openoffice.connaught-hall.org.uk, but will publish an update if there are any changes to this.

Remember, you can find answers to many questions about Hall life on the Hall website - www.connaught-hall.org.uk, in the Residents' Handbook - http://handbook.connaught-hall.org.uk and in the FAQs section of this blog - http://faq.connaught-hall.org.uk.

This poster details the right people to contact for specific types of problems in Hall:
http://www.connaught-hall.org.uk/documents/Connaught-Hall-help-and-advice.pdf.

This poster contains details of reputable external sources of help & advice:
http://www.connaught-hall.org.uk/documents/Connaught-Hall-help-poster.pdf.

I am sorry for any inconvenience caused by my temporary absence from normal duties.

No new cases of D&V this weekend

There have been no new cases of D&V reported in Hall since Thursday evening (more than 48 hours ago). Well done everyone and thank you for helping to contain the virus.

Toilet restrictions lifted

We now have microbiological confirmation that our outbreak of diarrhoea & vomiting was caused by Norovirus. This is extremely unlikely to have originated from the kitchen, but the catering investigation will continue, so if you were affected by this outbreak, please return a "food poisoning allegation" form to the Bursar's Office as soon as you can.

There have been no new cases today.

We have removed the signs designating toilets for affected and unaffected people. All the communal toilets are now back to normal. The hand sanitisers will remain in place until further notice. Please continue to practice rigourous hand hygiene, until we get the all clear from the health agency.

If you or anyone has diarrhoea or vomiting symptoms then please contact the Senior Member on duty over the weekend or email: sicknessreporting@connaught-hall.org.uk.

If the toilets or bathroom areas become soiled / blocked with sick or diarrhoea then please report this immediately to reception and they will contact maintenance to clean any soiled areas.

Laundry: wash your bed sheets and clothes on the hottest temperature the fabric can take. Use the "whites" or "hot" feature on the washing machine; this should be up to 60 degrees - but make sure your clothes can be safely washed at this temperature first. Contact the Bursar's Office if you have any visibly soiled bed linen.

We all hope everyone who was affected is now feeling much better.

Update on outbreak of diarrhoeal illness

In the last 24 hours, we have received 8 new notifications from residents who are unwell. At least two of those are probably unrelated to the outbreak. This compares with 31 new notifications in the first 48 hours of the outbreak. So it looks as though things are starting to settle down.

Regular handwashing with soap & water, especially after using the toilet, before eating, and after spending time with anyone who has been unwell, is still very important. The alcohol gel is a useful additional measure but does not replace hand washing with soap & water.

It's also really important that if you have been unwell, you must continue to use the "pink" bathrooms for 48 hours after your symptoms resolved, and be absolutely scrupulous about hand hygiene. Where possible, try to avoid social contact for 48 hours.

We are still waiting for microbiological data about the cause of this illness.

I think we are all very grateful to Dr Mark Hunter, the GP from 20 Gower Street, who spent around 3 hours in the Hall on Tuesday seeing unwell residents, and has been back another 3 times since. I will write to Dr Hunter to express our thanks and invite him to the University's big Diamond Jubilee party on 2nd June.

A common question arising now is about mitigating circumstances claims for missed exams, or exams where residents feel their performance will be impaired by having been unwell. The advice I give is as follows:

Ask your tutors what the procedure is at your particular institution for making an extenuating/mitigating circumstances claim. In most cases (and certainly if you actually miss your exam) they will expect a formal medical certificate from a doctor who has examined you. In this case, you should seek an appointment with your London GP (general practitioner / primary care physician / family doctor) as soon as possible.

I can provide a letter along the following lines, but it will be supplementary evidence only - not enough on its own to support a claim:

This person is a resident student at Connaught Hall. There has been an outbreak of diarrhoea and vomiting in the Hall, affecting a very significant proportion of our residents.

The likely causative organism of this outbreak is Norovirus, a very highly infectious virus sometimes called the “winter vomiting bug”. The Health Protection Agency (HPA) and local GPs are involved. Affected residents are being encouraged to isolate themselves for 48 hours after the last episode of diarrhoea, but the HPA recognises that this may not be possible during the exam season.

Please take these considerations into account with regard to any attendance logs, course work, or examinations expected of residents at Connaught Hall this week and next. Due to the timing, inability of those affected to leave the building – both due to isolation and the need to be close to a toilet - and the large numbers affected, they may not all be able to obtain a medical certificate from their doctor as quickly as we should like.

If you are going to see your GP, this text might be useful to show them.

I hope everyone affected is back to full health very soon. Remember there is lots of advice available in this blog and elswhere online for treating D&V and getting better afterwards:

http://connaughthall.blogspot.co.uk/search/label/diarrhoea

http://www.patient.co.uk/health/Gastroenteritis-in-Adults.htm

http://www.nhs.uk/conditions/diarrhoea/Pages/Introduction.aspx

Getting back to full health after diarrhoea & vomiting

Helping yourself get better after being ill with diarrhoea and vomiting:

Make sure you drink plenty of water in the first two days after your illness – aim for 3 litres / 24 hours. Dehydration can make you feel really weak and tired. Dioralyte is useful – it contains the right balance of salts for your body and can really pick you up quickly from dehydration. You can buy Dioralyte at any pharmacy.

Get some energy inside you: (flat) fizzy drinks like lemonade (not the diet kind) are good for this.
If you’re a regular caffeine drinker, you may be withdrawing from caffeine a bit after a day or more of vomiting and reduced intake. “Pro plus” or flat Coke will help you get over this withdrawal feeling.

Use paracetamol (1g up to four times a day) to help relieve any muscular aches and pains or headache. If you have stomach cramps, Buscopan – available at any pharmacy – is really good.

Infection control precautions

Handwashing is one of the most important ways of controlling the spread of infections, especially those that cause diarrhoea and vomiting, and respiratory disease. Use liquid soap, warm water and paper towels / hand dryer. Cover all cuts and abrasions with waterproof dressings.

Always wash your hands after using the toilet, before eating or handling food, and after contact with anyone who is unwell.
Use the dedicated toilets (pink signs) if you are unwell, and for 48 hours after your symptoms have gone. If you are not unwell, do not use the pink sign toilets: only use the toilets with a green sign.

If you are unwell, and for 48 hours afterwards, try to stay in your room and limit visitors as much as you can. It's not practical to achieve complete isolation, but the more you can stay away from residents who are well, the sooner this outbreak will die out.

Try not to invite guests from outside the Hall to come in while this outbreak is ongoing. If you do have outside guests, warn them about washing their hands.

If you are unwell, and for 48 hours afterwards, do not touch or prepare food for anybody else.

Laundry: wash your bed sheets and clothes on the hottest temperature the fabric can take. Use the "whites" or "hot" feature on the washing machine; this should be up to 60 degrees - but make sure your clothes can be safely washed at this temperature first. Contact the Bursar's Office if you have any visibly soiled bed linen.

Coughing and sneezing easily spread infections.Cover your mouth and nose with a tissue. Wash hands after using or disposing of tissues. Spitting should be discouraged.

Avoid touching your eyes and mouth. The most common route of infection is from your hands and into your body through the eyes or mouth when you touch your face.

Cleaning of the environment should be frequent, thorough and follow national guidance. We have increased our cleaning schedules and are using the recommended strength of bleach solution.

Separate toilets for residents who are unwell

In accordance with Health Protection Agency guidance we are designating a communal toilet per floor for those with vomiting and diarrhoea symptoms. Each toilet will have a pink sign and will be for both male and female residents.

Please could all other residents use the other toilet further along the corridor, and again for both male and female residents. This will have a green sign on the door.

These arrangements will be in place until further notice.

Once again may I stress the crucial importance of strict hand hygiene for EVERYONE. Use the alcohol gel. But remember the best hand hygiene is from thorough washing with soap and water.

Individuals affected can remain infectious for up to 48 hours after their symptoms have gone, so if you have been unwell, keep up your hand washing and try to avoid contact with unaffected people for 2 days after your last episode of diarrhoea.

Diarrhoea & vomiting update

We now have 25 reported cases of diarrhoea and vomiting in the Hall. The Health Protection Agency (HPA) have been involved and they are treating this as a Norovirus outbreak at present. This is unlikley to be food related but our caterers will continue their full food safety review. We expect to have microbiology data within 72 hours and then we should know exactly what has caused this illness. Remember you can tell us that you are unwell by emailing sicknessreporting@connaught-hall.org.uk.

There is more information about diarrhoea & vomiting here: http://www.patient.co.uk/health/Gastroenteritis-in-Adults.htm.

I must again stress the crucial importance of strict hand hygiene for EVERYONE. Use the alcohol gel. (Don't steal it - the 2nd floor dispenser disappeared within hours of us putting it out, and we don't have any more yet!) But remember the best hand hygiene is from thorough washing with soap and water.

We have implemented increased cleaning of bathrooms and other areas with disinfectant to help prevent spread of illness.

Individuals affected can remain infectious for up to 48 hours after their symptoms have gone, so if you have been unwell, keep up your hand washing and try to avoid contact with unaffected people for 2 days after your last episode of diarrhoea. The HPA, however, are being pragmatic and understand that this is exam time so you may have to go to your exams, so long as you fee better, without observing this 48-hour exclusion rule.

So that I do not have to keep filling your inbox with email, further updates will be posted on my blog here: http://connaughthall.blogspot.co.uk/search/label/diarrhoea and links to those posts will be published via Facebook and Twitter (@connaughthall).

I hope everyone affected feels better soon. Let us know if we can help in any way.

Update on diarrhoeal illness

We are now aware of 18 students in Hall with gastro-intestinal symptoms overnight.

REPORTING:
If you've been unwell with diarrhoea in the last 12 hours, please contact the Bursar's Office today or email sicknessreporting@connaught-hall.org.uk. Please visit your GP today if possible, tell them several residents have been unwell with the same symptoms, and ask if they will send a stool sample for you. The purpose of a stool sample is to figure out what organism has caused this outbreak. This can help guide your treatment (e.g. indicate whether antibiotics might be useful) but we also need to know if this is a virus spread from one resident to another or if it might be food poisoning.


TREATMENT:

Remember to drink plenty of clear fluids, use paracetamol to relieve pain and/or fever, and let a friend know that you're unwell. Please observe strict hygiene in the bathrooms and elsewhere to avoid passing any bugs to others! There is more advice about self-treatment of diarrhoea and vomiting here: http://www.nhs.uk/Conditions/Diarrhoea/Pages/Treatment.aspx.
You must definitely see a doctor if your symptoms last more than 72 hours, if you collapse or feel faint when you stand up, or if there is blood in your stool. you may also need to see your doctor if you have an exam in the next few days: it will be useful to have medical confirmation that you have been unwell, in case you need to make a mitigating circumstances claim or miss your exam.
A doctor from 20 Gower Street Pactice is coming to Connaught Hall around 12.30 this afternoon. If you have informed us before then that you are unwell, we may be able to have the doctor come to see you in your room. Use the sicknessreporting@connaught-hall.org.uk email address.


PREVENTION:
If you are not affected by any symptoms, please remember to wash your hands thoroughly with soap and water after using the bathroom or visiting anyone who is unwell. This will help ensure you don't catch anything. We have cleaners working to disinfect all the toilet blocks this morning.

We have placed alcohol hand sanitiser pumps at reception and on every floor. There is also a pump on the wall in the dining hall. These can help hand hygiene but are not a substitute for proper hand washing with soap and water: some stomach bugs are partly resistant to the hand gel but are easily washed off with soap and water.


INVESTIGATION:
As mentioned above, stool samples are important to help us work out what has caused this illness and whether the local authorities need to be involved. There is currently no evidence of a connection with food: those affected ate different things at dinner last night. This could just as easily be a norovirus outbreak, which is usually spread by personal contact rather than through food. Of course the kitchen will review the food temperature logs to ensure everything was kept hot enough last night, and send samples of any leftovers for analysis.


I hope everyone affected by this feels better soon. If you are not affected, please don't worry: just wash your hands carefully and you should stay well!

Have you been unwell with diarrhoea today?

If you've been unwell with diarrhoea in the last 12 hours, please contact the Bursar's Office today (Tue) or email sicknessreporting@connaught-hall.org.uk. Please visit your GP today if possible, tell them several residents have been unwell with the same symptoms, and ask if they will send a stool sample for you. This will help us work out which bug has caused people to be unwell, and maybe where ...it came from.

Remember to drink plenty of clear fluids, use paracetamol to relieve pain and/or fever, and let a friend know that you're unwell. Please observe strict hygiene in the bathrooms to avoid passing any bugs to others! There is more advice about self-treatment of diarrhoea and vomiting here: http://www.nhs.uk/Conditions/Diarrhoea/Pages/Treatment.aspx.

If you are not affected by any symptoms, please remember to wash your hands thoroughly with soap and water after using the bathroom or visiting anyone who is unwell. This will help ensure you don't catch anything.