Guidelines for Recreational Camps During Boil Water Advisory

NOTE: These guidelines have been designed for generic use in a boil water advisory. Please speak to the inspection department of your local Health Unit for information regarding the particular circumstances of a specific boil water event.

The guidelines below are provided to operators of recreational camps further to the boil water advisory issued by the Medical officer of health.

General Precautions

1. All guests at the camp must be properly notified of the advisory. This includes (but is not limited to) posting signs at all entrances to the campgrounds, on information boards and at campsites where possible and necessary.
   
2. Water that is intended for human consumption should be:
   * Subjected to a rolling boil for at least 1 minute, or treated with a suitable filtering or water treatment device, or
   * Obtained from a known safe supply (e.g. municipal supply that is not subject to the boil water advisory or commercially bottled water).
3. All staff and guests should be encouraged to regularly wash their hands, especially before preparing food and after using the toilet. The use of alcohol-based hand disinfectants containing more than 60% alcohol can be used for disinfecting hands. NOTE: This should be used as an added step to proper hand washing and is not intended as an alternative.
4. Avoid consuming ice, fountain drinks, fruit drinks mixed with tap water, ice tea or ice coffee, unpasteurized juices and raw foods that have been washed with water that has not been disinfected.

Food Service Operations

1. Discard all food and beverages made with untreated and/or potentially contaminated water. Disinfect all containers storing these products.
2. All water that is provided for drinking purposes must be commercially bottled; or must be treated by heating it to a rolling boil for at least one (1) minute and then storing the water in clean covered containers until used for serving.
3. Signs advising not to drink the tap water should be posted at all sinks.
4. All foods that do not require cooking and need washing (e.g. fruits and vegetables) are to be rinsed or soaked only in water that has been disinfected.
5. Water that is used as an ingredient in any food product that is considered "ready-to-eat" i.e. without cooking, e.g. infant formula, pudding, Jell-O, fruit juices and drinks etc… must be heated to a rolling boil for at least one (1) minute.
6. All ice must be obtained from water that has been heated to a rolling boil for at least one (1) minute, or from commercially bottled water, or from a commercial ice manufacturer that is unaffected by the Boil Water Advisory.
7. All soft drink beverage lines connected directly to tap water for mixing must be disconnected.
8. Any employee reporting that they are suffering from diarrhea must be excluded from work and can be tested by their family doctor. Employees should not return to work until symptoms have subsided.
9. For washing and sanitizing of utensils;
   
   • All re-usable dishes and cutlery should be disinfected. Dishwashing machines can be used if there is a "dry" cycle or final rinse that exceeds 45°C / 113°F for 20 minutes or 50°C / 122°F for 5 minutes or 72°C / 162°F for 1 minute. If unsure, check with the manufacturer of the unit.
10. If no dishwashing machine is available, dishes and/or utensils should be cleaned and sanitized in accordance with the procedure(s) outlined in the current edition of the Ontario Food Premises Regulation or the Ontario Recreational Camps Regulation. Only boiled water should be used for this process.
11. As a matter of convenience, single-service articles (e.g. disposable plates, cups, bowls, knives, forks etc…) should be used whenever possible.

Swimming

General

1. All persons exhibiting signs of diarrhea should avoid swimming in public bathing areas. This includes but is not limited to swimming pools, lakes, rivers, ponds etc.
   
2. Babies, young children and bathers who do not have control of their bowels should wear appropriate clothing to prevent fecal discharge into the pool, spa or other bathing area.
   
3. Sign(s) should be posted in conspicuous location(s) advising bathers not to ingest water.
   
4. Drinking water fountains in and around bathing areas must be shut off or rendered inaccessible. All water coolers should be emptied and disinfected prior to reuse. Commercially bottled water or other suitably disinfected water should be made available to bathers.
   
5. Ensure that all bathers are showering (i.e. with warm water and soap) prior to entering a pool or spa.

Pool/Spa Fouling Incident (i.e. vomit or stool)

Option A:
Normal Circumstances

1. Clear the pool or spa;
   
2. Close the pool or spa immediately;
   
3. Stop the recirculation pump;
   
4. Remove any solid particles with a dipper screen. Disinfect the dipper screen;
   
5. Vacuum any waste products not picked up by the dipper screen directly to the sanitary sewer or septic system;
   
6. Superchlorinate the pool or spa to a minimum free available chlorine (FAC) level of 50 mg/L and maintain this concentration for at least 2 ½ hours, or 80 mg/L for at least 1 ½ hours. The pH should be maintained between 7.0 and 7.2 during the process;
   
7. Restart the recirculation pump following the superchlorination process; and
   
8. Reopen the pool or spa when chemical levels return to acceptable levels.
   
9. Record all fouling incidents in the pool or spa logbook including time, location and action taken.

Option B:
If the above-mentioned cleaning procedures cannot be carried out effectively or the stool/vomit is widely dispersed in the pool/spa.

1. Drain the pool/spa;
   
2. Steam clean pool or spa basin, decks and gutters;
   
3. Refill the pool or spa and superchlorinate the recirculation and filtration systems to a level of 80 mg/L FAC, keeping the pH between 7.0 and 7.2 during the procedure; and
   
4. Reopen the pool or spa when chemical levels return to acceptable levels.
   
5. Record all fouling incidents in the pool or spa logbook including time, location and action taken.

Upon Lifting A Boil Water Advisory

General

1. Re-start and flush all water-using equipment in accordance with the manufacturer's specifications.
   
2. Flush pipes/cold water faucets for at least 3 minutes before using the water
   
3. Run drinking water fountains continuously for at least 1 minute before drinking the water
   
4. Flush all garden hoses by running cold water through them for at least 1 minute
   
5. Run all water softeners through a regeneration cycle
   
6. Drain and refill all hot water heaters that have been set below 45° C / 113°F
   
7. Backwash pool filters and change media and water (if possible)

Staff

Maintain exclusion policy for food preparation staff exhibiting symptoms of diarrhea until at least 48 hours following the cessation of symptoms or as directed by the Medical officer of health.

Adapted from the Cryptosporidium and Water: A Public Health Handbook (Centers for Disease Control and Prevention, 1997) and the Protocol for the Investigation and Control of Cryptosporidium and Giardia Waterborne Outbreaks (Ontario Ministry of Health, 1997).