Hospitals and healthcare facilities in Canada deal with outbreaks on a regular basis. These outbreaks are often caused by viruses or bacteria that spread easily, especially when facilities are busy, short-staffed, or under pressure to move patients quickly. During these times, infection prevention and control efforts rely heavily on good cleaning and disinfection practices to help reduce the spread of illness.
Cleaning and disinfection are not just about making a space look clean. Germs can live on surfaces that people touch every day, such as bed rails, door handles, call buttons, and shared equipment. If these surfaces are not cleaned and disinfected properly, germs can move from surfaces to hands, and from hands to patients, staff, and visitors. In real life, following cleaning and disinfection rules exactly as written can be difficult. During outbreaks, cleaning teams are often working faster, covering more areas, and dealing with staff shortages. When instructions are hard to follow or contact times are difficult to achieve, the risk of missed or incomplete disinfection increases.
This whitepaper explains the most common outbreaks seen in Canadian healthcare facilities and the role environmental cleaning and disinfection play in supporting broader infection prevention efforts. It focuses on practical challenges faced by cleaning teams and highlights why realistic, easy-to-follow disinfection practices matter in busy healthcare environments.
Outbreaks in Canadian Healthcare Settings: Current Context
Healthcare facilities deal with certain germs all year long, while others increase during specific seasons. Some organisms are always present in healthcare environments, while others cause sudden outbreaks that require extra controls and cleaning measures.
Respiratory illnesses such as influenza (flu), COVID-19, and respiratory syncytial virus (RSV) tend to increase during fall and winter. These illnesses spread quickly, affect both patients and staff, and often lead to higher absenteeism and increased pressure on hospital units.
Stomach illnesses caused by viruses like norovirus can happen at any time of the year and often spread very quickly once they enter a facility. These outbreaks can result in unit closures, increased cleaning demands, and disruption to normal operations. Patients in hospitals and post-acute care areas are often more vulnerable to infection due to age, weakened immune systems, or longer stays. Frequent patient movement, shared equipment, and high levels of contact make it easier for germs to spread if cleaning and disinfection are not done consistently.
Some organisms, such as Clostridioides difficile (C. difficile), are harder to manage because they form spores that can survive routine cleaning. These situations require special products and enhanced cleaning procedures, showing that healthcare facilities often need different tools for different outbreak risks.
Healthcare systems also face ongoing challenges, including staffing shortages, faster room turnover, and high patient volumes. These pressures make outbreak management more difficult and highlight the importance of cleaning and disinfection practices that fit into real workflows.
Environmental Surfaces and the Chain of Transmission
Germs do not only spread directly from person to person. They can also spread through surfaces that are touched many times throughout the day. In hospitals, this includes bed rails, bedside tables, IV poles, wheelchairs, door handles, light switches, and shared medical equipment. When a contaminated surface is touched, germs can transfer to hands. If hands then touch another surface or a patient, the germs can continue to spread. This is why cleaning and disinfection are important parts of infection prevention in healthcare settings.
Hand hygiene and surface cleaning work together. Even when hand hygiene is done properly, dirty or contaminated surfaces can still reintroduce germs into the environment. Reducing germs on surfaces helps support other IPAC measures and lowers overall risk.
For cleaning and disinfection to be effective, products must be used correctly, surfaces must stay wet for the required contact time, and processes must be realistic for staff to follow during busy shifts.
Common Outbreak-Causing Pathogens and Environmental Considerations
Norovirus is one of the most common causes of stomach outbreaks in hospitals and long-term care facilities and is responsible for approximately 90% of all outbreaks of epidemic gastroenteritis. It spreads extremely easily, requires only a very small amount of virus to cause infection, and can persist in the environment for extended periods of time. As a result, norovirus outbreaks can be difficult to control and, in some cases, have been reported to last for several weeks or even longer than three months.
Because norovirus can remain on surfaces and spread rapidly through touch, cleaning teams are often required to increase cleaning frequency and focus heavily on high-touch areas during outbreaks. Disinfectants used in these situations need to work quickly and be practical to apply correctly when staff are under pressure. If contact times are too long or difficult to achieve, surfaces may dry too quickly, increasing the risk that the virus remains on the surface and continues to spread.
From an operational perspective, norovirus outbreaks are often especially frustrating. Just as areas are cleaned, new cases can appear, making it feel as though the outbreak is never fully under control. There is often confusion about how easily norovirus spreads and why routine cleaning measures may not be sufficient, even when staff are following established procedures. The situation can quickly become overwhelming as multiple areas require repeated cleaning, staff begin calling in sick, and units may face temporary closures or restrictions. Cleaning teams are frequently asked to do more, move faster, and perform more detailed work at the same time, all while trying to follow strict protocols. One of the biggest challenges is maintaining consistent, effective disinfection during busy shifts, when surfaces dry quickly and instructions can be difficult to carry out exactly as written.
Respiratory viruses such as influenza, COVID-19, and respiratory syncytial virus (RSV) mainly spread through coughing, sneezing, and close contact. However, these viruses can also land on environmental surfaces and be transferred by hands, contributing to ongoing transmission in healthcare settings. Respiratory viruses remain a significant cause of illness and hospitalization across Canada and continue to place sustained pressure on hospitals, particularly during seasonal surges.
RSV, in particular, has had a measurable impact on Canadian healthcare facilities. Since late August 2025, nearly 2,000 RSV-associated hospitalizations, over 60 intensive care unit admissions, and 17 deaths have been reported nationwide. These outcomes highlight the ongoing burden respiratory viruses place on healthcare systems, especially during periods of increased activity. Shared equipment, patient rooms, waiting areas, and staff workstations are common areas where respiratory viruses can spread through surface contact. During busy periods, rooms often need to be cleaned and prepared quickly for the next patient, which can make proper disinfection more challenging.
From an operational standpoint, respiratory outbreaks are particularly frustrating because they often feel constant. Just as one wave begins to slow, another follows. For many teams, it can be confusing to understand how much surfaces contribute to the spread compared to close contact, especially when guidance changes between seasons or outbreak situations. These outbreaks frequently feel overwhelming because they coincide with high patient volumes, staffing shortages, and rapid room turnover. Cleaning teams are expected to maintain high standards while working under significant time pressure, often in shared and high-traffic spaces. The main challenge becomes balancing speed with thoroughness, turning rooms over quickly while still ensuring surfaces are properly disinfected and safe for the next patient.
Effective cleaning and disinfection help reduce the amount of virus on surfaces and support other Infection Prevention and Control measures already in place. When environmental hygiene practices are practical and achievable in real workflows, they better support consistent application, even during the most demanding periods
Antibiotic-resistant organisms, such as MRSA and VRE, are bacteria that no longer respond well to common antibiotics. In healthcare settings, this means infections caused by these bacteria are harder to treat and can lead to longer hospital stays and more complicated care. Unlike viruses that cause sudden outbreaks, these bacteria tend to spread quietly and gradually, often without obvious warning signs.
MRSA and VRE can live on surfaces such as bed rails, bedside tables, medical equipment, and shared items for long periods of time. When these surfaces are not cleaned and disinfected properly, the bacteria can be transferred by hands or equipment and spread to patients or staff. Routine cleaning and disinfection are an important part of managing these organisms, with enhanced cleaning used in higher-risk areas or when increased transmission is identified.
From a day-to-day perspective, managing these bacteria can be especially frustrating and confusing. Because they do not cause sudden spikes in illness the way viral outbreaks do, it can be unclear when routine cleaning is enough and when extra measures are needed. Different units may follow different protocols, which adds to the confusion for cleaning teams moving between areas.
Over time, these organisms can feel overwhelming because control depends on doing the basics correctly every single day, not just during short outbreak periods. Cleaning teams often feel pressure knowing that small missed steps can allow bacteria to remain on surfaces and continue spreading. One of the biggest challenges is maintaining consistent, repeatable cleaning practices over long periods, especially when workloads increase and priorities compete.
Operational Challenges Implementing Environmental Measures
In real healthcare environments, cleaning teams face many challenges that can make it difficult to follow protocols exactly as written. During outbreaks, staff may be short-handed, working overtime, or covering larger areas than usual. Keeping surfaces wet for the full contact time listed on a disinfectant label can be difficult when rooms need to be turned over quickly. When staff are rushed, surfaces may dry too soon or steps may be skipped, even when teams are doing their best. Training levels can vary, especially when temporary staff or new hires are brought in during high-demand periods. Staff may need to remember different instructions for different areas or outbreak situations, increasing mental load and the chance of error.
There can also be a gap between written policies, audit results, and what actually happens during a busy shift. Understanding these realities is important when selecting products and designing cleaning programs that staff can realistically follow every day.
Aligning Environmental Cleaning and Disinfection with Healthcare Programs
Strong cleaning and disinfection programs work best when they are aligned with the overall infection prevention strategy. This includes choosing products and procedures based on the type of germs being managed and how the facility operates. Disinfectant labels provide important instructions that must be followed to achieve the expected results. Training and regular refreshers help ensure staff understand how to use products correctly and consistently. Monitoring, audits, and feedback help identify where improvements can be made and allow facilities to adjust practices as conditions change. Environmental Services teams play a critical role in IPAC programs and should be included in planning, training, and outbreak response discussions.
When cleaning and disinfection practices are practical and easy to follow, staff are more likely to use them correctly, even during busy or stressful periods.
Strengthening Outbreak Preparedness Through Environmental Measures
Cleaning and disinfection are one part of a larger infection prevention strategy. They work best when products, procedures, and expectations match the realities of day-to-day hospital operations. Outbreak preparedness depends on choosing cleaning and disinfection approaches that are effective, realistic, and easy for staff to apply consistently. Ongoing evaluation, training, and communication across teams help ensure environmental hygiene continues to support patient safety. By focusing on both science and practicality, healthcare facilities can strengthen their response to outbreaks and help create safer environments for patients, staff, and visitors.
Featured Products
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Unitab® - Sporicidal Disinfection for C. difficile
Unitab is a sporicidal disinfectant designed for environments where Clostridioides difficile is a concern. When used according to label directions, Unitab kills C. difficile spores on hard, non-porous surfaces with a 4- or 10-minute contact time, depending on concentration.
UniTab
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Hydrofect EHP - Designed for Real-World Cleaning Workflows
Hydrofect® EHP is a hydrogen peroxide–based disinfectant designed to support environmental cleaning in healthcare settings. It provides a 1-minute contact time against key outbreak-related viruses, including norovirus and RSV, helping support practical disinfection in busy environments.
Hydrofect EHP
