Region of Waterloo Form

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International Agrifood Workers Outbreak Reporting

This form is for reporting suspect or confirmed cases of gastrointestinal or respiratory illnesses in International Agrifood Worker Settings.

The following form can be used for:

  • Reporting symptomatic workers who are suspect cases of gastrointestinal, COVID-19 or other respiratory illnesses
  • Reporting COVID-19 positive molecular test (PCR) or RAT results in workers
  • Reporting results from Respiratory Virus testing in workers
  • Reporting COVID-19 Virus and Respiratory Viruses or RAT results in staff ONLY when your facility is currently in a confirmed outbreak.
    • If you have multiple workers to report, complete the International Agrifood Workers Case Line List and submit it through this web-reporting form.
    • If you do not already have a International Agrifood Workers Case Line List, request one by mailing outbreak@regionofwaterloo.ca

Once submitted, you will receive an email confirmation. Region of Waterloo Public Health will follow up based on the level of priority. To report lab confirmed influenza call 519-575-4400 for the Service First Call Centre.

Submit this form daily BEFORE 1 p.m., even if waiting for further information or test results. This will ensure timely assessment and follow-up. Information received by the facility after 1 p.m. can be submitted to Public Health the following day.

Affiliation of Person Completing the Report
 
Do you have the Region of Waterloo International Agrifood Workers Case Line List?
 


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