Health officials say some doctors and nurses aren't washing their hands. (CBC)

Clostridium difficile is expected to be added to a list of reportable illnesses in Nova Scotia, which could make it easier to control outbreaks.

Suzanne Rhodenizer-Rose, director of the province's infection prevention control centre, said under a proposed law, all cases of C. difficile would have to be reported to the public health department.

"Then we'll have the data to look at which case are health-care acquired, which cases are community acquired, and it will give us an idea of where the transmission and the development of infections is actually occurring," she said.

Knowing where the cases originate will help public health officials focus their efforts on stopping the spread of the illness, she said.

Meanwhile, the Cape Breton District Health Authority said on Friday that two more patients with hospital-acquired C. difficile have died. The patients had other illnesses in addition to the C. difficile infection, the health authority said.

A total of four people have died during the current outbreak at the Cape Breton Regional Hospital.

Greg Boone, a spokesman for the Cape Breton District Health Authority, said the hospital continues to apply stringent cleaning protocols.

"It includes specialized cleaning but it also includes following all of the practices that are necessarily to help limit or prevent the spread of C. difficile," Boone told CBC News.

"What we have to do is avoid any breaches in any number of those things to help limit the spread. We hope and we believe that the measures are working. However, we certainly don't want to get too cocky and think that we're out of the woods."

No new cases in past 10 days

There are eight patients currently at the hospital with C. difficile, and Boone said there are been no new hospital-acquired cases in the past 10 days.

C. difficile bacteria causes diarrhea and abdominal pain. It can be life-threatening for those taking antibiotics or who have serious pre-existing health issues. Infections are known to occur in hospitals and nursing homes.

The Cape Breton District Health Authority has faced two outbreaks of C. difficile in the last year. Under the current rules, its facilities are not required to report cases to the province.

But even if cases are reported, stopping the spread of C. difficile can be difficult.

Rhodenizer-Rose said workers in the Cape Breton health district were still dumping bedpans in shared bathrooms several months after the district was urged to stop the practice.

"Everybody has problems with compliance," she said of the districts. "We are still having problems getting people — doctors, nurses, health-care providers — to wash their hands."

Rhodenizer-Rose said the province is working with the health districts to come up with reporting tools and processes by April 1.