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Pandemic Preparedness:
How Concerned Should Camps Be?
by Linda Ebner Erceg, R.N., M.S., P.H.N.
The threat of an Avian (Bird) Flu human pandemic has caused many camp
professionals moments of concern. Both West Nile Virus and SARS conditioned
us to taking note of threats posed by communicable diseases. Now,
as we move toward Summer 2006, we again find ourselves considering preparedness,
and trying to determine a level of camp preparedness appropriate to threats
of diseases such as pertussis (whooping cough) and mumps, let alone a
pandemic.
What action
should a camp take to remain proactive about communicable disease threats?
The first
step is access to reliable information. One of the best is
the Centers for Disease Control and Prevention, commonly known as the
CDC. Access
this resource online at www.CDC.gov;
bookmark this searchable site. It includes information about specific
diseases, international travel, and access to publications as well as
enough data and statistics to keep even the most number-crunching staff
member delighted. Both pertussis
(whooping cough) and mumps should be a concern to camps this summer.
CDC's
Web site coaches what to look for, how to minimize the potential for
an outbreak, and tips for controlling an outbreak should one occur.
CDC's homepage has a direct link to another Web site, www.pandemicflu.gov.
Clicking into this site's "Community Planning" link
brings one face-to-face with a preparedness checklist, a guide for planning
that includes topics such as internal and external communication, assessment
of the threat in relation to your program's mission and the people
you serve, policies to follow during a pandemic, allocation of resources
with an emphasis on protection, and coordination with the camp's
external community. Following the "Individual
Planning" link on the Web site provides access to an information-filled
PDF called "Pandemic Influenza Planning: A Guide for Individuals
and Families."
Another reliable resource, one appreciated by those who need to stay
up-to-date with emerging information, is the Center for Infectious Disease
Research & Policy
(CIDRAP) at www.cidrap.umn.edu. This
site provides information beyond influenza; it includes food safety,
bioterrorism, and biosecurity. Sign up for CIDRAP updates on self-selected
topics by following the "E-mail Alerts" link.
A fourth resource is your state's Department of Health. Whereas
previously mentioned resources target national and international information,
your camp's
State Department of Health is specific to your geographic locale, including
county-by-county information. Know your local Department of Health staff
by name and how to access them should need arise. Because these folks
typically don't understand
camp, invite them for dinner some evening and spend time talking about
your camp's
preparedness plans. Department of Health staff—such as your local
epidemiologist—can
provide critical information, including how camp plans should/could be
linked to community resources.
In addition to reliable information, the second
step in preparedness is implementing reasonable and prudent communicable
disease control strategies at camp—now. After
an outbreak occurs is not the time to do this. Strategies currently
used by camps include the following:
- Adequate and effective hand washing. At minimum, after using
the bathroom and before each meal. A growing number of camps
have placed a pump-dispenser of hand sanitizer around camp, on each
table in particular. Staff monitor that campers use the sanitizer
before touching any food.
- Sneezing and coughing into one's forearm or shoulder—not
the hands. We do a lot with our hands and often do not wash adequately
after coughs and sneezes. Coughing into one's shoulder or forearm
minimizes the potential to pass droplet contamination from person-to-person
much more effectively than covering those sneezes with one's
hand.
- Keeping people at least an arm's length away from one another
while sleeping, and placing them head-to-foot in bunk beds – and
tents.
- Screening people upon arrival at camp. Physical assessment may not
be necessary but, at minimum, everyone should be asked (a) how they're
feeling upon arrival; (b)if they've been exposed to any communicable
diseases in the past two, three weeks; and (c) have they been given
a visual appraisal for signs of communicable diseases (e.g., scratching
the head, sniffling, feverish appearance).
- Maintaining personal resilience by making sure everyone—staff
and campers alike—has adequate food, water, and sleep/rest. Consider
sleeping-in for thirty minutes on rainy days, sending tired youth to
bed early, extending rest hour on rainy days, and having down-time
to use effectively (especially important for staff). Since many kids
can't eat enough at one meal to last to the next, consider having
a nutritious snack available in your dining area. Assess access
to drinking water for campers and staff; is it adequate? Is it
used?!?
- Know the immunization status of campers and staff; advocate for appropriate
immunizations. Granted, most camp professionals agree that tetanus
status has the most immediate impact upon camp life, but having information
about other immunizations—especially mumps and pertussis—can
make a difference in today's world.
- Consider the risk profile of international campers and staff as well
as your camp population's travel history. Some countries
are endemic for certain diseases such as tuberculosis. Talk with
your medical director about the feasibility of targeted screening,
such as a Mantoux test, for at-risk people. (See the article, American
Camp Association Immunization Recommendations for International Staff,
in the Spring 06 issue of The CampLine.)
- Monitor Health Center activity for signs of emerging communicable
disease. Health care staff see people for common things: sore
throats, upset stomachs, coughs, various rashes, red eyes. Often
benign, these signs and symptoms could also signal an emerging threat
instead of one more minor complaint. Don't minimize an
emerging threat.
The world of today and tomorrow will
continue to pose disease threats as we travel more, continue to live
close to one another, and stretch personal coping reserves to the limit.
Our camp programs are excellent opportunities to shape human behavior
conducive to good health while also maintaining surveillance for emerging
problems. But this is only possible with access to reliable information
coupled with appropriate risk-reduction strategies. People don't
come to camp to get ill; they come to enjoy the magic of your program.
It's worth the effort to make your campers and staff as resilient
as possible!
Linda Ebner Erceg, R.N., M.S., P.H.N., is assistant director of Health & Risk
Management for the Concordia Language Villages as well as executive director
of the Association of Camp Nurses. Passionate about "Healthier
Camping for All," Linda is interested in hearing from you about
additional resources, ideas for improving camp health, and your stories
of risk reduction efforts. Contact her via erceg@campnurse.org. |
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