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")
- 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!
Flu Terms Defined
Seasonal (or common) flu is a respiratory illness
that can be transmitted person to person. Most people have some immunity,
and a vaccine is available.
Avian (or bird) flu is caused by influenza
viruses that occur naturally among wild birds. The H5N1 variant is deadly
to domestic fowl and can be transmitted from birds to humans. There is
no human immunity and no vaccine is available.
Pandemic flu is virulent
human flu that causes a global outbreak, or pandemic, of serious illness.
Because there is little natural immunity, the disease can spread easily
from person to person. Currently, there is no pandemic flu.
This article is reprinted from the May 2006 issue of Inside ACA, ACA's
online member newsletter.
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