Contagious Disease Outbreaks

[malraux]

13 minutes ago, qwazse said:

do we have incident reports of such things?

To clarify, what are you asking? Do we have incident reports of measles outbreaks occurring at a summer camp ever, or do we have a measles out break at a bsa summer camp in the last 5 years?

[WisconsinMomma]

Summer camps can, of course, make any rules they want within the law and within BSA policies, but if it's too much of a hassle / extremely restrictive, then not as many people will go to summer camp.

Any PR problems with the BSA coming across as either pro-vax or anti-vax in the media would be a disaster. 

Edited October 19, 2018 by WisconsinMomma

[RichardB]

Communicable diseases are a real risk, there are some incident reviews that are in the works but are not ready for publication.  

The American Camp Association also has some great resources.   

https://www.acacamps.org/staff-professionals/core-competencies/health-wellness/communicable-diseases-infestations

[Eagle94-A1]

Communicable diseases are a major threat for camps. One sick camper could possibly shut down an entire camp, and worse.

One camp I worked at had a GI bug going around. Over 150 campers ended up in the health lodge at some point that week, and ALL of the camp staff were in the health lodge at some point in a 10 day period. Health department came in to inspect the camp a second time, with the possibility of shutting the camp down. People believed it was either the trading post or dining hall causing the problem. No problems there. Review of the health records showed that it came from one particular troop. Camp thankfully remained open.

Fast forward 6 months and talking to my cousin about the issue at camp since her son's troop was there that week. She was saying how awful the GI bug was and how she hated sending her son to camp sick. But since she paid for camp he had to go.  🤬

[WisconsinMomma]

Well, ya can't get a shot for norovirus (although, people are working on it).  There will always be a risk of illnesses at camp. 

[shortridge]

5 hours ago, RememberSchiff said:

Second the camp nurse check-in, IMO this stop has been more about checking the paperwork and collecting meds and less checking the camper's current health for admission.  How are you feeling? I'm okay. Shouldn't everyone have their temp and neck glands checked?

Third a complete refund if a scout/scouter is sick. 

Let’s say the camp’s lone health officer (a paramedic around here) spends 2 minutes per camper X 400 Scouts and Scouters = 800 minutes = 13+ hours just on wellness checks alone, no prescription or health/activity restriction checks. If your camp can call up a team of nurses or physicians willing to help with that for free every Sunday afternoon in June and July, more power to you, but we don’t have that resource.

The refund idea is good, but creates a giant loophole for abuse for people who just don’t want to come at the last minute. Who’s the doctor that will make that call?

Edited October 19, 2018 by shortridge

[shortridge]

1 hour ago, WisconsinMomma said:

Any PR problems with the BSA coming across as either pro-vax or anti-vax in the media would be a disaster.

The BSA is already pro-vaccination, thank goodness. See Public Health merit badge, requirement 2.

[malraux]

3 minutes ago, shortridge said:

The BSA is already pro-vaccination, thank goodness. See Public Health merit badge, requirement 2.

Or their vaccine page on camp. 

[cgail]

You can catch any communicable diseases even though you are vaccinated.   They wear off as you age, and as the flu vaccines show us every year, some are not a effective as others.  Someone choosing not to vaccinate their child for whatever reason CAN impact my family's health.  

 

The BSA should come out as pro vaccination.  It's as much a part of teaching about the public good as the citizenship and preparedness lessons we use daily with our Scouts.

[RememberSchiff]

19 minutes ago, shortridge said:

Let’s say the camp’s lone health officer (a paramedic around here) spends 2 minutes per camper X 400 Scouts and Scouters = 800 minutes = 13+ hours just on wellness checks alone, no prescription or health/activity restriction checks. If your camp can call up a team of nurses or physicians willing to help with that for free every Sunday afternoon in June and July, more power to you, but we don’t have that resource.

The refund idea is good, but creates a giant loophole for abuse for people who just don’t want to come at the last minute. Who’s the doctor that will make that call?

Yes we are better staffed for Sunday check-in whether that is due to staff planning, state regulation, or camp accreditation I don't know.  

Well if a scout/scouter has a fever , open wound,  fracture,...or a doctor's note, I can't see the argument.

Back in the day when polio vaccine came out, Public Health Mb was a  recommended merit badge for Eagle Scouts.  Be prepared.  

Another $0.02

 

 

[hiker67]

While comparisons to stomach bugs and other illnesses may be helpful, it is important to note that diseases like measles seem to be very different.

1. People who have contracted measles are contagious for four days before symptoms appear; by contrast, patients infected with the flu are contagious for just one day before symptoms appear.  Checking glands and temperatures upon arrival will not catch measles in advance; by the time infected people are found, others have already been exposed.

2. Unlike the flu, there is no "season" for diseases like measles.  While it may spread faster in the cold months, the current outbreaks in Europe have flourished during summer.

3. While hygiene and sanitation play a key role in stomach bugs, flu, etc., they may not help as much with measles.  Once an infected person leaves a room, the viral particles in the air may remain viable for up to two hours.

4. While the vast majority of people will recover from measles, there is a small risk of fatalities.  There is also a small risk of permanent vision, heart or neurological problems.  There is also a small risk of virus reactivation years after the initial occurrence; if this happens, it is always fatal and there is no treatment.

Camps probably have not had to deal with the likes of measles since the 1950s, so this is essentially new ground (outbreaks of mumps and whooping cough are also occurring).  At this point, it is unlikely that BSA will require the immunizations that are currently recommended.  Even if they were required, people could write in fake dates in the immunization sections of health forms (if the doctors left them blank).

So, camps, along with their state health departments, may need to consider a number of questions, the answers of which may vary, depending on the disease.

Should infected people go to the health lodge or should the health staff go to the infected people (perhaps, to minimize exposure to others)?

Should all people without vaccination for the disease in question be sent home, or just those with symptoms, or close proximity to the infected persons?

Should unvaccinated people be restricted from coming to camp during the following week of camp?

At what point would a camp be closed entirely and for how long?

Refund policies?

[packsaddle]

I was a member of that first wave of recipients of the polio vaccine. Then shortly later, the Sabin vaccine. At school everyone got the Sabin vaccine. I remember it well. We all lined up and walked past the nurse who administered the dose. There was no choice and you had to be apocalyptically stupid to reject this somehow. The Salk vaccine was given at the public health department and I remember being taken there along with my sister. I had an aunt who contracted polio as an adult, and a friend in high school whose family had rejected it...and he was permanently handicapped from the disease. It was another case of the child paying the price for the stupid decision by parents. I always get my flu shot. And I have a very disparaging view of the anti-vax bunch. What they really are is 'anti-science'. 

That said, I suspect that summer camp has a much greater risk for something like norovirus than flu or measles. But that could be the result of residual herd immunity and that can change fairly quickly if the population doesn't maintain its vigilance against these things.

[mds3d]

This could quickly turn into an I&P thread at this rate, but as a health professional, I am going to say that I also believe that the BSA should come out as pro-vaccination.  High vaccination rates have kept these things from being an issue for a long time, but that may not be true for long.  While I acknowledge that parents currently have a legal right to decide not to vaccinate, that doesn't mean that these families have a right to have their children around mine. 

Summer camps, winter camps, and all sorts of other BSA activities are high risk for disease transmission of all kinds.   

[hiker67]

Rockland measles cases hit 40; more unvaccinated kids ordered home

"The 25 schools targeted — with more than 1,000 students — have under a 70 percent vaccination rate and students must remain home for 21 days after the last confirmed measles case."

[RememberSchiff]

More than 80,000 Americans died of the flu in the winter of 2017-2018, the highest number in over a decade, federal health officials said last week.

Although 90 percent of those deaths were in people over age 65, the flu also killed 180 young children and teenagers, more than in any other year since the Centers for Disease Control and Prevention began using its current surveillance methods.

https://www.nytimes.com/2018/10/01/health/flu-deaths-vaccine.html

That said, I wish the information presented was more complete. e.g., how many who died were vaccinated and with what vaccine, how many were in group living ?

Last month, I got the high dose Flu vaccine. I hope it is the right dose.

Another $0.02