Pandemic Influenza A in Residential Summer Camps—Maine, 2009

Robinson, Sara; Averhoff, Francisco; Kiel, John; Blaisdell, Laura; Haber, Michael; Sites, Anne; Copeland, Daphne

doi:10.1097/inf.0b013e31824f8124

Cited by 3 publications

(7 citation statements)

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“…Both the number and duration of close contacts could be higher in residential camps. This is supported by the outbreaks reported from Maine where the camp size and the number of campers per cabin were associated with influenza outbreaks [25]. Though respiratory disease transmission can occur at summer camps, influenza transmission during the summer (in the United States) outside a pandemic is uncommon; pdm09HIN1 was circulating since early spring and was involved a number of school-based outbreaks in states reporting camp-related influenza outbreaks in summer 2009.…”

Section: Discussionmentioning

confidence: 77%

“…The size of most camp sessions was small, ranging between 100 to 600 campers and staff. Nineteen (76%) of the 25 Influenza A H1N1 (pdm09H1N1) outbreaks were reported from an online survey of 2009 summer camp participants in Maine [25]. In this survey, camp-related outbreaks (defined as having at least three confirmed cases of pdm09H1N1) were statistically associated with having both a larger number of camp participants per session and a larger number of campers per cabin.…”

Section: Published Literaturementioning

confidence: 94%

“…The 21 articles included 18 manuscripts describing 14 individual mass gathering-related respiratory disease outbreaks (the same outbreak could be described in more than one article) and three articles [21,25,36] describing pathogen-specific summaries of outbreaks across different settings and included 59 additional mass gathering-related outbreaks ( Table 2, Fairs. More than half (n = 44, 61%) of the 72 identified outbreaks occurred at state or county agricultural fairs ( Table 3).…”

Section: Published Literaturementioning

confidence: 99%

“…Twenty-seven (38%) of the 72 identified outbreaks occurred at residential recreational, academic, or cultural camps. Each lasted for three days or more and involved either Influenza A (H1N1) (n = 25) [22][23][24][25][26][27][28][29] or mumps (n = 2) [16][17][30][31]. The size of most camp sessions was small, ranging between 100 to 600 campers and staff.…”

Section: Published Literaturementioning

confidence: 99%

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Mass Gatherings and Respiratory Disease Outbreaks in the United States – Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System

2016

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BackgroundBecause mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings during a moderate or severe pandemic. Despite these recommendations, limited empirical information exists on the frequency and characteristics of mass gathering-related respiratory disease outbreaks occurring in the United States.MethodsWe conducted a systematic literature review to identify articles about mass gathering-related respiratory disease outbreaks occurring in the United States from 2005 to 2014. A standard form was used to abstract information from relevant articles identified from six medical, behavioral and social science literature databases. We also analyzed data from the National Outbreaks Reporting System (NORS), maintained by the Centers for Disease Control and Prevention since 2009, to estimate the frequency of mass gathering-related respiratory disease outbreaks reported to the system.ResultsWe identified 21 published articles describing 72 mass gathering-related respiratory disease outbreaks. Of these 72, 40 (56%) were associated with agriculture fairs and Influenza A H3N2v following probable swine exposure, and 25 (35%) with youth summer camps and pandemic Influenza A H1N1. Outbreaks of measles (n = 1) and mumps (n = 2) were linked to the international importation of disease. Between 2009 and 2013, 1,114 outbreaks were reported to NORS, including 96 respiratory disease outbreaks due to Legionella. None of these legionellosis outbreaks was linked to a mass gathering according to available data.ConclusionMass gathering-related respiratory disease outbreaks may be uncommon in the United States, but have been reported from fairs (zoonotic transmission) as well as at camps where participants have close social contact in communal housing. International importation can also be a contributing factor. NORS collects information on certain respiratory diseases and could serve as a platform to monitor mass gathering-related respiratory outbreaks in the future.

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Section: Discussionmentioning

confidence: 77%

Section: Published Literaturementioning

confidence: 94%

Section: Published Literaturementioning

confidence: 99%

Section: Published Literaturementioning

confidence: 99%

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Mass Gatherings and Respiratory Disease Outbreaks in the United States – Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System

2016

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“…Two of the four previously unpublished pandemic-related outbreaks occurred at summer camps in 2009. As highlighted in our literature review, camp outbreaks typically involve close contact and social mixing among school-aged children in communal housing and during camp activities [ 12 , 14 – 15 ].…”

Section: Discussionmentioning

confidence: 99%

Estimating the frequency and characteristics of respiratory disease outbreaks at mass gatherings in the United States: Findings from a state and local health department assessment

2017

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Mass gatherings create environments conducive to the transmission of infectious diseases. Thousands of mass gatherings are held annually in the United States; however, information on the frequency and characteristics of respiratory disease outbreaks and on the use of nonpharmaceutical interventions at these gatherings is scarce. We administered an online assessment to the 50 state health departments and 31 large local health departments in the United States to gather information about mass gathering-related respiratory disease outbreaks occurring between 2009 and 2014. The assessment also captured information on the use of nonpharmaceutical interventions to slow disease transmission in these settings. We downloaded respondent data into a SAS dataset for descriptive analyses. We received responses from 43 (53%) of the 81 health jurisdictions. Among these, 8 reported 18 mass gathering outbreaks. More than half (n = 11) of the outbreaks involved zoonotic transmission of influenza A (H3N2v) at county and state fairs. Other outbreaks occurred at camps (influenza A (H1N1)pdm09 [n = 2] and A (H3) [n = 1]), religious gatherings (influenza A (H1N1)pdm09 [n = 1] and unspecified respiratory virus [n = 1]), at a conference (influenza A (H1N1)pdm09), and a sporting event (influenza A). Outbreaks ranged from 5 to 150 reported cases. Of the 43 respondents, 9 jurisdictions used nonpharmaceutical interventions to slow or prevent disease transmission. Although respiratory disease outbreaks with a large number of cases occur at many types of mass gatherings, our assessment suggests that such outbreaks may be uncommon, even during the 2009 influenza A (H1N1) pandemic, which partially explains the reported, but limited, use of nonpharmaceutical interventions. More research on the characteristics of mass gatherings with respiratory disease outbreaks and effectiveness of nonpharmaceutical interventions would likely be beneficial for decision makers at state and local health departments when responding to future outbreaks and pandemics.

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Preventing and Mitigating SARS-CoV-2 Transmission — Four Overnight Camps, Maine, June–August 2020

Blaisdell¹,

Cohn²,

Pavell³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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On August 26, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). The World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020.* Shortly thereafter, closures of 124,000 U.S. public and private schools affected at least 55.1 million students through the end of the 2019-20 school year. † During the summer of 2020, approximately 82% of 8,947 U.S. overnight camps did not operate. § In Maine, only approximately 20% of 100 overnight camps opened. ¶ An overnight camp in Georgia recently reported SARS-CoV-2, the virus that causes COVID-19, transmission among campers and staff members when nonpharmaceutical interventions (NPIs) were not strictly followed (1); however, NPIs have been successfully used to mitigate SARS-CoV-2 transmission among military basic trainees (2). During June-August 2020, four overnight camps in Maine implemented several NPIs to prevent and mitigate the transmission of SARS-CoV-2, including prearrival quarantine, pre-and postarrival testing and symptom screening, cohorting, use of face coverings, physical distancing, enhanced hygiene measures, cleaning and disinfecting, and maximal outdoor programming. During the camp sessions, testing and symptom screening enabled early and rapid identification and isolation of attendees with COVID-19. Among the 1,022 attendees (staff members and campers) from 41 states, one territory, and six international locations, 1,010 were tested before arrival; 12 attendees who had completed a period of isolation after receiving a diagnosis of COVID-19 2 months before arrival were not tested. Four (0.4%) asymptomatic attendees received positive SARS-CoV-2 test results before arrival; these persons delayed their arrival, completed 10 days of isolation at home, remained asymptomatic, and did not receive any further testing before arrival or for the duration of camp attendance. Approximately 1 week after camp arrival, all 1,006 attendees without a previous diagnosis of COVID-19 were tested, and three asymptomatic cases were identified. Following isolation of these persons and quarantine of their contacts, no secondary transmission of SARS-CoV-2 occurred. These findings can inform similar multilayered public health strategies to prevent and mitigate the introduction and transmission of SARS-CoV-2 among children, * https://www.who.int/dg/speeches/detail/who-director-generals -openingremarks-at-the-media-briefing-on-covid-19-11-march-2020.

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Pandemic Influenza A in Residential Summer Camps—Maine, 2009

Cited by 3 publications

References 0 publications

Mass Gatherings and Respiratory Disease Outbreaks in the United States – Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System

Mass Gatherings and Respiratory Disease Outbreaks in the United States – Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System

Estimating the frequency and characteristics of respiratory disease outbreaks at mass gatherings in the United States: Findings from a state and local health department assessment

Preventing and Mitigating SARS-CoV-2 Transmission — Four Overnight Camps, Maine, June–August 2020

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