Manual Purpose

Every summer, thousands of children are sent to various recreational camps across Ontario to discover the wondrous outdoors and take part in our beautiful natural playground. Unavoidably every summer, at least one recreational camp in Ontario will have the misfortune of a large scale outbreak.

Due to the nature of recreational camps, with multiple children lodged in rustic cabins, the use of common washrooms and showers and direct contact games/activities, it is very easy for an infectious agent to be transmitted. In an outbreak situation, it is not uncommon for high numbers of children and staff to be ill at the same time, which can make programming, supervising, cleaning and health care for the ill very difficult. Additional health care resources may not be immediately accessible posing additional challenges for the owner/operator.

A recent example occurred in the summer of 2006 when a local recreational camp had over 70 children and 30 staff become ill with vomiting and diarrhea within a 36 hour period. It should also be noted that outbreaks or reportable diseases in a staff or camper of the camp usually cause anxiety for the families of campers/staff which can lead to logistical and communication challenges.

Although these outbreaks cannot always be prevented, they can be managed and effectively controlled with little disruption to scheduling or enjoyment of campers, families and staff of the camp. The best way to manage an outbreak is to be prepared. Some items to consider when planning for an outbreak:

• Large numbers of ill staff and children will need to be housed separately from the well staff and children
• Staffing ratios may be decreased, particularly if healthcare staff should become ill. This could impact camp programming and adequate supervision (e.g. waterfront activities may have to be cancelled if insufficient number of guards)
• Cleaning and disinfection of the camp will have to be increased and additional staff/resources may need to be used
• Notification of parents should occur in an efficient manner
• External services may have to be called in to support regular camp programming during outbreak (e.g. food or cleaning services)

It is the responsibility of every recreational camp to ensure compliance with the Health Protection and Promotion Act R.S.O. 1990, Regulation 568. Of particular importance as it applies to this section of the manual is Section 7 of the Regulation which states that;

“Every operator shall ensure that one of the following persons are present in each camp:

1. A physician
2. A registered nurse.
3. A person who is a holder of,
   1. A Canadian Red Cross Society’s Standard First Aid Certificate,
   2. A St. John Ambulance Association’s Standard First Aid Certificate, or
   3. A certificate that the medical officer of health considers equivalent to a certificate referred to in subparagraph i or ii. (R.R.O. 1990, Reg 568, s. 7 (1))

Furthermore it is stated that, “Where a physician is not in residence in a recreational camp, the operator shall ensure that the services of a physician can be obtained quickly in the case of a medical emergency.” (R.R.O. 1990, Reg. 568, s. 7 (2))

The following sections of the manual will outline the role of the Simcoe Muskoka District Health Unit (SMDHU) during any outbreak or case of a reportable disease. It will also provide information and resources for the development of policies, procedures or contingency plans to effectively and efficiently manage outbreaks or reportable diseases.

Purpose

1. To provide communicable disease information and resources, including fact sheets on reportable and non-reportable diseases, for camp staff, that may be useful in the event of illness/infection occurring during a camping session.
2. To provide on-site health care providers and camp staff with information about reportable diseases and the reporting requirements to the Simcoe Muskoka District Health Unit.
3. To provide fundamental infection prevention and control information that will assist in preventing, limiting and controlling infections in both staff and campers during camping sessions.
4. To provide information and resources on outbreak management and control measures that will enable staff in the early recognition of outbreaks and to effectively prevent/control the spread of an outbreak.