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. 2019 Nov 6;8(5):392-399.
doi: 10.1093/jpids/piy068.

Prevention and Control of Youth Camp-Associated Acute Gastroenteritis Outbreaks

Anita K Kambhampati  1   2   3 , Zachary A Marsh  1   3   4 , Michele C Hlavsa  5 , Virginia A Roberts  5 , Antonio R Vieira  5 , Jonathan S Yoder  5 , Aron J Hall  1   4
Affiliations

Prevention and Control of Youth Camp-Associated Acute Gastroenteritis Outbreaks

Anita K Kambhampati et al. J Pediatric Infect Dis Soc. .

Abstract

Background: Approximately 14 million children attend more than 14000 US camps every year. Shared accommodations and activities can facilitate acute gastroenteritis (AGE) outbreaks.

Methods: We analyzed data from the National Outbreak Reporting System on US youth camp-associated AGE outbreaks that occurred between 2009 and 2016. We also conducted a systematic literature search of youth camp-associated AGE outbreaks that have occurred around the world and a gray literature search for existing recommendations on outbreak prevention and control at camps worldwide.

Results: Thirty-nine US jurisdictions reported a total of 229 youth camp-associated AGE outbreaks to the National Outbreak Reporting System. Of the 226 outbreaks included in our analyses, 120 (53%) were reported to have resulted from person-to-person transmission, 42 (19%) from an unknown transmission mode, 38 (17%) from foodborne transmission, 19 (8%) from waterborne transmission, 5 (2%) from animal contact, and 2 (<1%) from environmental contamination. Among 170 (75%) outbreaks with a single suspected or confirmed etiology, norovirus (107 [63%] outbreaks), Salmonella spp (16 [9%]), and Shiga-toxin producing Escherichia coli (12 [7%]) were implicated most frequently. We identified 43 additional youth camp-associated AGE outbreaks in the literature that occurred in various countries between 1938 and 2014. Control measures identified through the literature search included camp closure, separation of ill campers, environmental disinfection, and education on food preparation and hand hygiene.

Conclusions: Youth camp-associated AGE outbreaks are caused by numerous pathogens every year. These outbreaks are facilitated by factors that include improper food preparation, inadequate cleaning and disinfection, shared accommodations, and contact with animals. Health education focused on proper hygiene and preventing disease transmission could help control or prevent these outbreaks.

Keywords: camp; gastroenteritis; outbreak; prevention; youth.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Numbers of youth camp–associated outbreaks of acute gastroenteritis in the United States, including Puerto Rico, reported to the National Outbreak Reporting System from 2009 through 2016 according to reporting jurisdiction (N = 229). Outbreak reporting largely depends on surveillance activities in the individual states and does not necessarily indicate the true incidence of outbreaks in a given state.
Figure 2.
Figure 2.
Numbers of youth camp–associated outbreaks of acute gastroenteritis reported to the National Outbreak Reporting System from 2009 through 2016 according to pathogen type and primary mode of transmission (N = 226). Etiology categories are defined in Table 1. The waterborne disease outbreak data for 2015 to 2016 are provisional.
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References

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