Parents who arrived for visiting day on Sunday at Camp Matoaka in Smithfield, Me., got a iny bottle of Purell, and at lunch, the serving staff wore masks and gloves.
“This is a different year,” said Jason Silberman, the director.
The shimmering lakes are as idyllic as ever, the bunks as cozy, and the dining halls as deafening, but here in Maine, summer camp is not quite the same in the era of H1N1. Temperature checks start the moment the campers get off the bus or plane. Many intercamp sports and socials have been canceled or postponed. And hand sanitizer is everywhere.
“We’ve never had flu in the summer like this,” said Dr. Dora Anne Mills, Maine’s public health director. “We have 33 camps in Maine with outbreaks, and another 10 in the pipeline being tested. Some of them have 70 to 100 kids in isolation, so they’re running shadow camps for them.”
Dr. Mills and other experts believe the outbreaks here are a barometer for what will happen in the schools this fall.
Of course, swine flu has wrought havoc with summer camps in other states, too. In Georgia, Camp Coleman canceled its first session because so many counselors got sick right before camp started that it seemed impossible to provide a good program. In Vermont, Camp Killooleet had one or two sick children on a Monday soon after camp began, according to its director, Dean Spencer, but that grew to 12 or 15 on Tuesday — so on Wednesday, Mr. Spencer sent all 100 campers home for a week.
But Maine, with more than 100 sleep-away camps, seems to have been hit especially hard. Some camps send children home as soon as they develop a fever — often disrupting the plans that parents had made for those weeks, whether it was a second honeymoon or a chance to paint the kitchen.
But most camps are not sending campers home, instead keeping them in the infirmary, the gym, the arts and crafts building, wherever emergency cots will fit, for the seven-day isolation period.
Camp Modin, with about 380 campers and 130 staff members, had about 90 cases of flu, enough so that both the Beavers cabin and the Teen Center were cleared out and used for quarantine housing.
“We’ve taken 6,000 temperatures this summer,” said Howard Salzberg, the camp director. “We’ve bought all the Clorox wipes in every Wal-Mart we could drive to. We’ve spent about $45,000 on this, $30,000 on Tamiflu alone, and probably another $15,000 on the masks, the gloves, the games for the kids in isolation.”
Camp Modin brought the outbreak to a dead halt by offering prophylactic Tamiflu to all of the campers and counselors, a move it took on the advice of one of the parents, Dr. Marc Siegel.
“Tamiflu is used prophylactically in nursing homes quite successfully,” said Dr. Siegel, an associate professor of medicine at N.Y.U. Langone Medical Center. “And I think when there’s a big outbreak in summer camp, where kids live very close together in their bunks, it makes sense to follow to follow the same protocol.”
Almost 300 campers and 100 staff members went on prophylactic Tamiflu for 10 days, Mr. Salzberg said, and the H1N1 virus stopped spreading.
After hearing of the results at Camp Modin, several other Maine camps encouraged parents to approve the prophylactic use of Tamiflu.
“We had to go to 10 different places to get enough Tamiflu,” said Fritz Seving, the director of Camp Fernwood in Poland, Me. “We had 2 sick girls, then 6, then 28, but within 24 hours of starting Tamiflu, it ended.”
“Of our 330 campers and staff, 297 decided to take the Tamiflu,” Mr. Seving said. “Since we began it July 11, the only girl who got sick was not taking it. You can’t argue with those results.’
For camp directors, there may be no argument. But for Dr. Mills, the issue is far less clear.
“I understand completely why they’re doing it,” she said, “but from the broad public health point of view, I can’t recommend it. When you start giving Tamiflu in large quantities, you start breeding resistance. If you give it to otherwise healthy young people who’ve been exposed, every boarding school and college student will be on Tamiflu pretty soon, and since you don’t stop prophylactic use until seven days after the last case, you can imagine the quagmire.”
This month, though, Modin and other camps with large outbreaks were deep in their own quagmire.
“The hardest part for a camp is that this is such a mild flu that kids feel better after a day or two, but we have to keep them isolated for a full seven days, when they’re feeling fine and getting bored,” Mr. Salzberg said. “We brought in a Wii, movies, board games, arts and crafts, everything. And when the other kids went to the beach, the kids in isolation came out and played basketball and volleyball.”
Modin, the oldest Jewish camp in New England, even made an outdoor quarantine area, staked like a crime scene with orange fluorescent tape, where sick campers could visit with their healthy friends and bunkmates, across a six-foot open-air divide.
On June 30, when Josh Vershleiser woke up at Camp Modin on his 11th birthday feeling “not so good,” he had seen enough others in his bunk take ill that he knew exactly what was coming.
“I knew I was going to get quarantined eventually,” Josh said. “It wasn’t so bad. There were others from my bunk there, and we got to play Wii all day.”
His counselor, Josh Burns was already there to welcome him, along with other infected counselors, who greeted campers with “Welcome to Swine ’09,” made friendship bracelets for each camper in isolation, and played games to keep them occupied.
For Mr. Salzberg and his four nurses and office managers, life became a constant round of giving medicine, taking temperatures, talking to parents. Even with the camp’s hospital-style touch-screen medical records system, tracking, packaging and labeling the Tamiflu for each camper took hours.
“We kept sending out these e-mails to parents telling them what was going on with the swine flu, but we’d have to remember to say that, Oh yes, we still had the water-skiing, the trip to the water park, the regular camp things,” Mr. Salzberg said. “You know, this camp got through World War II, and it didn’t close. And this is just the flu.”