Camps: Be Better Prepared for Health & Medical Issues This Year

Camp health care teams faced three major challenges in 2019: measles, CBD oil, and staff mental health concerns. Did your camp encounter any other health concerns in 2019?  How equipped was your staff to manage them?

Reviewing your camp's experiences, plus its injury and illness reports, can help you identify which situations may merit a different approach in the coming season. Explore what education, training, or resources could help your team be better prepared to manage health and medical issues this year.

Let's look at the top three from the past summer with the help of Tracey Gaslin, PhD., APRN, CRNI, executive director of the Association of Camp Nursing. A professor and dual-certified nurse practitioner, Gaslin frequently publishes material about camp nursing.

Measles

The worst measles outbreak in more than two decades had camps across America this year scrambling to verify that all campers and staff had been vaccinated against this highly contagious disease.

The Centers for Disease Control and Prevention was among several organizations urging camps to take special precautions to reduce the chance of measles spreading among staff and campers. When camp season started in early May 2019, the number of confirmed measles cases stood at 764.¹ Although that number had grown to 1,182² by early August 2019, the Association of Camp Nursing was not aware of a single case of measles being reported at a camp this summer, Gaslin said.

Many of the precautions that camps took this year to prevent the spread of measles will apply again in 2020, Gaslin said. This includes working with state and local public health officials to develop an infectious disease plan and requiring all campers, staff, and volunteers to document that they have received age-appropriate vaccines. 

Camps should also make sure that they’re checking staff for signs of infection upon arrival and following protocols for international staff, she says. Measles is still common in many parts of the world, and travelers with measles can carry the disease into the United States. 

The following resources offer information that can help you develop policies and procedures for managing measles and other infectious diseases. 

Information About Measles Prevention

• CDC: Measles and Camps  
• ACA: Measles Information for Camps
• ACN: Communicable Disease Management in the Camp Setting
• AAP: Measles – 2019 Outbreaks

Download sample liability waiver forms from Brotherhood Mutual to use with campers who have not been vaccinated for medical, religious, or philosophical  reasons. 

CBD Oil

Cannabidiol (CBD), a compound derived from the cannabis plant, is being marketed as a remedy for everything from anxiety to ADHD. However, most products containing CBD are not approved or regulated by the U.S. Food and Drug Administration. CBD oil becomes an issue for camps when parents expect staff to administer the product as if it were medicine, Gaslin says. 

"A bottle may say that it contains less than 0.3 percent THC, but there's nobody regulating that product," Gaslin said. "So, we don't really know what's in the bottle."

Some tests have found products that were mislabeled or that contained more than the permitted amount of THC, the psychoactive agent associated with a "high."³ 

Other issues for camp nurses include uncertainty about proper dosing, side effects, and how CBD oil interacts with other medications, Gaslin said. If a camper were to become ill after taking CBD oil, liability could rest on the camp and its staff, Gaslin said. 

The FDA says there are many unanswered questions about the science, safety, and quality of products containing CBD. It has not approved CBD products for medical use, apart from one prescription drug to treat two rare forms of epilepsy. In a July 2019 news release, the FDA warns consumers to beware of purchasing or using CBD products.⁴

Medication management regulations vary by state and can be affected by pharmacy regulations, boards of nursing, and rules governing camps. It’s important to understand your state’s laws on medicine management, as well as the issues surrounding CBD oil. This Camp Medication Management FAQ offers a good starting point for your research.

Information About Medication Management 

• Medication Management Practice Guidelines 
• Medication at Camp — Mitigating the Risk 
• Managing, Monitoring and Administering Medications at Camp
• CDC: Medication Safety 

Information About CBD Oil

• FDA: What You Need to Know…About Products Containing Cannabis
• Mayo Clinic: Is CBD Safe to Use
• Harvard Medical School: Cannabidiol (CBD)—What we know and what we don’t

Staff Mental Health Issues

The American Camp Association encourages camps to prepare for mental health concerns of both campers and staff. In a review of calls made to the ACA’s Camp Crisis Hotline in 2018, the association reported that camps often seek help with mental health issues such as anxiety, cutting, and suicidal thoughts.⁵ The Hotline offers third-party support for camps in crisis. It doesn’t provide medical or legal advice, but it does offer resources, strategies, and support.

“The number of calls to the Hotline on mental health concerns appears to mirror a societal trend,” the report said. “Camps need to have a mental health support system in place and should add mental health resources and experts to the team and healthcare plan.” 

Gaslin answers many of the ACA’s Hotline calls regarding health and medical issues. She invites camps to ask themselves: How do we better take care of staff, so they can take care of campers?” 

The following resources from the Association of Camp Nursing and other organizations offer information that can help you better manage the mental health of both staff and campers.

Information about Mental Health 

• Mental, Emotional & Social Health (MESH) Resources
• What Directors Need to Know About Staff Mental Health
• Biting My Nails: Revisiting Staff Anxiety
• Mental Health, Breaks and Self Care at Camp

Take Time to Recharge

Running a great camp requires an enormous amount of effort. Take some time to rest and reflect on the past season, so you are mentally ready to tackle the challenges ahead. Then, open up some of these resources. Call your insurance agent to talk about risk management. Ask your local health department for some pointers. Then, you’ll be ready to start gearing up for another great year of hiring, training, and helping staff members do their best work at summer camp.

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Revised March 4, 2020
Created September 23, 2019
Appeared in the October 2019 edition of Camp News 

Sources:
1. Gonden, Rowena. “Enrolling Your Kid in Summer Camp? Better Get That Measles Vaccination.” Healthline. May 30, 2019. https://www.healthline.com/health-news/summer-camps-tightening-rules-on-vaccinations#Parents-who-are-uncertain Accessed August 11, 2019.
2. Measles Cases and Outbreaks. Centers for Disease Control. https://www.cdc.gov/measles/cases-outbreaks.html Accessed August 12, 2019.
3. Hsu, Tiffany. “Ads Pitching CBD Oil as a Cure-All Are Everywhere. Oversight Hasn’t Kept Up.” The New York Times. https://www.nytimes.com/2019/08/13/business/media/cbd-marijuana-fda.html Accessed September 3, 2019.
4. “FDA warns company marketing unapproved cannabidiol products with unsubstantiated claims to treat cancer, Alzheimer’s disease, opioid withdrawal, pain and pet anxiety.” U.S. Food and Drug Administration. July 23, 2019. https://www.fda.gov/news-events/press-announcements/fda-warns-company-marketing-unapproved-cannabidiol-products-unsubstantiated-claims-treat-cancer Accessed September 3, 2019.
5. American Camp Association. “ACA Camp Crisis Hotline Annual Review 2018.” November 2018. https://www.acacamps.org/resource-library/campline/aca-camp-crisis-hotline-annual-review-2018 Accessed July 22, 2019.