Thanks to outbreaks of the H1N1 virus, thousands of kids with muscular dystrophy won't be having their “best week of the year” this summer.
On June 19, the Muscular Dystrophy Association (MDA), after discussion with the Centers for Disease Control and Prevention (CDC), canceled the remainder of its 80 annual summer camps throughout the US to protect the camps' high-risk population. Eleven cases of swine flu had been reported from among the 1,800 children who had already attended the 33 camp sessions held between May 24 and June 20. Some of the cases appeared during the camp session, while others became ill after leaving camp.
Several factors led to the shut-down, which is unprecedented in the summer camp program's 54-year history, said Valerie A. Cwik, MD, senior vice president of research and medical director at the MDA in Tucson, AZ. The “normal” flu season is typically over by the time most MDA camp sessions begin. But this year is different, with the World Health Organization (WHO) indicating that a pandemic is underway and the CDC announcing there is 10 times more flu than normal for this time of year — 90 percent of these cases are due to the H1N1 virus.
“So far with the H1N1 virus, the largest number of confirmed and probable cases has occurred in people between the ages of 5 and 24, which includes all MDA campers and many of the volunteers who staff our clinic,” she said.
Children with neuromuscular disorders are at increased risk for the flu and its complications. “The combination of the high-risk population attending MDA summer camps along with outbreaks in three of our camp sessions, in completely different geographic areas, led MDA to take preemptive action.”
The confirmed cases were found in attendees from camps in Pennsylvania, Utah, and Minnesota. “Three children have been hospitalized; two have been released and one child is currently in intensive care,” said Dr. Cwik. “Other cases are suspected and there has been at least one confirmed case, requiring hospitalization, in a sibling of a child who got sick at camp.”
The MDA is still gathering information about the cases, but symptoms have included nasal congestion, cough, chills, and fever.
Individuals may be contagious for up to one day before any symptoms appear, and for up to seven days after symptom onset, said Dr. Cwik. “Children may be contagious for a longer time. This would mean it's not always possible to detect those who are already infected and contagious, and they may not know that they have been exposed. We suspect that is the case in MDA camps, as campers and volunteers were screened at camp check-in for recent exposure or symptoms and signs of illness. At least one camper and several volunteers, including a member of a camp medical staff, were turned away before the start of MDA camp sessions because of known exposures to swine flu.”
No other MDA programs have been affected by the outbreaks, but staff members are urging MDA staff to take precautions to prevent the flu, particularly in group settings, said Dr. Cwik.•