Bundled in a soft fleece blanket, 13-year-old Connor slumps in a cushioned wicker chair in the pine-paneled common room of the camp infirmary. In the next chair, 11-year-old Sam is similarly swaddled and slouched.
The boys, one from South Africa and the other from New York, are quietly sharing a collection of comic books, as well as a box of tissues and a pump bottle of hand sanitizer.
Close at hand, they each have a personalized N-95 paper respirator mask, ready to don when visitors enter the room.
Connor and Sam — officials at Camp Winnebago in Fayette asked that the boys’ full names not be disclosed — are among dozens, perhaps hundreds, of bummed-out kids at Maine summer camps this year who are presumed to be suffering with the H1N1 swine flu virus.
According to Dr. Dora Anne Mills of the Maine Center for Disease Control and Prevention, at least 30 of Maine’s summer camps, primarily in the southern half of the state, have been hit by the virus, which often targets children and young adults.
The annual influx of kids from urban areas — including Boston and New York City where the virus is especially widespread — is expected to bring many more cases into Maine in coming weeks. In the close confines of camp sleeping cabins, shared bathrooms, dining halls, recreation centers and other indoor gathering areas, H1N1 will find ideal conditions to replicate and spread.
As of July 10, the Maine CDC had confirmed 203 cases of H1N1 — 114 in year-round residents and 89 in visitors from out of state.
Of the latter group, Mills said, most are youngsters attending Maine’s approximately 200 summer camps. But in addition to the number of laboratory-confirmed cases, Mills said there are at least 10 times as many “probable” cases and possibly many more than that.
At this, the height of Maine’s summer season, she said, anyone suffering from a cluster of wintry flu symptoms — including fever, sore throat, cough, fatigue and general malaise — should be presumed to have swine flu.
Andy Lilienthal, the owner and director of Camp Winnebago, said that he has been in close contact for several months with parents planning to send their boys to camp this summer.
“I asked the families to be very vigilant,” he said. “I said, please, if your son is feeling ill, don’t send him until he’s better.”
But, sure enough, in the first busload that arrived on June 26, there was one boy from New York who clearly was not well.
“We isolated him the first night he was here,” Lilienthal said. “Of course, the boy who sat next to him on the bus got sick, too.”
As of last week, eight of Camp Winnebago’s 160 campers — ages 8 to 15 from 23 states and four countries — have been isolated with H1N1, although only two cases have been confirmed with laboratory testing.
In two of the eight cases, parents came and took their sons away from camp to care for them personally — back home to New York, in one case, and to an area motel for a few days in the other. Both those boys came back to camp once their symptoms subsided and finished serving out their seven-day isolation at “Chiefs,” the camper-friendly name of Winnebago’s three-bedroom infirmary cottage. v
According to the Maine Youth Camping Association, summer camps generate about $245 million each year for the state economy.
Most campers at Winnebago attend for the full 53-day summer session from June 26 to Aug. 17 at a cost of almost $10,000.
But long before any campers arrived last month, Lilienthal said, plans were in place for identifying those who might be getting sick and for keeping them from sickening others. Those plans were developed with guidance and input from the Maine CDC, which has been working closely with all Maine camps to address the H1N1 outbreak. The Maine Emergency Management Agency, or MEMA, has also helped camps prepare.
Mills said most camps are now screening each youngster whenever a group enters or leaves the facility. These “med checks” include taking everyone’s temperature and asking about flulike symptoms. Counselors are instructed to be on high alert throughout the season for emerging symptoms and are instructed to bring affected campers immediately to the infirmary for treatment and isolation.
For camps such as Winnebago that serve a lot of out-of-state families, she said, it may not be practical to send sick youngsters home, so those camps have prepared to isolate campers with H1N1 for seven days. But day camps and overnight camps that serve primarily local children and families should plan to send sick campers home, Mills said.
Several Maine camps have had 40 or 50 campers needing care and isolation, she said.
“Camps this summer are giving us a bellwether of what we might be facing in the winter in colleges and universities,” Mills said. “The camp experience is showing us that in residential settings, H1N1 spreads very quickly.”
Mills said it is unclear whether getting sick with the swine flu virus now will confer immunity in the future.
“The one thing that’s certain about this virus is that nothing is certain,” she said.
MEMA spokeswoman Lynette Miller said Monday that the agency has supplied cots and blankets to four Maine camps so far with the agreement that camps will pay to have the items cleaned before returning them to the MEMA stockpile. About 140 cots have been distributed, she said.
“You would think that camps would have plenty of cots,” Miller said, “but a lot of camps have built-in bunk beds.”
In addition, MEMA will help camps purchase spare tents to use as expanded infirmary space.
Campers with physical disabilities are more likely to get seriously ill from H1N1, so camps that serve that population have been urged to be especially vigilant. The Muscular Dystrophy Association recently announced its decision to close all the camps it operates because of swine flu fears.
But at the independent Pine Tree Camp for children and adults with disabilities, spokeswoman Erin Rice said it is pretty much business as usual.
No H1N1 cases have been reported at Pine Tree. But the camp, which is in Rome, has implemented all Maine CDC recommendations, Rice said, and recently has opened an expanded health center to serve campers and staff.
Because Pine Tree campers are all from in Maine, she said, “If we do have any campers or staff who become sick, they’ll be discharged immediately.”
Back at Camp Winnebago, despite shouts of laughter floating up from the lake and the dazzling sunlight outside, Connor and Sam seemed more than content to rest in the darkened infirmary cottage.
Camp Nurse Gwyn Lysaght said H1N1 cases at the camp so far have run a typical course.
“They’re down for at least five days,” she said. “Then on the sixth day they wake up rarin’ to go. It’s hard for them to stay on campus and know their friends are going off for an eight-day trip on the Allagash. We just try to keep them busy.”