Abstract
The Camp Fire, California's deadliest wildfire, began November 8, 2018, and was extinguished November 25 (1). Approximately 1,100 evacuees from the fire sought emergency shelter. On November 10, acute gastroenteritis (AGE) was reported in two evacuation shelters; norovirus illness was suspected, because it is commonly detected in shelter-associated AGE outbreaks. Norovirus is highly contagious and resistant to several disinfectants. Butte County Public Health Department (BCPHD), assisted by the California Department of Public Health (CDPH), initiated active surveillance to identify cases, confirm the etiology, and assess shelter infection prevention and control (IPC) practices to guide recommendations. During November 8-30, a total of 292 patients with AGE were identified among nine evacuation shelters; norovirus was detected in 16 of 17 unique patient stool specimens. Shelter IPC assessments revealed gaps in illness surveillance, isolation practices, cleaning, disinfection, and handwashing. CDPH and BCPHD collaborated with partner agencies to implement AGE screening, institute isolation protocols and 24-hour cleaning services, and promote proper hand hygiene. During disasters with limited resources, damaged infrastructure, and involvement of multiple organizations, establishing shelter disease surveillance and IPC is difficult. However, prioritizing effective surveillance and IPC at shelter activation is necessary to prevent, identify, and contain outbreaks.
Highlights
Evacuees from the Camp Fire wildfire; all volunteers for the wildfire response, and James Watt, Gil Chavez, Susan Fanelli, Karen Smith, California Department of Public Health; Monica Soderstrom, Andrew Miller, Butte County Public Health Department; Emergency Medical Services Authority of California; Commissioned Corps of the U.S Public Health Servic
All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of possible conflicts of interest
Shelter assessment revealed deficiencies in illness surveillance and infection prevention and control (IPC), which prompted public health intervention
Summary
Evacuees from the Camp Fire wildfire; all volunteers for the wildfire response, and James Watt, Gil Chavez, Susan Fanelli, Karen Smith, California Department of Public Health; Monica Soderstrom, Andrew Miller, Butte County Public Health Department; Emergency Medical Services Authority of California; Commissioned Corps of the U.S Public Health Service.
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