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Publications (3)4.57 Total impact

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    ABSTRACT: Describe two 2009-H1N1 influenza outbreaks in university-based summer camps and the implementation of an infection control program. 7,906 campers across 73 residential camps from May 21-August 2, 2009. Influenza-like-illness (ILI) was defined as fever with cough and/or sore throat. Influenza A was identified using PCR or rapid-antigen testing. We implemented an infection control program consisting of education, hand hygiene, disinfection, symptom screening, and ILI case management. An initial ILI cluster involved 60 cases across 3 camps from June 17-July 2. Academic Camp-1 had the most cases (n = 45, 14.9% attack rate); influenza A was identified in 84% of those tested. Despite implementation of an infection control program, a second ILI cluster began on July 12 in Academic Camp-2 (n = 47, 15.0% attack rate). ILI can spread rapidly in a university-based residential camp. Infection control is an important aspect of the medical response but is challenging to implement.
    Journal of American College Health 04/2011; 59(5):419-26. · 1.45 Impact Factor
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    ABSTRACT: Little is known about the clinical presentation and course of novel H1N1 influenza in summer camps. To describe the clinical course and evaluate the effect of influenza treatment in a summer camp population. Two large influenza outbreaks occurred in university-based residential camps between May 21 and August 2, 2009. Through active daily surveillance, medical evaluation at symptom onset, and data collection during isolation, we describe the clinical course of a large outbreak of novel H1N1 influenza. Influenza-like illness (ILI) was documented in 119 individuals. Influenza A was confirmed in 66 (79%) of 84 samples tested. Three early samples were identified as novel H1N1. ILI cases had an average age of 15.7 years and 52% were male. Sixty-three were treated with oseltamivir or zanamivir, which was initiated within 24h of diagnosis. Cough, myalgia and sore throat occurred in 69, 64 and 63% of cases, respectively. The highest temperature over the course of illness (T(max)) occurred within 48h after symptom onset in 87.5% of individuals. Average T(max) was 38.4 degrees C (range 36.1-40.2 degrees C). Among confirmed influenza cases, 69% defervesced by 72h and 95% defervesced by 96h. Defervescence at 72h was not different in the treated and untreated groups (p=0.12). Novel H1N1 generally has a mild, self-limited course in healthy adolescent campers. Defervescence occurred within 72h and was unaffected by treatment.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 03/2010; 47(3):286-8. · 3.12 Impact Factor
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    ABSTRACT: Background: Residential communities are prone to high influenza attack rates. However, little is known about the effectiveness of standard infection control measures in this setting. Methods: An outbreak of novel H1N1 occurred across several residential summer camps. We instituted infection control interventions (including CDC recommendations) such as screening all incoming campers, screening existing campers daily, isolation of campers with influenza-like-illness (ILI), prophylaxis of potential vectors, education, social distancing and provision of hand sanitizer. We report ILI attack rates (AR) for 2 outbreaks, June 17-July 2 and July 12-24, during and after implementation of infection control measures, respectively. Results: Between May 21 and Aug 2, 2009, 75 residential camps with 8,178 enrolled campers in addition to staff were hosted at a large university. Participants originated from mulitple states and nations. We detected 2 clusters of ILI. The first involved 60 cases spread across 3 camps from June 17 - July 2, age range 10-26 yrs. Academic Camp-1 (AC1) had the most cases (n=45, 14.9% AR, 26 influenza A of 31 tested). Dance Camp (DC) had 5 ILI cases (1.0% AR, 3/4 influenza A). Youth Program had 10 cases (4.4% AR, 6/7 influenza A). AC1 ended on July 4 although the DC and 28 AC1 counselors (none with ILI) remained on campus until the next AC session (AC2) began on July 12. On July 13, one AC2 camper developed ILI. Despite full prior implementation of infection control measures, there were 47 cases in the AC2 camp by July 24, age range 14-61 yrs (15.0% AR, 39/46 influenza A), prompting closure of AC2. Conclusion: Despite implementing aggressive infection control measures, the ILI attack rate did not change between outbreaks. However spread was contained within one camp population during the second outbreak. Residential camps are a unique and challenging infection control environment.
    Infectious Diseases Society of America 2009 Annual Meeting; 10/2009