title: Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team.
abstract: Introduction In late October of 2012, Hurricane Sandy struck the northeast United States and shelters were established throughout the impacted region. Numerous cases of infectious viral gastroenteritis occurred in several of these shelters. Such outbreaks are common and have been well described in the past. Early monitoring for, and recognition of, the outbreak allowed for implementation of aggressive infection control measures. However, these measures required intensive medical response team involvement. Little is known about how such outbreaks affect the medical teams responding to the incident. Hypothesis/Problem Describe the impact of an infectious viral gastroenteritis outbreak within a single shelter on a responding medical team.
  
  
  METHODS
  The number of individuals staying in the single shelter each night (as determined by shelter staff) and the number of patients treated for symptoms of viral gastroenteritis were recorded each day. On return from deployment, members of a single responding medical team were surveyed to determine how many team members became ill during, or immediately following, their deployment.
  
  
  RESULTS
  The shelter population peaked on November 5, 2012 with 811 individuals sleeping in the shelter. The first patients presented to the shelter clinic with symptoms of viral gastroenteritis on November 4, 2012, and the last case was seen on November 21, 2012. A total of 64 patients were treated for nausea, vomiting, or diarrhea over the 17-day period. A post-deployment survey was sent to 66 deployed medical team members and 45 completed the survey. Twelve (26.7%) of the team members who responded to the survey experienced symptoms of probable viral gastroenteritis. Team members reported onset of symptoms during deployment as well as after returning home. Symptoms started on days 4-8, 8-14, on the trip home, and after returning home in four, four, two, and two team members, respectively.
  
  
  CONCLUSIONS
  Medical teams providing shelter care during viral gastroenteritis outbreaks are susceptible to contracting the virus while caring for patients. When responding to similar incidents in the future, teams should not only be ready to implement aggressive infectious control measures but also be prepared to care for team members who become ill.
authors.affiliation: 1United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response,Office of Emergency Management,National Disaster Medical System,Tucson,ArizonaUSA.
authors.forename: Joshua B
authors.initials: JB
authors.lastname: Gaither
authors.affiliation: 1United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response,Office of Emergency Management,National Disaster Medical System,Tucson,ArizonaUSA.
authors.forename: Rianne
authors.initials: R
authors.lastname: Page
authors.affiliation: 1United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response,Office of Emergency Management,National Disaster Medical System,Tucson,ArizonaUSA.
authors.forename: Caren
authors.initials: C
authors.lastname: Prather
authors.affiliation: 1United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response,Office of Emergency Management,National Disaster Medical System,Tucson,ArizonaUSA.
authors.forename: Fred
authors.initials: F
authors.lastname: Paavola
authors.affiliation: 1United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response,Office of Emergency Management,National Disaster Medical System,Tucson,ArizonaUSA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Garrett
mesh_terms: D000328:Adult; D055867:Cyclonic Storms; D004196:Disease Outbreaks; D060731:Emergency Responders; D060447:Emergency Shelter; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D009515:New Jersey; D009518:New York; D009784:Occupational Diseases / Q000453:epidemiology*; D014777:Virus Diseases / Q000453:epidemiology* / Q000635:transmission
keywords: CDC Centers for Disease Control and Prevention; IV intravenous; PPE personal protective equipment; cyclonic storms; disaster; disease outbreak; gastroenteritis; infection control