Summer Camps includes those camp establishments which provide food or lodging accommodations for groups of children or adults engaged in organized recreational or educational programs. It also includes day camps, church assemblies, and retreats.

Any person operating a summer camp within the State of North Carolina is required to possess a valid summer camp permit from the Health Department.

In order to receive a summer camp permit, the owner must submit a Summer Camp Application to the health department prior to commencement of summer camp. The application will be reviewed and an Registered Environmental Health Specialist, REHS, will be assigned. The REHS will contact the applicant to schedule a site visit. Once the camp has met all of the requirements of the Rules Governing the Sanitation of Summer Camps 15A NCAC 18A .1000, a permit may be issued.

Once the permit has been issued and summer camp has commenced, the REHS will conduct a sanitation inspection of the camp. Sanitation inspections of summer camps will be made at least once during each season's operation.
    *Summer Camp Sanitation Rules
    *Summer Camp Inspection Form

In addition to the summer camp permit and inspection, summer camps that prepare food onsite will require a separate inspection of the summer feeding site. 
    *Summer Feeding Site Inspection Form

For more information about Summer Feeding Site programs, refer to the flow charts listed below:

    Summer Feeding Site Flow Chart Basic

  Summer Feeding Site Flow Chart Advanced

Rabies Prevention at Summer Camps

Summer camps offer unique opportunities for campers and staff to experience nature, but also the potential for exposure to wildlife and their diseases. Mammals commonly infected with rabies in North Carolina (rabies vector species) include bats, raccoons, skunks, foxes, beaver, groundhogs as well as bobcats, coyotes and other large carnivores. However, any mammal, including lower risk wildlife and cats, dogs and livestock, may be infected with and transmit rabies.

In the United States each year, about one to two human rabies cases result from unrecognized bat exposures or bat exposures that were not considered significant. Potential exposure to bats (including sleeping in a room or cabin where bats have been found) has resulted in large numbers of campers and staff being referred for rabies post-exposure prophylaxis at great expense to camps and local and state health departments. 

If a bite or scratch from a wild, feral/stray or domestic animal occurs, IMMEDIATELY wash the victim’s wound(s) thoroughly with soap and water for 15 minutes. Seek medical attention. Exposures to rabies may also occur when there is direct contact with a bat or in circumstances where persons were in the same room as a bat and might be unaware that a bite or direct contact had occurred (e.g., a sleeping person awakens to find a bat in the room or an adult witnesses a bat in the room with a previously unattended child, mentally disabled person, or intoxicated person). Camp staff should immediately contact local animal control to have the exposing animal captured/confined/tested (depending on the species) and report the bite/exposure to the local health department communicable disease nurses, who will then provide rabies risk assessments and medical guidance (http://www.cdc.gov/rabies/medical_care/index.html).If the exposing animal is not captured then camp staff should discuss referral of the exposed person for post-exposure prophylaxis with the local health department communicable disease nurses.

Key rabies prevention strategies include the following:

• Inspect all facilities to ensure all bats, wildlife and potential portals of entry into buildings are eliminated prior to occupancy or use and on a daily basis to ensure that bats and other wildlife are not present.
• Hire a Wildlife Damage Control Agent (WDCA) for professional inspection and exclusion of bats and wildlife. Locate an agent in your county at http://www.ncwildlife.org/Trapping/WildlifeDamageControlAgent.aspx.
• Provide education to staff and campers to reduce the risk of rabies transmission, see the NC DHHS website on rabies at http://epi.publichealth.nc.gov/cd/diseases/vph.html.
• Instruct campers and staff to not approach, touch, feed, capture or rehabilitate wild or stray animals. Leave them alone.
• Be certain camp dogs, cats and other domestic animals are currently vetted, free of parasites, infectious disease and are rabies-vaccinated. Maintain proof of a current rabies vaccination (i.e., a rabies certificate) on file at the camp. 

Tick & Mosquito Prevention at Summer Camps

Summer camps represent a great opportunity for children to spend time outdoors and participate in a variety of educational, environmental and recreational opportunities. However, just like at home, children may be exposed to ticks and mosquitoes that, in addition to being a nuisance, can cause disease. We would like to take this opportunity to provide some suggestions on how children and camp administrators can be prepared to minimize the impact of ticks and mosquitoes.

Tick and mosquito-borne diseases are common in NC. For the 5-year time period from 2010 through 2014 an annual average of 427 cases of Rocky Mountain spotted fever, 88 cases of Ehrlichiosis, and 127 cases of Lyme disease have been reported from across the state. While tick-borne diseases such as these are most common, mosquito-borne diseases are also reported. During the same 5-year time period an average of 22 cases of LaCrosse Encephalitis was reported. However, the distribution of LaCrosse cases is not uniform; over 75% of cases are reported from the southwestern portion of NC, primarily Henderson, Transylvania, Jackson, Swain, Haywood and Buncombe Counties. Fortunately, the risk of acquiring all of these vector-borne diseases can be reduced by following the steps below.

Prior to the arrival of children at camp:

1. Request parents educate children about appropriate use of repellents such as DEET, which is used on exposed skin.
2. Have children bring clothing that is treated with permethrin, which is an effective repellent and acaricide.
3. Have children bring fine-tipped tweezers that they (or camp medical personnel) can use to remove attached ticks.

Camp Administrators should:

1. Educate children about avoiding tick habitats (wooded and bushy areas with high grass and leaf litter) and eliminate tick habitats to the extent possible.
2. Instruct children to walk in the center of trails; this will help avoid tick habitat.
3. Eliminate mosquito-breeding sites by emptying standing water from flowerpots, buckets, barrels, tires and other containers such as clogged rain gutters at least weekly. Drill holes in tire swings so water drains out.
4. Educate campers upon arrival about proper tick removal: http://www.cdc.gov/ticks/removing_a_tick.html.
5. Instruct children to conduct daily tick checks and remove them appropriately, or see camp medical personnel.

For additional information:

• CDC information on preventing mosquito bites
• CDC information on preventing tick bites
• Information on tick and mosquito borne diseases in NC
• North Carolina Tick-Borne disease poster

For additional information, please contact: 
Lisa Morgan, Food and Lodging Program Supervisor
(919) 545-8309
lisa.morgan@chathamcountync.gov

The Environmental Health Division can be reached from 8 a.m. to 5 p.m. Monday through Friday at (919) 542-8208.