New Guide Released to Prevent Infections In Crowded Shelters

As natural disasters like hurricanes and forest fires strike with greater frequency and ferocity and Americans are forced into close proximity with one another in temporary shelters, the risk of infections rises exponentially.

To help prevent infections and outbreaks, APIC – the Association for Professionals in Infection Control and Epidemiology — updated a comprehensive infection prevention guide for federal, state, and local emergency disaster coordinators.

Compiled by APIC’s Emerging Infectious Diseases task force, “Infection Prevention and Control for Shelters during Disasters,” gives step-by-step recommendations for how coordinators can keep displaced persons and shelter personnel safe from common types of infectious diseases including gastrointestinal, skin-related, and respiratory.

“We updated the guidebook so emergency planners would have the necessary information to reduce the risk of infection before the next natural disaster hits,” says Terri Rebmann, PhD, RN, CIC, FAPIC, lead author of the updated resource and a member of APIC’s Emerging Infectious Diseases task force. “Ideally, infection prevention and control experts would be onsite as part of a locality’s disaster planning, and infection prevention would be a component of routine disaster exercises and drills. But because this is not always the case, the guide was written to be incorporated into a community disaster plan without onsite IPC professionals,” says Rebmann.

Unfortunately, disasters and infectious disease often go hand-in-hand. In 2017, Hurricane Harvey displaced tens of thousands in Harris County, Texas and triggered a seasonal influenza outbreak at a megashelter. When the Camp Fire ravaged Butte and Glenn Counties in northern California a year later, nearly 300 evacuees out of 1,100 in a crowded shelter were stricken with acute gastroenteritis from a norovirus infection.

“We urge emergency disaster coordinators to utilize this resource so that communities are able to provide the safest possible shelter for displaced residents,” says APIC 2024 President Tania Bubb, PhD, RN, CIC, FAPIC.

The updated APIC guidebook makes a series of important updates to the original 2009 document that provides recommendations to prevent and control the spread of infections in shelters:

• Updated the protocols related to:

• Personal Protective Equipment (PPE) optimization when supplies are limited

• Infection prevention for a medical/first aid area within the shelter

• Added information regarding how to manage if a humanitarian crisis coincides with a disaster or if a group of individuals displaced because of a humanitarian crisis need to be housed by the community disaster shelter

• Added a log/report for tracking infections/infectious diseases within the shelter

• Added a checklist for what an infection preventionist should do/check when they first arrive at the shelter if they were not involved in shelter planning

• Added information about partnering with public health if/when physical distancing may be required at the shelter

The guide can be accessed here.