Since its opening last week, camp counselors at New Jersey's Liberty Lake Day Camp disinfect door knobs, take the temperatures of children as they arrive and remind the campers not to share canned sodas.
Many of the 12,000-plus summer camps in the United States are ramping up their efforts to guard against the spread of the new H1N1 swine flu, which has caused the first pandemic of the 21st century.
While H1N1 influenza has caused mild symptoms that go away without medication in most patients, it has killed 170 people in the United States and more than 300 globally.
The U.S. Centers for Disease Control and Prevention says at least a million Americans are likely infected.
Swine flu outbreaks have prompted temporary closure of Indiana-based Camp Livingston, a YMCA day camp in West Virginia, and all of the Muscular Dystrophy Association's summer programs.
Many parents are debating whether they should deprive their kids of the summer camp experience because of the new flu.
New York resident Jing Zhang said she decided to keep her 5-year-old daughter at a local day-care center.
"Why I would want to spend a fortune on the summer camp when the risk is the same?" she asked.
"My kids can always go back to the program at a later date. If not, I will sign them up for some local arts and crafts programs," added Lin Huang, who has sent her two children to the Little Red School House day camp in Manhattan.
Group Settings
Dr. Daniel Rauch, a pediatrician at New York University Langone Medical Center, said the risk of catching swine flu is only greater in intimate or group settings, for instance, when kids sleep near each other in bunk beds, tents or cabins.
Unless children already have underlying ailments or immunodeficiencies, going to summer camps does not necessary pose a greater risk of catching swine flu than going to public spaces such as playgrounds and shopping malls, he added.
Some camp administrators said they would send any sick children home immediately or isolate them in an infirmary and let them play board games while they are being observed.
"We try to create a temporary community in the summer and we are very vigilant about it," said Andy Pritikin, director of Liberty Lake Day Camp in Mansfield, New Jersey, who sent a child with fever home last week, with full credit to come back later in the summer.
Parents should also be well informed of what kind of medical facilities or whether camp nurses are available on site. "If there's only a bottle of aspirin and a cot in the back room, and it takes three and a half hours to get to the nearest hospital, you need to know that," said Sean Nienow, director of the National Camp Association.
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