Camp Health (Poison Ivy)
By Myra Pravda, RN, MSN
Dear Myra, This past summer we had more cases of poison ivy than we have had in a long time. Many of our staff and campers had to be taken to the camp physician for extra treatment. Can you tell me how it spreads and how we can prevent such severe cases?
Answer: The poison ivy rash can make any staff member or camper miserable! If the rash is severe, participation in camp activities might be effected which would impact on the child's camp experience. Your staff member with a severe case of poison ivy will be unable to work to their full potential and put a strain on the other employees of camp. Educating your campers and staff is the key to prevention. As the saying goes, "An ounce of prevention is worth a pound of cure." This especially holds true with poison ivy. Everyone in camp should be able to identify the plant, know how poison ivy is spread, and know how to care for themselves after an exposure to the plant. Last summer during our first session, we also had many cases of poison ivy. Doing some risk management, second session we had the health center staff visit every cabin, they took the campers outdoors, pointed out poison ivy, discussed prevention, and the number of cases decreased significantly. Education works!
Poison ivy and poison oak are variants of the Rhus plant family and differ mainly in the shape of their leaves. Both are woody perennial plants found along fences, paths and roadways, in the woods and is often partially hidden by other foliage. Poison ivy grows east of the Rockies while poison oak usually grows in the western United States. The plant may take the form of vines climbing up tree trunks to considerable height, shrubs standing by themselves, or vines trailing along the forest floor, sometimes also trailing out into meadows from the woods. Both varieties have regular groupings of three leaflets. The leaves may be notched or smooth and vary in length from one to five inches. They are shiny, dark green in summer and orange or red in the fall. In May and June, there are tiny white berries that cluster at the base of the leaves. People who learn to recognize poison ivy in one part of the country may not at first recognize it elsewhere. The one characteristic which makes it easy to recognize is the LEAVES ALWAYS GROW IN CLUSTERS OF THREE!
Poison sumac is a tall, smooth-stemmed shrub of swamps throughout the eastern US and Canada. It has stems of from seven to thirteen leaflets, including one at the tip. The fruits are white or yellowish berries in clusters similar to those of poison ivy. The leaves are dark green in the summer and turn red in the fall. It is very important to be able to recognize and avoid the poisonous plants that grow in and around your camp.
Poison ivy, poison oak, and poison sumac contain a lacquer like resin in their sap. The resin is composed of active substances that provoke a sensitizing reaction in most, if not all, persons the first time effective contact occurs. The resin, present in all parts of the plant, is very resistant to breakdown and must contact the skin for the poison to take effect. Direct contact may be made by just bruising past the leaves as you walk next to the plant. In the winter after the leaves have fallen you can still get poison ivy from contact with the stem. Indirect contact may be from pets, contaminated clothing, or garden tools which have had contact, often much earlier, with the poison ivy plant. How the resin is spread is important to remember when instructing campers and staff about being in the woods. Smoke from burning ivy plants is particularly troublesome because the smoke particles can carry the resin and effect all uncovered parts of the body and also be inhaled. When instructing campers and staff about gathering wood for fires make sure to look for poison ivy that may be on the branches on the ground or climbing up the tree trunks.
An initial exposure is necessary to "sensitize" the person to the poison ivy plant. A subsequent exposure will result in an allergic reaction if the resin remains in contact with the skin. The resulting rash forms from several hours to three later after exposure. First, the skin reddens and begins to itch. Small watery blisters soon appear, often in lines indicating the point of contact with the plant, and the itching becomes intense.
The condition is self-limiting and recovery takes place in one to four weeks, even without treatment. Scratching slows healing, invites infection, and may spread the resin from one location to another. The watery fluid in the blisters does not spread the reaction. The resin from the plant that remains on the skin is what spreads the reaction. A physician should be consulted in severe cases or if sensitive parts of the body, such as around the eyes, become involved. Ask your camp physician what to use to relieve the itching of poison ivy. This information should be part of your camp's standing orders.
Now that we understand the poisonous plants and the allergic reaction rash from contact, we need to discuss prevention.
Poison Ivy Tips
If it has three leaves, let it be. Learn to recognize poison ivy, poison oak, and poison sumac. Show pictures of poison ivy as well as point out the plant to campers and staff at your camp. Avoid poison ivy's favorite places like the woods. Be prepared for hiking in the woods. Wear hats, long sleeve shirts, and long pants tucked into socks when hiking. Don't play games like "Capture The Flag" or "Frisbee" in areas where people might run into woods. Make the wooded areas off limits. Don't burn poison ivy!
If you are exposed, wash and scrub the area immediately with warm water and soap. Repeat the washing to try to remove all the resin. Remember to clean fingernails.
Wash all clothing that has possibly been contaminated with the resin of the plant.
Campers often only have a couple pairs of jeans and want to wear them again instead of putting them in the laundry. Touching clothing that has been contaminated with the resin, can cause a reaction, even several days later! You can spread poison ivy on yourself if the resin is on the skin. If the person scratches the area with the resin, then rubs his eyes there is a good chance the resin will spread to that area around his eyes.
Don't play with camp pets. The resin can stick to their coats and rub off on humans.
Try not to scratch when poison ivy itches. See the camp nurse for treatments. Poison ivy is not contagious. It can not be spread once the resin has been absorbed by the skin or removed.