American Academy of Disaster Medicine's (AADM) President Comments on U.S. Public Health System, Discusses Swine Flu Infection and Prevention

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The President of the American Academy of Disaster Medicine's (AADM), Gary Klein, MD, MPH, MBA, CHS-V, provides commentary and analysis from a disaster medicine perspective on the recent swine flu outbreak. Klein's comments include: an explanation of why improvements are needed to the U.S. public health system to manage a widespread outbreak of any virus or pathogen; how disaster medicine specialists are helping other health care providers; and what the public needs to know about the virus, including preventive efforts.

Detection, screening, and containment of this disease are very difficult. With the number of primary care providers at an all time low, it is likely that many hospital emergency rooms and urgent care centers could be overwhelmed by sick and

The emerging details regarding the evolving global outbreak of the swine flu is continuing to demand the attention of clinicians, public health, and government officials across the U.S. According to Gary M. Klein, MD, MPH, MBA, CHS-V, President of the American Academy of Disaster Medicine (AADM), "The U.S. public health system needs to be better prepared to cope with a potentially deadly outbreak of swine flu, or any other serious infectious disease."

Klein explains, "Detection, screening, and containment of this disease are very difficult. With the number of primary care providers at an all time low, it is likely that many hospital emergency rooms and urgent care centers could be overwhelmed by sick and "worried well" patients. Such a development would exacerbate the overcrowded conditions faced by many of these facilities on a daily basis." In addition, Klein strongly urges that families stock up on essential food, water, and medication items for at least 10 days.

AADM is assisting its colleagues with printed materials as well as training efforts with various state and local health-related entities. The Academy's primary concern is to prevent a surge of patients into local emergency rooms causing them to be overwhelmed during a period of epidemic and/or disaster.

"The need for physicians of all specialties to be trained in disaster medicine is why the AADM and its board exam were founded," Klein explained. "The AADM's belief has always been that it takes the collective community of all physicians, including family practitioners, internists, emergency room physicians, trauma surgeons, and psychiatrists, to fulfill the roles of assisting our country and population in the event of a disaster."

The AADM offers training programs, professional certification, and the opportunity to be part of a community of highly dedicated medical pioneers from all areas of medicine.

The following questions and answers on swine flu are for patient education purposes:

1. What is swine flu?
Swine influenza, or "swine flu", is a highly contagious respiratory disease that normally affects pigs, at all times throughout the year. It is caused by a type-"A" influenza virus, known as "H1N1". The concern now is that this virus has "jumped" from pigs to humans, causing this new strain to become a mix of animal and human viruses. What in essence was initially a pig-isolated virus has now transmitted itself to humans. This is often a concern for any new viruses.

2. What is causing the spread of the virus, and is this a bio-terrorism concern?
At this time we do not know what is causing this virus to spread. What we do know is that there are cases of swine handlers catching the disease from pigs, but now individuals are also becoming ill with no proximity or contact with the animals. The virus spreads in much the same way a cold or flu normally spreads. An infected individual coughs, sneezes, or touches another person, who then may touch their mouth, eyes, or nose. All of this can happen in the absence of any initial symptoms in the infected person.
a.    Researchers and physicians are concerned that because the virus has spread quickly from person to person, the virus can mutate more rapidly making it much more difficult to identify and treat. At this time no bio-terrorism-related concern has been noted according to the recent briefing by the U.S. Department of Homeland Security.

3. What are the symptoms of this new swine flu in humans?
The symptoms are vague - just like one would expect from a regular flu - such as fatigue, sore throat, cough, nausea and vomiting, chills, and watery bowel movements, to name a few.

4. Can this new swine flu be even more fatal then the so-called "seasonal flu"?
Any flu has the potential to cause high rates of sickness and death, primarily in those patients who have weak immune systems from any pre-existing conditions. We need to remember each year the seasonal flu can cause anywhere from 300,000 to 600,000 annual deaths worldwide. The concern with the current swine flu is the rapid spread among populations with no ability to vaccinate high risk groups, including the elderly or those with pre-existing conditions, or even the entire population at large. Because this viral strain is new, the current supply of vaccines will not work.

5. How can I keep myself and my family from catching the swine flu?
No vaccines are available to help develop immunity. The "keys" here are the following:
a) Wash your hands after contact with anyone
b) Stay clear of densely packed environments such as stadiums or concerts until the virus has been controlled
c) Eat a proper diet with plenty of washed fruits and vegetables, and get regular exercise
d) Avoid prolonged contact with individuals who are ill. Keep bathrooms and kitchens particularly clean.

6. Can I take any medicines to prevent swine flu, and there medicines available for treatment?
There are no medicines, over-the-counter products, or vaccines to currently prevent against this virus. There are anti-viral medications that can be administered within the first 36-48 hours of the appearance of symptoms. These medications can help reduce the duration of illness if infected, and can keep non-symptomatic patients from spreading the virus. However, patients must seek immediate attention if they believe they have been infected.

AADM recommends all persons consult with their own primary care physicians prior to traveling to an emergency room.

About the American Academy of Disaster Medicine

The American Academy of Disaster Medicine (AADM) is an affiliate of the American Board of Disaster Medicine, (ABODM). AADM formed to meet this and the myriad of needs created by the disaster planning, preparation, education, response and recovery environment.

The American Board of Disaster Medicine (ABODM), founded in 2006, is a member board of the American Board of Physician Specialties (ABPS). The ABPS, North America's third largest physician multi-specialty certifying organization, is the official certifying division of the American Association of Physician Specialists (AAPS). AAPS is a not-for-profit organization with headquarters in Tampa, Florida. More information is available on AAPS.

Gary M. Klein, MD, MPH, MBA, CHS-V
President, American Academy of Disaster Medicine
(770) 842-8749

William J. Carbone
CEO, American Association of Physician Specialties (AAPS)
(404) 550-2425

Timothy Bell
Director of Government Affairs, American Association of Physician Specialties (AAPS)
(813) 433-2277


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Gary Klein, MD, MPH, MBA, CHS-V

William J. Carbone
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