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Harnessing the Web to Fight H1N1 May 8, 2009

Posted by Joanne KY Teoh in Convergence, Journalism, News, Social Media, Trends.
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The Web is becoming a key source of information on emerging diseases and has become integral to public health surveillance. Internet-based systems have become a critical medium for clinicians, public health practitioners, and the public seeking health information. Data about diseases and outbreaks are disseminated not only through online announcements by government agencies but also through informal channels, ranging from press reports to blogs to chat rooms to analyses of Web searches.

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These sources provide a view of global health that is fundamentally different from that yielded by the disease reporting of the traditional public health infrastructure. In the past 15 years, Web systems using informal electronic information have been credited with reducing the time to recognition of an outbreak, preventing governments from suppressing outbreak information, and facilitating public health responses to outbreaks and emerging diseases.

Web-based sources frequently contain data not captured through traditional government communication channels. This makes the Web useful to public health agencies, including the Global Outbreak Alert and Response Network of the World Health Organization which relies on such sources for daily surveillance activities.

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Early efforts in this area were made by the International Society for Infectious Diseases’ Program for Monitoring Emerging Diseases, or ProMED-mail, which uses the Web to disseminate information on outbreaks by e-mailing and posting case reports, including many gleaned from readers, along with expert commentary. The Public Health Agency of Canada and WHO created the Global Public Health Intelligence Network (GPHIN), whose software retrieves relevant articles from news aggregators, using extensive search queries.

ProMED and GPHIN played critical roles in informing public health officials of the outbreak of SARS in Guangdong, China, as early as November 2002, by identifying informal reports on the Web through news media and chat-room discussions.

News aggregators and visualization tools have spawned a new generation of disease-surveillance “mashups” that can mine, categorize, filter, and visualize online intelligence about epidemics in real time. For instance, HealthMap is a public health intelligence system that uses data from disparate sources to produce a global view of ongoing infectious disease threats.

Similar systems include MediSys, Argus, EpiSPIDER, BioCaster, and the Wildlife Disease Information Node. Automated analysis of online video materials and radio broadcasts will soon provide additional sources for early detection. Blogs, mailing lists, RSS feeds, and mapping technology allows individual experts to create an important global resource.

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For instance, Declan Butler of Nature took data from various sources to track the spread of H5N1 avian influenza on a Google Earth interface. Claudinne Roe of National Intelligence produces Avian Influenza Daily Digest and blog, a collection of unclassified information about H5N1 influenza.

Although news media are important to the public health infrastructure, the information they report pales in comparison to the potential collective intelligence that can be garnered from the public. The Web is also providing new opportunities for connecting experts who identify and report outbreaks.

Wikis, social networks, and Web portals can facilitate communication to quickly disseminate reports of infectious diseases and aid in mobilizing a response. Some scientific societies are leveraging technologies for distributed data exchange, analysis, and visualization. For instance, the International Society of Travel Medicine has created the GeoSentinel project, which brings together travel and tropical-medicine clinics in an electronic network for surveillance of travel-related illnesses.

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Social-networking sites for clinicians, patients, and the general public hold potential for harnessing the collective wisdom of the masses for disease detection. Eventually, mobile-phone technology, enabled by global positioning systems and coupled with short-message-service messaging and Twitter might also come into play.

Information overload, false reports, lack of specificity of signals, and sensitivity to external forces such as media interest may limit the realization of their potential for public health practice and clinical decision making. Though promising, new Web technologies require careful evaluation and it is health care professionals and the public who will best determine how to use this channel for surveillance, prevention, and control of emerging diseases.

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