Outbreak.com: Using the Web to Track Deadly Diseases (Time)

[Guest guest]

Outbreak.com: Using the Web to Track Deadly Diseases in Real Time

By Walsh Tuesday, Aug. 16, 2011

Back in February 2003, if you subscribed to the ProMED e-mail list — a

clearinghouse for intelligence about infectious-disease outbreaks — you might

have seen quizzical messages about a strange spate of respiratory disease

cropping up in the southern Chinese city of Guangzhou. Those messages — some of

which were translated versions of news items appearing in the mainland-Chinese

press before government censors stepped in — were the first public descriptions

of what would later be known as severe acute respiratory syndrome or SARS.

In just a few months SARS would escape from southern China and spread — thanks

to international jet travel — to Singapore, Canada, Taiwan and Europe, infecting

more than 8,000 people and killing more than 900 in the first serious pandemic

of the 21st century. Before the Centers for Disease Control and Prevention (CDC)

or the World Health Organization knew anything about the new disease, the

information was out there on the wire — and if the right people had known

earlier, there's a chance the outbreak could have been halted before it became a

pandemic.

A century ago — before jet planes — it took new diseases months to travel around

the world, and many pathogens probably never made it out of their isolated rural

stomping grounds. But now no place is truly isolated, no matter how remote. We

live in a world that's more connected than ever before, one where humans — and

the viruses hitchhiking inside us — can circle the planet in a day. As a result,

we're at greater risk from new infectious diseases than ever before. (See the

top 10 terrible epidemics.)

But there's an upside to our interconnectedness as well. Thanks to the Internet

and cell phones, we can know what's happening in nearly every corner of the

globe almost instantaneously — and that's a boon for epidemiology. In the arms

race between us and the viruses, communication is our advantage. By analyzing

the Internet's everyday wealth of data, we can catch new diseases before they've

emerged — and stop them before they become a deadly threat.

That's what Brownstein, a digital epidemiologist at Children's Hospital

Boston, is working to do with his HealthMap project. HealthMap automatically

trolls news sites, eyewitness reports, government data, even wildlife-disease

cases to identify new patterns in outbreaks, presenting the results on a

clickable map. Want to know about an ongoing polio outbreak in Angola? HealthMap

will show you where it's occurring and who's dying. " We bring in all the cases

we can on one site, which enables early detection and heightened awareness of

new diseases, " says Brownstein, who developed the site with software expert

Freifeld. " This is a way for epidemiology to move forward. "

HealthMap first launched about five years ago, but it has just relaunched with a

new focus toward what Brownstein calls " participatory epidemiology. " HealthMap

will tap the wealth of potential information on social media — think tweets

about flu outbreaks and Facebook postings about contaminated food. The result is

more finely tuned intelligence about emerging outbreaks, presented in a

personalized format — Facebook by way of the CDC. HealthMap already has a

related mobile app called Outbreaks Near Me, which gives users news about public

health around their location — and allows them to report information as well.

" It's really taking the local-weather-forecast idea and making it applicable to

disease, " says Brownstein. " We're trying to make these ideas that much more

relevant to the general population. " (See photos of the swine flu in Mexico.)

The ideas behind digital and participatory epidemiology have merit. Scientists

have already managed to find spikes in seasonal flu before the CDC by analyzing

online search queries and Twitter feeds for flu-related items. (If an unusually

large number of people in Pittsburgh are suddenly searching for influenza

symptoms and treatment, chances are an outbreak is already under way.)

Brownstein himself has worked with Google and the CDC to use the same methods to

track outbreaks of mosquito-borne dengue fever, which has recently reappeared in

the U.S. The neat project Bio.Diaspora, at the University of Toronto, combines

intelligence on outbreaks from HealthMap with real-time information on

international travel. And Global Viral Forecasting Initiative — a group I spent

time with recently in Cameroon — is working to get on-the-ground intelligence in

disease hot spots like the Congo and China.

The challenge with HealthMap and other digital epidemiology projects is the same

one that all intelligence experts face: separating the signal from the noise.

Brownstein points out that HealthMap could show unusual cases of respiratory

illness in Mexico in the early spring of 2009, before what would become the H1N1

flu pandemic burst onto the global stage, but it's still difficult to separate

truly dangerous events from run-of-the mill outbreaks. The hope is that sharper

data collection will allow future digital epidemiologists to identify the

patterns that indicate a potentially deadly new disease in time to actually do

something to stop it. " We're trying to improve our algorithms to make sure that

we catch the really important events, " says Brownstein.

One way to do that might be to get more people participating in participatory

epidemiology. To that end, HealthMap is part of a public-education campaign

built around the upcoming disease thriller Contagion. The

Soderbergh–directed film — which opens in U.S. theaters on Sept. 9 and stars

Gwyneth Paltrow, Matt Damon and Jude Law, among others — tells the story of a

deadly pandemic that spreads around the world. (Imagine H1N1 if it had killed

20% of those it infected, instead of at most 1%.) " We want to get people talking

about this threat, so they can take it seriously without being scared, " says

Brownstein. Fighting new infectious diseases is no different than any other war

— the first step is good intelligence.

http://www.time.com/time/health/article/0,8599,2088868,00.html