Stories about: epidemiology

Viral discussion: Epidemics experts sound off on the future of infection control

Image of flu virus, which experts think will eventually lead to future epidemics
Is the next flu pandemic around the corner?

During the 1918 influenza pandemic, the average life expectancy in the U.S. dropped below 40 years old. Today, public health and medical professionals need to be actively preparing for the next great pandemic, according to leaders of the Massachusetts Medical Society, The New England Journal of Medicine and Microsoft founder Bill Gates, who delivered the keynote address at a Boston-based meeting on April 27 called Epidemics Going Viral: Innovation vs. Nature. Here’s recap of what we heard from various panelists.

The five key drivers of epidemics are population growth/urbanization, travel, animals, environmental/climate changes and conflicts/natural disasters, according to Harvey Fineberg, MD, PhD, President of the Gordon and Betty Moore Foundation and former president of the Institute of Medicine. When it comes to predicting and preventing the next epidemic, Fineberg believes that data from a social media platform like Twitter isn’t going to help identify the next big outbreak.

But John Brownstein, PhD, an epidemiologist and Chief Innovation Officer at Boston Children’s Hospital, disagreed with that idea.

“I believe it’s possible for Twitter to find the next microbe,” Brownstein said. “This information comes in real time and at global scale.” Attendees who were live tweeting with the hashtag #epidemicsgoviral were quick to highlight this difference of opinion.

Uber flu shot, “a cool millennial thing to do”

Anne Schuchat, MD, deputy director of the Centers of Disease Control, busted the myth that non-vaccination rates are rising. She explained that media stories about anti-vaccination supporters can make it seem as though vaccination rates are falling when they actually aren’t.

“Less than one percent of kids aren’t vaccinated in the U.S.,” Schuchat said.

But some vaccinations, like the annual flu shot, still have big gaps to close. Brownstein described how a partnership with Uber — dispatching flu vaccines and nurses to people’s homes — was able to influence people to get their first-ever flu shot.

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How social media and a mumps outbreak teach us that vaccines build herd immunity

Mumps virus, pictured here, is usually preventable by vaccination.
The mumps virus, pictured here, has been spreading through Arkansas communities. Surprisingly, many affected people say they have received vaccinations to prevent it. Analyzing social media data helped a Boston Children’s Hospital team understand why so many people got sick.

Residents of Arkansas have been under siege by a viral threat that is typically preventable through vaccination. Since August 2016, more than 2,000 people have been stricken with mumps, an infection of the major salivary glands that causes uncomfortable facial swelling.

The disease is highly contagious but can usually be prevented by making sure that children (or adults) have had two doses of the measles-mumps-rubella (MMR) vaccine. But strangely, about 70 percent of people in Arkansas who got sick with mumps reported that they had received their two doses of the MMR vaccine.

So, members of the HealthMap lab, led by Chief Innovation Officer and director of the Computational Epidemiology Group at Boston Children’s Hospital, John Brownstein, PhD, asked, “Why did this outbreak take off?”

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Plugging gaps in Zika surveillance with online news reports

Zika surveillance
Zika virus disease reports as of May 31, 2016 (click to enlarge)

As the Zika epidemic continues to unfold, most affected countries are flying blind: they have limited government disease surveillance systems in place to track new cases. That leaves public health officials unable to estimate how fast Zika is spreading, where the hotspots are and when the outbreak will peak — much less contain it and prepare for cases of microcephaly and Guillain-Barré syndrome, both now presumed to be caused by the Zika virus.

“One of the things we really struggled with in the early days of Zika was a lack of official data sources,” says research fellow Maia Majumder, MPH, of the Computational Epidemiology Group at Boston Children’s Hospital. “Surveillance has been really lagging. When we don’t know how many cases there are day to day, week to week, it’s really hard to characterize how bad an outbreak is.”

A study this week led by Majumder suggests a readily available data source for estimating actual case counts on the ground: online local news reports, adjusted using data from Google search trends.

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Digital disease detection: Public health by the “web kids”

In his essay, “We, the Web Kids,” Polish poet and pundit Piotr Czerski writes: “We don’t use the Internet…we live on the Internet and along it…communicating with one another in a way that comes naturally to us, more intense and more efficient than ever before in the history of mankind.”

As Czerski emphasizes, we want the option of “here and now, without waiting for the file to download.” We (myself included) expect immediacy. So in my role as a public health advocate in the digital age, waiting for an official infectious disease outbreak report to come weeks after the outbreak started—as often happens with traditional reporting methods—is unacceptable. Earlier detection of disease outbreaks means earlier response—and more lives saved. This video produced by NPR illustrates the “web kid” mindset when it comes to public health:

Such thinking lay at the core of the first International Conference on Digital Disease Detection, brought together last month by HealthMap of Children’s Hospital Boston and funded by the U.S. Centers for Disease Control and Prevention.  

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Tweeting in the time of cholera

Improving or maintaining access to clean drinking water is the best way to prevent a cholera epidemic. Twitter could prove an excellent way to help stop one. (Julien Harneis/Flickr)

It was after the devastating 2010 Haiti earthquake that mobile-friendly social media services like Twitter and Ushahidi came into their own as disaster management and relief tools. With the nation’s already unsteady infrastructure destroyed, these tools helped speed the deployment of people and supplies to where they were needed by giving relief workers on-the-ground intelligence about what was happening, what was needed and where in nearly real time.

With hindsight, Twitter and other informal data sources could also have sped up efforts to halt the spread of one of the disaster’s most feared aftermaths – cholera.

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Google searches: Real health behaviors in real time

Did the "S-CHIP tax" really motivate people to quit smoking? (Photo: AaronC/Flickr)

In April 2009, the U.S. federal cigarette excise tax was raised from $0.39 to $1.01 per pack as part of Congress’s reauthorization of the State Children’s Health Insurance Program. This well-intentioned “SCHIP tax” was meant to encourage people to quit smoking.

But a different story emerges from an analysis of Google searches.

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