H1N1 (Swine Flu): Social Media Meets H1N1 And Reports From The Southern Hemisphere
SOCIAL MEDIA MEETS H1N1 – OUTBREAKS NEAR ME
As an iPhone user I am always looking at cool new apps. As an emergency manager I am always trying to find ways to make information more available and easy to use. Viola! A new iPhone application, created by researchers at Children’s Hospital Boston in collaboration with the MIT Media Lab, does all of that and it is about diseases (my third favorite thing1!)
This app enables users to track and report outbreaks of infectious diseases, such as H1N1 (swine flu), on the ground in real time. The application, “Outbreaks Near Me,” builds upon the mission and proven capability of HealthMap, an online resource that collects, filters, maps and disseminates information about emerging infectious diseases, and provides a new, contextualized view of a user’s specific location – pinpointing outbreaks that have been reported in the vicinity of the user and offering the opportunity to search for additional outbreak information by location or disease.
Additional functionality of Outbreaks Near Me is the ability to set alerts that will notify a user on their device or by e-mail when new outbreaks are reported in their proximity, or if a user enters a new area of activity.
“We hope individuals will find the new app to be a useful source of outbreak information – locally, nationally, and globally,” says HealthMap co-founder John Brownstein, PhD, assistant professor in the Children’s Hospital Informatics Program (CHIP). “As people are equipped with more knowledge and awareness of infectious disease, the hope is that they will become more involved and proactive about public health.”
The new application also features an option for users to submit an outbreak report. This will enable individuals in cities and countries around the world to interact with the HealthMap team and participate in the public health surveillance process. Users may take photos – of situations and scenarios of, and/or leading to, disease – with their iPhone and submit them to the HealthMap system for review and eventual posting as an alert on the worldwide map.
“This is grassroots, participatory epidemiology,” says HealthMap co-founder Clark Freifeld, a PhD student at the MIT Media Lab and research software developer at CHIP. “In releasing this app we aim to empower citizens in the cause of public health, not only by providing ready access to real-time information, but also by encouraging them to contribute their own knowledge, expertise, and observations. In enabling participation in surveillance, we also expect to increase global coverage and identify outbreaks earlier.”
ASSESSMENT OF THE 2009 H1N1 OUTBREAK IN THE SOUTHERN HEMISPHERE
The Department of Health and Human Services (HHS) was asked by the White House in August 2009 to study the characteristics and impact of the H1N1 outbreak in the Southern Hemisphere. The assessment explored the characteristics and impact of the disease in select southern hemisphere countries that have been experiencing the H1N1 outbreak in May to August, concurrently with their normal influenza season. The assessment included: Argentina, Australia, Chile, New Zealand, and Uruguay as they more closely resemble the U.S. with respect to demographics and economic development.
The information in this report comes mainly from reports of the Ministries of Health of the selected countries, press releases, government publications, and U.S. embassies abroad covering the period from May 1 to August 24, 2009. From this assessment, the following general observations were developed:
- All countries report that after mid July, disease activity in most parts of the country decreased. This indicates that the duration of the current influenza season in the Southern Hemisphere, in which the 2009 H1N1 virus is the predominate strain, may be similar in length to an average seasonal influenza season.
- Virologic data indicates that the H1N1 virus strains currently circulating in the Southern Hemisphere are similar to those detected in the U.S. Data suggest that the 2009 H1N1 virus remains antigenically stable. Thus, the H1N1 virus strain selected by the U.S. for vaccine manufacturing should closely match the currently circulating 2009 H1N1 strains.
- Moreover, almost all H1N1 viruses tested remain sensitive to neuraminidase inhibitors (oseltamivir and zanamivir). In all five countries, antiviral drugs were used to treat individuals with confirmed and severe cases, for individuals suspected of having the virus, and for individuals with risk factors for complications who were in contact with people having or suspected of having the virus. However, comprehensive studies of the effectiveness of antiviral treatment to reduce disease severity ormortality in infected patients are not currently available.
- The most at-risk populations in the Southern Hemisphere are similar to those observed in the U.S. Similar to situation in the U.S. this past spring, H1N1 infections generally caused mild disease. H1N1 infections predominantly occurred in school-aged children and adults under 65 years of age. Only a small proportion of cases were fatal. Pregnant women or individuals with other existing conditions made them at higher risk for influenza complications. Australia and New Zealand reported higher rates of hospitalization of cases in their indigenous population (5 and 3 times higher, respectively) when compared to cases in the non-indigenous population.
- Commonly used community mitigation measures included school closures, cancellation of mass gatherings, isolation and quarantine, and other social distancing measures. All countries inconsistently implemented some form of community mitigation measures including temporary and local school closures, cancellation of mass gatherings, isolation or quarantine of sick or exposed individuals, and other social distancing measures as well as border screening and temporary flight cancellations.
- Health care systems experienced stress, but it was generally geographically isolated and relatively short lived. All five countries reported early regional surges in hospital, emergency department and outpatient visits. Some countries reported transient hospital bed, equipment or medication shortages.
- Available data suggest that all countries experienced some time-limited and/or geographically-isolated socio/economic effects and a temporary decrease in tourism. Although it is too early to determine whether the 2009 H1N1 pandemic has caused a long-term economic impact in Australia, Argentina, Chile, New Zealand, and Uruguay, some of these countries reported limited social and economic effects from implementation of social distancing measures and decreased tourism.
The report concluded that in considering the implications of the Southern Hemisphere experience for the U.S. this coming fall, readers should consider that all the countries profiled differ from the U.S. in terms of their public health and surveillance systems, the organization of their health care systems, their customs and traditions, and care-seeking behavior. In addition, these countries did not have a 2009 H1N1 outbreak prior to enter in their normal influenza season, as in Mexico and the U.S. How and whether 2009 H1N1 virus will behave in the Southern Hemisphere, after their normal flu season ends, remains to be seen. In other words…stay tuned.