HealthMap FIFA World Cup Surveillance

Visit our special surveillance page for the World Cup!

As soccer/football fans turn their attention to South Africa, HealthMap is watching for signs of outbreaks besides World Cup Fever. Teams and fans will be travelling great distances, and their local germs may be hitching a ride. This year's measles outbreak in British Colombia has been attributed to visitors to the Vancouver Olympics. Previous mass gatherings have seen more serious dispersion of disease. For example, Saudi Arabia saw an outbreak of meningococcal meningitis among pilgrims to the Hajj in 2000.

To provide early warning of highly contagious or dangerous disease threats, BioDiaspora and HealthMap have teamed up to increase infectious disease surveillance of the most common countries of origin for travelers to South Africa in June. BioDiaspora studies airline passenger travel to predict patterns of emerging infectious diseases. They have analyzed airline traffic into South Africa and determined the most common countries of origin for travelers.

HealthMap has created additional surveillance feeds in English and Arabic for the top 30 cities of origins. Our normal surveillance feeds utilize an automated text-processing system, which evaluates news stories for disease and location of outbreaks. We have broadened our search terms to improve our ability to identify even vague reports of illness. Our curation team is evaluating the alerts as they come in before allowing them to go to the map. If you are interested in the details of the system, please check out our article in the Canadian Medical Association Journal where we describe our earlier surveillance efforts for the Vancouver Olympics.

Travelers can also encounter new diseases while they travel. South Africa is in the midst of a Rift Valley Fever outbreak. This disease is carried by mosquitoes and generally affects livestock, though humans can be infected as well. At least 166 people have been infected (mostly individuals with direct contact with livestock) and 15 have died. In addition to our regular surveillance efforts, ARGUS has shared their dataset of reports on the outbreak.

Visit http://healthmap.org/fifa/ to see disease alerts for the areas around the top 30 cities, alerts for the 32 teams playing at the World Cup, and Rift Valley Fever alerts in South Africa (including data contributed by ARGUS).

Enjoy the World Cup!!

The HealthMap Team

HealthMap New England Journal of Medicine Publication

The HealthMap team recently published Information Technology and Global Surveillance of Cases of 2009 H1N1 Influenza in the New England Journal of Medicine (NEJM). The online paper includes three interactive figures* and demonstrates how informal data can be used to understand epidemiological trends of infectious diseases.

(*Figure 1 shows the worldwide spread of the H1N1 virus, Figure 2 shows a timeline of informal reporting of cases worldwide, and Figure 3 shows the relationship between GDP and time lag between suspected and confirmed case reports)

During the 2009 H1N1 influenza pandemic, nontraditional surveillance sources such as Internet news sources provided new public health data. Collectively, these sources overcame certain limitations of traditional surveillance systems, including reporting delays, inconsistent population coverage, and a poor sensitivity to detect emerging diseases. In May 2009, in collaboration with NEJM and as part of the NEJM’s H1N1 Influenza Center (http://h1n1.nejm.org), HealthMap created an H1N1 interactive map (available at www.healthmap.org/nejm) displaying these reports to enhance the situational awareness of public health professionals, clinicians, and the general public regarding the global spread of 2009 H1N1 influenza infection. Visitors to the site could filter reports according to suspected or confirmed cases or deaths and view a chosen time interval to show the spread of disease. During the two major waves of the H1N1 pandemic, HealthMap collected more than 87,000 reports from both informal and official sources (43,738 reports during the first wave of infection, from April 1 to August 29, 2009, and 43,366 reports during the second wave of infection, from August 30 to December 31, 2009). These reports formed the dataset used in the analyses of this latest paper.

Overall, the 2009 H1N1 influenza pandemic presented an important test of new disease-surveillance systems. The use of data that were collected, coded, and analyzed through the NEJM’s HealthMap system shows how such systems, which were built largely around readily available informal sources, can provide both early warnings and an ongoing operating picture of the patterns of disease spread.

Citation for the publication can be found here.

HealthMap 3.0 – Site Redesign

The HealthMap Website has been redesigned, and is now live at http://healthmap.org. The new site features many improvements focusing on removing clutter and allowing for greater customizations to include:

• A quick search feature that auto-completes with a list of existing diseases and locations from the HealthMap database

• An advanced search feature that allows users to search by multiple diseases and locations in user-specified time periods

• The ability to create customized maps, which can be saved, shared and added to a selection of preset Quick-View maps

• The ability to rate alerts and to view those rated most significant by the HealthMap Community

• A sortable list displaying all alerts on the map

To take advantage of the complete set of new features, users can log in to the HealthMap site with an existing account, or register at http://healthmap.org.

The May 2010 HealthMap newsletter is also now available with more of our latest news.

Crisis in Haiti

Event Overview

On Tuesday, January 12^th, 2010, Haiti was hit by a shallow, 7.0 magnitude earthquake, leading to staggering numbers of lives lost and severe infrastructure damage. With the epicenter being less than 15 km from Haiti’s capital of Port-au-Prince, the heavily populated city suffered heavy devastation. Despite having plans in place for weather-related disasters such as hurricanes, the impoverished nation was ill prepared for a natural disaster of this scale.

Existing Risk Factors

Haiti is the third largest country in the Caribbean, however it is also the poorest nation in the Western hemisphere. According to the World Health Organization, in 2009 45% of Haitians lacked access to clean drinking water, and 83% lacked sufficient sanitation.

Tuesday’s earthquake damaged already compromised critical infrastructure such as hospitals and health clinics. An early report noted that at least eight Port-au-Prince area hospitals had either collapsed or had suffered severe damage. Basic utilities such as power, water, sanitation, transport, and lines of communication were significantly impacted immediately following the initial quake.

Earthquake Related Risks

High mortality due to trauma has already been seen with this disaster. Estimates of 100,000 to 200,000 dead are circulating, however the actual death toll may never be known due to the disposal of corpses in mass graves. Post-traumatic infections are the most immediate risk due to the lack of medical supplies and support.

Infectious disease such as measles, malaria, meningitis, tuberculosis, hepatitis, HIV/AIDS, and respiratory illnesses were present already in Haiti before the earthquake, but amplification is expected in the face of this complex humanitarian emergency. Waterborne diseases may begin to emerge at a particularly high frequency due to a lack of safe drinking water and sewage contamination due to damaged infrastructure. Occurrences of vector-borne diseases such as dengue, malaria, and rabies may also increase during the current emergency situation due to inadequate shelter.

Future Concerns

Longer-term public health concerns include environmental, reproductive, nutritional, and mental health risks. Interventions must be put into place quickly, and continued access to care needs to be assured for all Haitians affected by this disaster.

How HealthMap is Contributing

HealthMap began monitoring focused news feeds in seven languages to obtain breaking information, regarding public health related events in Haiti on January 14^th, 2010 please see: http://www.healthmap.org/haiti. We will continue to provide health alerts and other vital public health news regarding this natural disaster as it becomes available. If you are aware of any information that is not on our map, please add it via one of the HealthMap Community Contribution methods:

1. Leave a voice message or send an SMS text to the HealthMap Hotline at +1 919-MAP-1-BUG (919-627-1284)

2. Email your report to hotline@healthmap.org

3. Submit a form on our website (http://healthmap.org/ or http://healthmap.org/haiti)

4. Submit a report via the “Outbreaks Near Me” application available on both iPhone and Android

5. Post on Twitter with #healthmap

HealthMap is also linking to Partners in Health to assist in obtaining donations to support aid efforts in Haiti. The Partners in Health organization has a longstanding presence in Haiti, providing large-scale health care, development, job training and employment for Haitians. Donations can be made by clicking on the Partners in Health button on our Focus on Haiti website, or by visiting Partners in Health directly.

In the absence of national emergency management infrastructure, individual reports of neighborhood conditions can provide a mosaic of the crisis. Ushahidi provides highly detailed mapping of these accounts, including disease related news. You can visit http://haiti.ushahidi.com/main for all Ushahidi news reports, or http://www.healthmap.org/haiti for their health-related alerts.

Related articles (additional articles available at http://www.healthmap.org/haiti):

http://abcnews.go.com/Health/HaitiEarthquake/haiti-earthquake-slams-local-hospitals-struggling/story?id=9554083

http://news.bbc.co.uk/2/hi/americas/8456233.stm

http://news.bbc.co.uk/2/hi/americas/8465137.stm

http://news.xinhuanet.com/english/2010-01/14/content_12811437.htm

http://www.who.int/diseasecontrol_emergencies/publications/who_hse_gar_dce_2010_1/en/index.html

http://www.reuters.com/article/idUSTRE60H5DV20100118

http://new.paho.org/disasters/index.php?option=com_content&task=view&id=1099&Itemid=1

H1N1 (swine flu) weekly highlights: December 2 - December 8, 2009

The World Health Organization (WHO) reports that "Disease activity has peaked and is declining in North America and has either recently peaked or is currently peaking in much of western and northern Europe." In other good news, WHO also reports no signs of widespread resistance to Tamiflu.

Nevertheless, the WHO has clearly stated it is too soon to call the pandemic over. The global death toll from H1N1 rose to 8,768 as Cyprus, Albania, and the Gaza Strip recorded their 1st H1N1 deaths. The Netherlands saw their first Tamiflu-resistant death.

In the United States, only half of all states reported widespread flu activity, down from 43 states only two weeks ago. England reported new cases were half of the previous week's number.


* Please note that this post will conclude our weekly H1N1 blogs. While the pandemic is far from over, reports of first cases and deaths are less common as H1N1 has spread throughout much of the globe. Numerous H1N1 vaccines have been developed in countries all over the world, and the vaccine shortages seen earlier this year have abated.

HealthMap continues to track H1N1 and all other infectious diseases at http://www.healthmap.org. For the latest disease alerts, you can also follow us on twitter. We hope the H1N1 blogs have been informative and helpful.


Photo courtesy of: http://www.washingtonpost.com/wp-dyn/content/article/2009/12/04/AR2009120402611.html?hpid=sec-health

H1N1 (swine flu) weekly highlights: November 25 - December 1, 2009

Montenegro and Libya reported their 1st H1N1 deaths.

South Korea reported a suspect case of H1N1 reinfection in a young girl.

Reports have stated that the United States has likely reached its peak for H1N1, as only 32 of 50 states are now reporting widespread influenza activity.

While H1N1 may have peaked in parts of the Northern hemisphere, the number of deaths worldwide jumped by over 1,000 during the past week, reaching more than 7,800.

Transmission of the virus remains high in East Asia and Canada.

A large outbreak of H1N1 had been feared to occur during this year's Haj season, however only 73 cases and five deaths were reported.

The US Centers for Disease Control (CDC) reported an increase in serious pneumococcal infections associated with H1N1 cases in the United States. The CDC also released new figures stating that as many as 34 million may have already been infected.

Finland confirmed human-to-pig transmission of the H1N1 virus, while a pig herd in Indonesia was also reported to be infected.

Photo: http://www.google.com/hostednews/afp/article/ALeqM5igd_tCu9zIdryTTRkslBF6I39nxw

H1N1 (swine flu) Weekly Highlights: November 18 - 24, 2009

Somalia reported its 1st cases of H1N1, while Lithuania, Switzerland, Macedonia, Maldives, Madagascar, Romania, Estonia, and Denmark reported their 1st deaths.

The World Health Organization (WHO) tallied over 525,000 H1N1 cases and about 6,750 deaths worldwide.

As the US Centers for Disease Control (CDC) reported decreased flu activity in all regions of the US, the WHO noted the eastward spread of H1N1 across Europe and Asia.

Four H1N1 related deaths have been reported among pilgrims for the Hajj which starts on the 26th.

As immunization campaigns continue in over 40 countries, the WHO reiterated the safety of the H1N1 vaccine, adding that investigation into 40 post-vaccine deaths (among the over 65 million doses given in 16 countries alone) has found no association between the vaccine and the documented fatalities.

In a development not unexpected among experts, Tamiflu-resistant H1N1 clusters emerged among hospitalized patients with severe underlying medical conditions in Wales and North Carolina.

Norwegian scientists announced detection of a mutated H1N1 virus that may allow infection deeper into the airways leading to more severe disease. Hong Kong then reported the same mutation, and Finland saw it in July. The WHO subsequently stated that a similar mutation had been observed in six other countries as early as April. Despite the mutations, the H1N1 vaccine is still effective.

A single batch of H1N1 vaccine in Canada has been pulled after a higher than usual rate of severe allergic reactions.

CDC has confirmed a rare second H1N1 infection in the same individual in West Virginia.

In a study of US Army personnel, those who received the 2008 seasonal flu vaccine were 45% less likely to contract H1N1 and 62% less likely to be hospitalized if infected.

Photo source: http://www.examiner.com/x-29691-Boulder-Healthy-Living-Examiner~y2009m11d24-H1N1-Swine-Flu-Symptoms-Is-someone-on-your-flight-showing-flu-signs