And I’ll end with the longerterm potential for One Health solutions. And their untapped potential for solving some of our planet’s most pressing longer term problems. Economic crises, climate change, governance…
Initially official organizations were skeptical of social media, but they too have started to embrace it
And last month the UN requested the support of the Digital Humanitarian Network and their Standby Army of thousands of volunteers to help with the Philippines typhoon. Landfall Nov 8th 4:30 am local time.
Anyone with an internet connection can help classify and filter relevant messages to assist with the response. 3 mincarry out a rapid needs and damage assessment by tagging relevant tweets.Eg. on Friday Nov 8th collected 182,000 tweets and filtered down to 35,175 tweets based on relevance and uniqueness.DHN activated by UNOCHA on Nov 7, 2013 in response to Typhoon Yolanda.The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) just activated the Digital Humanitarian Network (DHN) in response to Typhoon Yolanda, which has already been described as possibly one of the strongest Category 5 storms in history. The Standby Volunteer Task Force (SBTF) was thus activated by the DHN to carry out a rapid needs & damage assessment by tagging reports posted to social media.http://blog.standbytaskforce.com/2013/11/11/typhoon-yolanda-update-1/The DHN Network has been mobilized to support Palau and the Philippines in support of the United Nations Office of Coordination for Humanitarian Affairs and the Philippines Red Cross to assist in providing information management support. In response to this activation the SBTF, Humanitarian Open Street Map, GIS Corp, ESRI Disaster response Program, Translators without Borders, Statistics without Borders, Info4Disaster and others have activated their respective volunteers.http://irevolution.net/2013/11/08/volunteer-typhoon-yolanda/
Turning now to disease outbreaks,A recent study looked at the underlying drivers of almost 400 emerging disease outbreaks and found that nearly 40% were due to a breakdown in public health measures… http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001354Preventing Pandemics Via International Development: A Systems ApproachTiffany L. BogichRumiChunara David Scales Emily Chan Laura C. PinheiroAleksei397 Public Health Events of International Concern
Seen here in blue. And more than half of these were due to a lack of sanitation and hygiene. http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001354Preventing Pandemics Via International Development: A Systems ApproachTiffany L. BogichRumiChunara David Scales Emily Chan Laura C. PinheiroAleksei397 Public Health Events of International Concern
There are currently 7 billion people in the world: Of those 7 billion, how many billion do you think have access to a latrine or toilet? That is our first poll question. POLL QUESTION 1: How many of the 7 billion people on the planet have access to a latrine or toilet? answers: 1 billion, 2 billion, 3 billion, … 7 billion ANSWER: 4.5 billion have access to a latrine or a toilet Why would cell phones be a higher priority? It is not the device itself, but the fact that it connects you to 6 billion other people.http://www.npr.org/blogs/health/2013/03/22/175032839/talk-globally-go-locally-cellphones-versus-clean-toilets
How many people have access to a cell phone? 6 billion. Being connected to 6 billion other people allows us to do things that weren’t previously possible, like mobile banking. M-Pesa (M for mobile and pesa is Swahili for money)Bank without buildings25% of Kenya’s GDPNot the te
Buying and selling things on the internet. Farmers in Kuwait are taking pictures of their sheep with their cell phones and selling them using instagram. How many of you have ever bought something over the Internet? POLL QUESTION 3: Have you ever bought anything over the Internet: ANSWERS Yes or No
In 2009 an article was published in Nature showing that it was possible to track when and where the flu was occurring by looking at how people searched for information about the flu using Google. It was similar to the US government’s (CDC) surveillance in accuracy, but was faster and cheaper and is now available as a tool called Google Flu Trends.
In 2011 this methodology was extended to look at Dengue trends in 5 countries: Bolivia, Brazil, Inda, Indonesia and Singapore.
Here we can see Google estimates of Dengue activity in blue, compared to actual cases recorded by the Brazilian gov’t in orange. It is fast and cheap compared to traditional surveillance. Some governments may only compile this data weekly, monthly or yearly, whereas Google can do this every day and at minimal cost.Where traditional surveillance isn’t feasible
It can also help us to improve food safety.The WHO estimates that 1.8 million people die from diarrheal diseases each year, most of them children. Dr. Gary Vroegindewey will now expand on the extent of the food safety problem and why we need a new approach.Two minutes + three poll questionsEven in the US, foodborne illness strikes 48 million people a year, killing 3,000 and hospitalizing over 100,000. How many of you think you might have had food poisoning in the past year? Raise your hands. Now keep your hand up if you went to the doctor. Of those that are sick, most don’t go to a doctor, few provide a sample and a confirmed lab diagnosis is rare (15).
Dr. Vroegindewey has demonstrated the vast problem of delays and under-reporting of food-borne illness. We rely on the tip of the iceberg to initiate an outbreak investigation, yet we still have to link cases, try to find a common food source and trace it back through an extremely convoluted food supply chain (13).
In 2011 we assembled a multidisciplinary team to look at the potential for using some of these new techniques to detect and respond to food borne illness. One subgroup, with expertise in knowledge synthesis and translation, conducted a scoping review to assess the current state of knowledge for digital disease detection.
This review was published in July of 2013 in the Journal of Medical Internet Research. You can easily find it by doing a Google search on these two words: JMIR and chronology (that’s the advantage of using an unique word in the title). A search of the Scopus database identified 693 articles of potential interest, of which 32 were primary research articles.Bernardo TM, Rajic A, Young I, Robiadek K, Pham MT, Funk JAScoping Review on Search Queries and Social Media for Disease Surveillance: A Chronology of InnovationJ Med Internet Res 2013;15(7):e147URL: http://www.jmir.org/2013/7/e147/doi: 10.2196/jmir.2740
The majority dealt with flu and a handful touched on foodborne illness. Most used Google search queries, with more recent forays into Twitter and other tools. A look at the twittersphere related to foodborne illness demonstrates the challenge of identifying relevant tweets.
in identifying relevant tweets. We see a variety of key words and misspellings, which must be put into context, and in some cases names of restaurants or hints that food was consumed at home (11).
There are now tools availablethat can listen to data streams from Twitter or Facebook. They can be trained to look for certain words or combinations of words that are likely to be relevant. The identification of a relevant message could trigger automated feedback with useful advice or a request for additional information.
This approach is already being used by the health department in the City of Chicago: they automatically search for tweets from their citizens that include the words “food poisoning” , then send them a message inviting them to file a report.http://articles.chicagotribune.com/2013-08-13/health/ct-met-twitter-food-poisoning-20130809_1_food-poisoning-smart-chicago-collaborative-health-departmentFoodborne Chicago, which tweets as @foodbornechi, was developed by Smart Chicago Collaborative, which describes itself as "a civic organization devoted to improving lives in Chicago through technology" and counts the city of Chicago as a founding partner.
In addition to information about who is sick and where they are located, sometimes photos can also be useful in an outbreak investigation. For example, a group of cyclists got sick after a ride and notified their local health department. Photos of the ride alerted the investigators to possibility of (15) mud, rather than food, as the source of contamination with Campylobacter.
mud, rather than food, as the source of contamination with Campylobacter. Even if geolocation information is not initially available, it may be possible to cross-link ill persons with other services such Foursquare (15) or Yelp to help reconstruct their food history and identify commonalities with other people who are ill.
In 2011, a German Internet entrepreneur got sick after attending a party in LA, so he posted his status on FB and asked who else got sick. Within hours, 24 people had added themselves to his list, 80 within a week. They suspected the artificial fog in the party tent and tentatively diagnosed legionellosis. CDC investigator also joined the FB page (instead of arriving at door) and suggested some tests that lead to confirmation of the diagnosis. This concludes our section on using social media for disease detection, Dr. Vroegindewey will now present other uses of social media related to food safety.
Over the long term we will probably be combining social data with that of sensors embedded throughout the food chain to enable earlier detection of food contamination and rapid traceback (13).6 minWe have summarized the use of passively collected data (search queries and twitter streams) for the detection of foodborne illness, and have seen examples of how we can actively involve people in these efforts, combining machine and human intelligence. In this final example, we will see how people sometimes take things into their own hands.
There was an interesting article in the Economist on “self tracking” and how people are recording everything from the number of steps they take to their sleep patterns, what they eat and drink and their moods in search of wellness. And Fujitsa has announced that they will provide a tracking service for dogs that will attach to a collar.Actually, Fujitsu has announced just such a service through a device that will attach to a dogs collar.The quantified selfCounting every momentThe article ends with an admonition: "what geeks do today, the rest of us often end up doing tomorrow.“ http://www.fujitsu.com/global/news/pr/archives/month/2012/20120514-02.html
http://www.scanadu.com/ temp, heart rate, oxygenation, even your ECG!
We also need to consider the power of open data. The US government started sharing GIS data several decades ago which spawned a billion dollar industry and is now starting to do the same for all sorts of data. Its making
Public health data available to the public and creating competitions for the best applications. The 1st health datapalooza consisted of about 40 people sitting around a table. Last year it sold out with 3,000 people in attendance and more of us online and included major health providers, venture capitalists and budding entrepreneurs.
One of the winning applications was a barcode scanner for food. People with allergies, special dietary needs or on prescriptions are alerted to potentially harmful selections and offered substitutions. It alerts people on special diets or with allergies, that alerts people to harmful products in their food based on scanning bar codeenter diet allowances, Rxeg. incompatible with drug she is takingoffers substitutions of products you can have!lists ingredients with bad ones on topdietary restrictions (eg. gluten free, allergies, pregnancy, breastfeeding, vegan, veg, etc.)calories!! interoperability among all deviceshave become authority on recalls - immediately get emails (members and nonmembers)become aware of things that are being recalled without notice.
Challenge.gov runs all sorts of challengeshttp://challenge.gov/ONC/529-crowds-care-for-cancer-supporting-survivors?sf12279650=1&goback=%2Emid_I690020315*420_*1%2Egmp_4868434%2Egde_4868434_member_242186250
Photosync is an open research project to crowdsource data collection of photosynthesis measurements from plant species around the worldGoal: create the tools and community to crowdsource data collection of photosynthesis and plant health data from species around the world
They are starting with a low cost, hand-held measurement device which researchers, educators and citizen scientists can use to build a global database of plant health. http://photosynq.org/Goal: create a low cost, hand-held measurement device which researchers, educators and citizen scientists can use to build a global database of plant health
Dr. Susan Love, a surgeon and researcher at UCLA is amassing an army of one million women to serve as a pool for breast cancer research. Sign up for email updates of clinical trials, decide which studies to take part in.Email details the research project and who and what the researchers need.Started in 2008
To date, 371,000 women have signed up to receive emails about research projects and they can decide whether they would like to take part. Sign up for email updates of clinical trials, decide which studies to take part in.Email details the research project and who and what the researchers need.Started in 2008
These are the kind of results they are getting: recruited 2,580 participants for Environmental Exposures and Breast Density study.Researchers from the University of Wisconsin Carbone Cancer Center and Fred Hutchinson Cancer Research Center are investigating whether cadmium, a heavy metal found in the environment, is related to breast density.
I hope you are all familiar with HealthMap which collates disease outbreak information from around the world and presents it on a map. It lets you search by location, or type of disease and view all the related reports within a specified timeframe.
Healthmap has an app called Outbreaks Near Me that will detect your location and show you what outbreaks have been reported in various categories, such as gastrointestinal disease. It also invites you to submit any missing outbreaks.
Last year the American Public Health Association teamed up with HealthMap to track flu cases through an application called “flu near you”. They challenged their membership to sign up as many people as possible to complete a short survey about flu symptoms and vaccination status. http://www.getreadyforflu.org/challenge.htm
Whether it is within a corporation, a government, or a community organization, the ubiquity of cheap mobile devices and the ease of creating new applications to link us together are creating great possibilities for engaging everyone in solving our most pressing problems.Vets without Borders Canada +Lifelearn + IDRCApp for CAHWs in Laos to improve poultry production by smallholder farmers
paxxxx: @xxx.xxx a couple days but this morning
was the worst! Threw up and (defecated) lost
weight n (stuff) food poisoing will (foul) u up
casualxxxx: @famousfastfoodplace Whats a
salmenella? My stepdad said he ate some at ur
restaurant and now hes real sick :(
SkxxJxx: Still Sick! Seriously food poisoning is
EVIL!Clean ur fridges,read expiration dates,&don't
sell/give it away cause don't want it 2go2 waste!
Army of Women
Study Closed in 26 hours!
I am honored to participate in such a wonderful study…
every step gets us closer to the final cure that will
impact a large segment of our world’s women.
Thank God for these researchers!
December 13th, 2012 9:09 am
Haiti Epidemic Advisory
Just received word from Borgne, Haiti in the
north that they are overwhelmed with cholera
cases, including fatalities. It is a very remote
region in the mountains and there is only a small
community hospital backed by a small NGO that
I usually work with, but I am presently in Port au
Prince. They have no resources. They need
cots, IV fluids, and ORS. They claim to have not
much support. Can anyone help?
a One Health challenge