Evolve

EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD , 2009, MUKDAHAN PROVINCE, THAILAND Taha Kass-Hout, MD, MS Director, Global Public Health and Informatics Innovative Support to Emergencies, Diseases, and Disasters

SE Asia Early Warning & Response A collaborative early warning and response space for latest health-related events in SE Asia

Overview
Infectious disease events represent substantial morbidity , mortality , and socio-economic impact in SE Asia
The infectious disease event reporting in SE Asia was of:
Low socioeconomic disruption (83%),
High socioeconomic disruption (17%); with indicators of a:
potential sociological crisis (16.4%), and
disaster (0.6%)

Snapshot
Information Sources
ProMed MBDS
Veratect
From September 1, 2008 to February 27, 2009
998 near real-time reports on
46 infectious diseases that effect humans or animals
Myanmar, Thailand, Laos, Cambodia, and Vietnam
220 provinces, 239 districts, and 14 cities

Indicators and Insights
Approximations of Epidemiological Features
Response
Local Public Community Reaction (Public and Responders)
Infrastructure
Infectious Disease Disaster

Apprx. of Epidemiological Features
What diseases were reported to have affected different age groups in SE Asia
Reports of mortal outcomes for all age groups
Which of the infectious disease events presented as
single cases, apparently localized clusters (approximation of an “ outbreak ”), and
apparent multiple cases in multiple locations (approximation of an “ epidemic ”)

Response
what level of government and non-governmental organization became involved in response by disease event

Local Public Community Reaction
Reaction of the public
The term ‘panic’ is not indicative of true panic but rather a proxy for social concern
‘ Panic with behavior’ is where we have documented non-routine public behavior such as panic buying, hoarding of medications, and so on, where concern has elicited non-routine action
‘ Flight’ is the ultimate outcome where a community’s inhabitants abandon their community and for a period of time, social disintegration is observed. This is the end point of infectious disease event damage from a sociological perspective, where a community ceases (transiently) to be an integrated social unit engaged in routine daily activities
Evacuation due to biological events is a rare phenomenon, but one for which we maintain a baseline for what diseases in what countries provoke such a reaction

Local Public Community Reaction
Reaction of responders
Responder anxiety, which follows the same conceptual framework as public anxiety
Here it is key to note those events where healthcare workers refuse to perform their duties or participate in response due to fear of exposure, illness, or death
Responder avoidance of duties is a rare phenomenon

Infrastructure
The infrastructure types affected (compromised) by infectious disease events in SE Asia either due to
absenteeism,
contamination,
work overload (i.e., response), or
any combination of the above

Infectious Disease Disaster
The most socially disruptive events in SE Asia, by country and disease that are assessed to be potential disasters
0.6% of all disease reports in SE Asia

InSTEDD Evolve Related items (e.g., News articles) are grouped into a thread. Threads are later associated with events (hypothesized or confirmed). InSTEDD Evolve : ( http://instedd.org/evolve ) Tag cloud and semantic heat map Delete/Recycle an Item Expert-generated Tags RSS Publishing Generate hypotheses and add evidence to the Basket Save filter (by keyword, tag, topic, location, and time) and email subscription Recycle bin An event is monitored through a thread of items

InSTEDD Evolve InSTEDD Evolve : ( http://instedd.org/evolve ) Map view

InSTEDD Evolve Filter feature which automatically filters content by topic of interest Filter feature which automatically filters content by radius InSTEDD Evolve : ( http://instedd.org/evolve )

InSTEDD Evolve Auto-generated (machine-learning) tags. These tags are semantically ranked (a statistical probability match). Users can further train the classifier by accepting or rejecting a suggestion. Users can similarly train the geo-locator by simply accepting or rejecting and updating a location. InSTEDD Evolve : ( http://instedd.org/evolve )

Automatic Classification
Current classification includes:
7 syndromes
10 transmission modes
> 100 infectious diseases
> 180 micro-organisms
> 140 symptoms
> 50 chemicals

InSTEDD Evolve InSTEDD Evolve : ( http://instedd.org/evolve ) Tracking the recent Avian Influenza Outbreak in Egypt (reports started to appear late January 2009). Notice the pattern of reported incidents along the Nile river.

Evolve Architecture and Processes Best Poster Award for Improving Public Health Investigation and Response at the Seventh Annual ISDS Conference, 2008 http://taha.instedd.org/2008/12/best-poster-award-for-improving-public.html

Acknowledgment

Through Funding from…

Thank You!
Taha Kass-Hout
Nicolás di Tada

Thank You! InSTEDD 400 Hamilton Avenue, Suite 120 Palo Alto, CA 94301, USA +1.650.353.4440 +1.877.650.4440 (toll-free in the US) [email_address] Cambodia, Photo taken by Taha Kass-Hout, October 2008 “ this pic says it all- our kids are all the same- they deserve the same ”, Comment by Robert Gregg on Facebook, October 2008

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Evolve

by Taha Kass-Hout, MD, MS

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