Slides from an August 29, 2018 talk at ICEID - the International Conference on Emerging Infectious Diseases - held in Atlanta, GA.

1. TOWARDS DIGITAL
PATHOGEN SURVEILLANCE
DR. JENNIFER GARDY
BC CENTRE FOR DISEASE CONTROL
UNIVERSITY OF BRITISH COLUMBIA
@JENNIFERGARDY

4. A time machine into the “pandemic lessons learned” literature

8. “WE HAVE LEARNED A GREAT DEAL FROM THE EXPERIENCE OF
PLANNING FOR THE PRESENT PANDEMIC”

9. “…by providing a test of the
capacity of each part of the public
health system, from national to
local and hospital responses,
[SARS] has better prepared the
world for the anticipated and
much-feared next real pandemic”

10. “The lessons learned from [H1N1] should
be applied to ensure better preparedness
in case of future pandemics”

11. spoiler alert

14. “The data suggest that the world remains
ill prepared to handle sustained responses
and global pandemics.”

15. DIGITAL DISEASE DETECTION FOR EARLY WARNING
+
GENOMICS FOR DIAGNOSTICS & EPIDEMIOLOGY

17. Traditional surveillance, if you’re lucky.

18. theinternetexistswherepublichealthinfrastructuredoesn't

19. PROMEDMAIL.ORG

21. HEALTHMAP.ORG BY JOHN BROWNSTEIN & TEAM

22. digital epidemiology
can act as an early
alert system

23. M E A S U R A B L E I M PA C T ?
PAT H O G E N S P E C I F I C IT Y ?
A C C U R A C Y V S T I M E L I N E S S V S ? ? ? ? ?
T R U ST I N T H E D I G ITA L P L AT F O R M
U S E R F E E D B A C K O N UT I L IT Y, U S A B I L IT Y, A N D E T H I C S
D I G ITA L H O T S P O T D E T E C T I O N ?

24. ADAPTED FROM K. Jones et al, Nature, 2008

25. High biodiversity, recent demographic shifts, increased farming activity
Civil unrest, breakdown in public health systems

26. GENOMIC EPIDEMIOLOGY
Genomics is changing how we diagnose and track communicable disease

27. GENOMIC EPIDEMIOLOGY
Genomics is changing how we diagnose and track communicable disease

34. Semi-automatedreconstruction
@xavierdidelot
@carolinecolijn

38. “…the longitudinal studies that we have examined
support a median incubation period of a few months to
two years, with only a small proportion of people getting
disease later…. Furthermore, the epidemiological data
do not support the existence of a special bacterial state
(such as dormancy) during the asymptomatic phase of
TB, no matter how prolonged.”

41. 6/7 COMMUNITY
1/7 HOUSEHOLD

42. 7/16 HOUSEHOLD
8/16 TRAVEL

43. 1/26 HOUSEHOLD

44. AmapofallMIRU-VNTRTBgenotypesinBC,2005-2014.
Canadian-born/BornoutsideCanada
38%Euro-American
15%EastAfrican/Indian
23%Indo-Oceanic
24%EastAsian

45. 42%

47. 24%

50. 1-day positive MGIT

51. BATCH & SEQUENCE

52. UPLOAD & ANALYSE

53. Whatifwecouldturnresultsaroundinhours?

54. AND SEQUENCE ANYWHERE?

56. REAL-TIME, IN-FIELD CLINICAL
METAGENOMICS IS CHALLENGING

60. artic.network

61. VIROLOGICAL.ORG

62. nextstrain.org

64. IF YOU BUILD IT, THEY STILL
PROBABLY WON’T COME

65. P U B L I C C O M M U N I C AT I O N
R I S K C O M M U N I C AT I O N SYST E M S
DY N A M I C L I ST E N I N G A N D R U M O U R M A N A G E M E NT
C O M M U N I C AT I O N E N G A G E M E NT W IT H A F F E C T E D C O M M U N IT I E S
I NT E R N A L A N D PA RT N E R C O M M U N I C AT I O N A N D C O O R D I N AT I O N

66. TRUST
TRANSPARENCY
COORDINATION

67. TRUST
AUTONOMY
RISK IMPOSITION

68. TOWARDS DIGITAL
PATHOGEN SURVEILLANCE
DR. JENNIFER GARDY
BC CENTRE FOR DISEASE CONTROL
UNIVERSITY OF BRITISH COLUMBIA
@JENNIFERGARDY