disease tracking

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Vomiting Up Brunch? Your Angry Tweet May Save Others From Food Poisoning

When you're in this position, you likely don't want to call health officials and report food poisoning. (Irina Souiki/Flickr)

When you’re in this position, you likely don’t want to call health officials and report food poisoning. (Irina Souiki/Flickr)

By Chelsea Rice

One of the last warm Saturdays in September, my boyfriend and I planned to celebrate his birthday at a Cambridge restaurant that friends had praised as their favorite brunch spot. The food tasted great: We shared a plate of oysters to start, and he enjoyed eggs Benedict for his main course while I opted for a breakfast take on the classic BLT sandwich, mainly because it was served on a croissant, a buttery weakness of mine.

But upon arrival back home…our brunch backfired.

I ran out to pick up the birthday cake. When I returned, I found the birthday boy almost paralyzed by stomach pain, feverish and violently ill. While he spent the rest of his birthday in a migratory pattern between the bathroom and bedroom, I waited to see if I would get sick and searched online to learn how to report the food poisoning.

Turns out that here in the Boston environs, residents call a special number at the Boston Public Health Commission. It connects with a public health nurse who asks questions about symptoms, what you ate over the past few days, and where you ate it. On that memorable day, I shouted this option into the bathroom at my sick partner, but he was so nauseous he could barely talk to me. Reliving what he had eaten in the past 48 hours was the last thing he wanted to do.

As a health journalist, I know it’s important to report food poisoning — one in six Americans gets it every year. But as a consumer, filing a public health report can be an intimidating and impersonal process for a very personal — and vulnerable — experience.

We told all our friends and canceled the rest of the festivities, vowing never to return to the scene of the crime, but I still wondered: Were we selfish? Could we have helped others with our story? Have other diners had a similar experience at that restaurant?

According to the restaurant’s worst reviews on Yelp, the list is long. (I’m not naming it to give it the benefit of the doubt — maybe it was having an off day? — but the picture is grim.) The worst reviews include bugs in the plates, under-cooked proteins and foreign objects that broke a tooth. There are even a few that reported diners getting sick after eating there. And those are just the brave few who posted. I was alarmed that this restaurant still had a line and a reservations list with complaints like that. There’s no way a health department could ignore claims like these, I thought, if they were written up in an official report.

Little did I know, there’s a new bridge between social media and public health that is finally crossing that divide.

In 2011, a research group out of Boston Children’s Hospital published a study using extracted, keyword-related Yelp reviews, showing that the ingredients people described in their reviews about food-borne illness matched up with relevant ingredients that the CDC reported were involved in food-borne outbreaks for that time.

An excerpt from HealthMap's tool to track tweets related to foodborne illness (Courtesy of HealthMap)

An excerpt from HealthMap’s tool to track tweets related to foodborne illness (Courtesy of HealthMap)

Now, that team is taking their work to help cities across the country address and more accurately monitor food-borne illness with HealthMap Foodborne Illness, part of a larger social media disease-tracking initiative based at Boston Children’s.

“When someone talks about diarrhea on Twitter they are really looking for people to care, and that’s really what it’s all about.”

– Dr. John Brownstein

Dr. Elaine Nsoesie and Dr. John Brownstein, who co-founded the project, are working with New York City, Chicago, St. Louis and other major cities to customize their foodborne disease tracking tool for each city’s needs.

“It’s hard to make people come to you,” said Brownstein. “People aren’t engaged necessarily in public health.” But if you can tap in to their online voices, he said, “you can actually get a huge amount of information that would not come from another vehicle.”

In Chicago, the city’s public health department monitors Twitter in a social media tracking initiative that HealthMap customized for them called FoodborneChicago. The tool filters tweets that are geocoded to a specified area through a system that recognizes key words related to food poisoning. Think “sick,” “food,” “vomiting,” “diarrhea,” “poisoning” and various combinations like “restaurant made me sick” or “vomiting after that lunch.”

A public health official can monitor the filtered tweets live, and sort them into “relevant” (ambulance icon), “questionable” (question mark) and “irrelevant” (trash can), as in the image above. Continue reading

Ebola Forecast: What To Expect Now And How To Contain Future Outbreaks

(European Commission DG ECHO via Compfight/Flickr)

(European Commission DG ECHO via Compfight/Flickr)

Veronica Thomas
CommonHealth Intern

A digital surveillance program used Twitter feeds and news headlines to pick up on the Ebola outbreak in West Africa a full nine days before the World Health Organization proclaimed it an epidemic. 

But that doesn’t mean the outbreak could have been prevented.

Dr. Alessandro Vespignani, a professor of computer science and physics at Northeastern University, uses network science to model and forecast the spread of disease. Like HealthMap, the online tool cited above, Vespignani’s computer simulations cannot anticipate an outbreak before it actually begins.

“They don’t have a crystal ball either,” he says. “HealthMap is really a novel way of doing disease surveillance that can provide a real edge in the early detection of outbreaks by monitoring news articles, journals, Twitter or other digital sources. But they can’t do this before the actual occurrence of the event. There was already a situation in West Africa. HealthMap was just able to pick up the anomaly before anyone else.”

As the death toll climbs over 1,000 in West Africa, I was curious to know what makes this particular outbreak so relentless and what the global community can do to contain its spread. My conversation with Dr. Vespignani, lightly edited:

First of all, what exactly are big data and network science research? And how do you use them to track disease outbreaks?

We create large-scale models for disease forecasting by creating a synthetic world in the computer that integrates all data about human mobility. Then we plug an infectious individual into the model and look at the spread of the disease. You can look at different levels of granularity—whether locally or internationally. Network science is important because most disease now spreads by human mobility. What you hear many times is, “We’re all one hop away from West Africa,” although it’s thousands of kilometers away. No one has a crystal ball, so we cannot say when there will be an Ebola disease outbreak. As soon as we have the data on the outbreak, what we can do is try understanding how it will evolve in the next few weeks or months, which is what we do with this modeling.
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