Decision Support System for the Response to Infectious Disease Emergencies Based on WebGIS and Mobile Services in China

Background: For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Methodology/Principal Findings: Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. Conclusions/Significance: The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts

Analysis of poultry trade networks to improve risk-based surveillance : a survey study in Gujarat Índia

Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Sanidade AnimalPoultry production and trading in India have been facing a spectacular growth as the demand for poultry products increases. Live bird shops (LBSs) and poultry trading practices are known risk factors in the spread of diseases within poultry production and distribution networks. Although such shops are ubiquitous in India, poultry trading practices and potential impact on disease risk are poorly understood. The objectives of this study were to characterise LBSs for Exotic Broiler (EB) and Desi species, based on trading practices likely to increase infectious risk, and to assess the connectivity between shops through the trade of live poultry. A questionnaire-based cross-sectional study was conducted in 86 LBSs, selected through a multi-stage sampling method. Eight cities were first purposively selected and, within each city, shops were identified using random spatial sampling. The standardised questionnaires focused on shop management characteristics, hygiene practices and details of their chicken suppliers. The suppliers were then contacted and asked about their trading practices and suppliers until catchment areas were identified. Finally, disease transmission pathways were investigated and poultry trading networks were constructed for EB chickens, to assess the connectivity between shops. Preliminary descriptive analysis suggests a high heterogeneity in the scale of operations, with daily sales ranging from 6 up to 800 and from 0 to 30 chickens, respectively for EB and Desi species. Most of the shops reported to have unsold chickens at the end of the day, with a proportion of unsold chickens reaching up to 26% and 45.2%, respectively for EB and Desi chickens. Several practices were identified as having a potential influence on disease introduction and transmission, into and within the shops. The transport of chickens from farms to shops typically involves one (85.3%) or two intermediaries (10.3%). While each city obtained chickens only from one to four districts (out of the 33 districts of Gujarat), four districts supplied more than one city. The described practices may promote pathogen amplification within Gujarat’s shops. Moreover, the network shaped by poultry movements, regarding EB chickens, connect distant poultry populations that include both tribal and non-tribal areas, increasing the risk of pathogen spread in the region. Nevertheless, most of the surveyed cities get their supplies from the closest district(s). Further investigation on risk pathways for disease transmission and identification of their geographical and socio-economic determinants are some of the next steps.RESUMO - ANÁLISE DE REDES DE COMÉRCIO DE AVES PARA MELHORAR A VIGILÂNCIA DE RISCO: UM ESTUDO DE CASO EM GUJARAT, INDIA - A produção e comércio de aves na Índia tem crescido face ao aumento da procura de produtos avícolas. Os mercados de aves vivas (MAVs) e práticas relacionadas são reconhecidos como fatores de risco na disseminação de doenças entre redes de produção e de distribuição (RPD) de aves. Embora os MAVs sejam ubiquitários na Índia, o impacto das suas práticas na introdução de agente patogénicos são pouco compreendidos. Este estudo tem como objetivo caracterizar os MAVs para as espécies “frango exótico” (“FE”) e “Desi”, com base nas diferentes práticas de comercialização que podem influenciar o risco de doença, e determinar o grau de conectividade entre mercados através do tráfego de aves vivas. Um estudo transversal foi conduzido em 86 MAVs, selecionados por método de amostragem multi-etapas. Inicialmente foram selecionadas 8 cidades e, em cada cidade, escolhidos os MAVs por método de amostragem espacial aleatória. Os questionários abordaram características comerciais, práticas de higiene e informação detalhada sobre fornecedores. Os fornecedores foram também contatados e as duas práticas foram novamente investigadas até identificar o local de origem das aves. Foram também investigadas vias de transmissão de agentes patogénicos, de acordo com as práticas descritas, e foram construídas RPD de aves, para avaliar a conectividade entre MAVs. A análise preliminar sugere uma grande heterogeneidade na escala de operações dos MAVs, com vendas diárias de 6 a 800 e de 0 a 30 galinhas, respetivamente para “FE” e “galinhas Desi”. A maioria dos MAVs reportaram ter aves por vender no final de cada dia, com proporções que chegam aos 26% para “FE” e 45.2% para “Desi”. Várias práticas foram identificadas como potenciais vias de introdução ou transmissão de doença, para e entre MAVs. O transporte de aves desde áreas de produção até aos estabelecimentos de venda, envolve geralmente 1 (85.3%) ou 2 (10.3%) intermediários. Cada cidade recebe galinhas desde 1 a 4 distritos (num universo de 33 distritos em Gujarat) e 4 distritos fornecem mais do que 1 cidade. As práticas descritas podem promover a persistência e amplificação de doença em MAVs em Gujarat. A rede formada pelos movimentos de aves entre estabelecimentos interliga populações distantes, incluindo áreas tribais e não tribais, o que incrementa o risco de disseminação de doenças. A maioria das cidades estudadas obtém as suas aves dos distritos vizinhos. Alguns dos próximos passos incluem investigações adicionais de vias da transmissão de doença e identificação de determinantes geográficos e socioeconómicos.N/

Report on the evaluation of surveillance systems relevant to zoonotic diseases in Kenya, 2015: A basis for design of an integrated human–livestock surveillance system

The Zoonoses in Livestock in Kenya (ZooLinK) is a project that seeks to enable Kenya develop an effective surveillance programme for zoonotic diseases (infectious diseases transmissible between animals and human beings). The surveillance programme will be integrated across both human and animal health sectors. To achieve this goal the project will work in close collaboration with Kenyan government departments in responsible for animal and human health. As a prelude to the start of the project, an evaluation of the existing surveillance systems for human and animal health was carried out. The evaluation focused on the national surveillance system and the systems at the western part of Kenya (Busia county, Kakamega county and Bungoma county) where the initial programme will be developed. In conducting the evaluation the investigators used key informant interviews, focused group discussion participant questionnaires, audio recordings and observation for data collection. Data analysis for the qualitative data focused on generating themes or theory around the responses obtained in the key informants interviews and focused group discussions. Univariate analysis was performed by use of simple proportions in calculation for surveillance system attributes like sensitivity, completeness, PVP and Timeliness for the human health surveillance systems. The findings of the evaluation revealed that there was poor linkage between animal health surveillance and the human health surveillance systems. None of the systems had surveillance structures dedicated to zoonotic diseases. Most practitioners used clinical signs for diagnosis of diseases with little reference to acceptable case definitions. Laboratory diagnosis in animal health services focused more on suspected notifiable diseases as opposed to being a standard operating procedure for diagnosis. In Human health services the health care facilities that had laboratory within the facility conducted laboratory diagnosis for cases referred by the clinicians. However, some clinicians preferred using clinical signs for diagnosis to avoid the wait or turn-around time in the laboratory. For effective surveillance of zoonoses to be realized it would be advisable to establish surveillance structures specific to zoonoses and the necessary resources allocated to the surveillance activities. In addition, an integrated approach that incorporated both human and animal disease surveillance should be employed in the surveillance of zoonoses

Disease Surveillance Networks Initiative Asia: Final Evaluation

The DSN Initiative was launched in 2007 under the new strategy of the Rockefeller Foundation. The initiative intends:[1] To improve human resources for disease surveillance in developing countries, thus bolstering national capacity to monitor, report, and respond to outbreaks;[2] To support regional networks to promote collaboration in disease surveillance and response across countries; and[3] To build bridges between regional and global monitoring effortsThe purpose of the DSN evaluation in the Mekong region was twofold:[1]To inform the work and strategy of the Foundation, its grantees, and the broader field of disease surveillance, based on the experience of DSN investments in the Mekong region. More specifically, the evaluation will inform future directions and strategies for current areas of DSN Initiative work, particularly in Asia, and will highlight potential new areas of work and strategy; and[2] To provide accountability to the Rockefeller Foundation's board, staff, and stakeholders for the DSN funds spent in the Mekong region

Data and Digital Solutions to Support Surveillance Strategies in the Context of the COVID-19 Pandemic

Background: In order to prevent spread and improve control of infectious diseases, public health experts need to closely monitor human and animal populations. Infectious disease surveillance is an established, routine data collection process essential for early warning, rapid response, and disease control. The quantity of data potentially useful for early warning and surveillance has increased exponentially due to social media and other big data streams. Digital epidemiology is a novel discipline that includes harvesting, analysing, and interpreting data that were not initially collected for healthcare needs to enhance traditional surveillance. During the current COVID-19 pandemic, the importance of digital epidemiology complementing traditional public health approaches has been highlighted. Objective: The aim of this paper is to provide a comprehensive overview for the application of data and digital solutions to support surveillance strategies and draw implications for surveillance in the context of the COVID-19 pandemic and beyond. Methods: A search was conducted in PubMed databases. Articles published between January 2005 and May 2020 on the use of digital solutions to support surveillance strategies in pandemic settings and health emergencies were evaluated. Results: In this paper, we provide a comprehensive overview of digital epidemiology, available data sources, and components of 21st-century digital surveillance, early warning and response, outbreak management and control, and digital interventions. Conclusions: Our main purpose was to highlight the plausible use of new surveillance strategies, with implications for the COVID-19 pandemic strategies and then to identify opportunities and challenges for the successful development and implementation of digital solutions during non-emergency times of routine surveillance, with readiness for early-warning and response for future pandemics. The enhancement of traditional surveillance systems with novel digital surveillance methods opens a direction for the most effective framework for preparedness and response to future pandemics

Surveillance Sans Frontières: Internet-Based Emerging Infectious Disease Intelligence and the HealthMap Project

John Brownstein and colleagues discuss HealthMap, an automated real-time system that monitors and disseminates online information about emerging infectious diseases

Pandemic Influenza: Ethics, Law, and the Public\u27s Health

Highly pathogenic Influenza (HPAI) has captured the close attention of policy makers who regard pandemic influenza as a national security threat. Although the prevalence is currently very low, recent evidence that the 1918 pandemic was caused by an avian influenza virus lends credence to the theory that current outbreaks could have pandemic potential. If the threat becomes a reality, massive loss of life and economic disruption would ensue. Therapeutic countermeasures (e.g., vaccines and antiviral medications) and public health interventions (e.g., infection control, social separation, and quarantine) form the two principal strategies for prevention and response, both of which present formidable legal and ethical challenges that have yet to receive sufficient attention. In part II, we examine the major medical countermeasures being being considered as an intervention for an influenza pandemic. In this section, we will evaluate the known effectiveness of these interventions and analyze the ethical claims relating to distributive justice in the allocation of scarce resources. In part III, we will discuss public health interventions, exploring the hard tradeoffs between population health on the one hand and personal (e.g., autonomy, privacy, and liberty) and economic (e.g., trade, tourism, and business) interests on the other. This section will focus on the ethical and human rights issues inherent in population-based interventions. Pandemics can be deeply socially divisive, and the political response to these issues not only impacts public health preparedness, but also reflects profoundly on the kind of society we aspire to be

Web GIS in practice VI: a demo playlist of geo-mashups for public health neogeographers

'Mashup' was originally used to describe the mixing together of musical tracks to create a new piece of music. The term now refers to Web sites or services that weave data from different sources into a new data source or service. Using a musical metaphor that builds on the origin of the word 'mashup', this paper presents a demonstration "playlist" of four geo-mashup vignettes that make use of a range of Web 2.0, Semantic Web, and 3-D Internet methods, with outputs/end-user interfaces spanning the flat Web (two-dimensional – 2-D maps), a three-dimensional – 3-D mirror world (Google Earth) and a 3-D virtual world (Second Life ®). The four geo-mashup "songs" in this "playlist" are: 'Web 2.0 and GIS (Geographic Information Systems) for infectious disease surveillance', 'Web 2.0 and GIS for molecular epidemiology', 'Semantic Web for GIS mashup', and 'From Yahoo! Pipes to 3-D, avatar-inhabited geo-mashups'. It is hoped that this showcase of examples and ideas, and the pointers we are providing to the many online tools that are freely available today for creating, sharing and reusing geo-mashups with minimal or no coding, will ultimately spark the imagination of many public health practitioners and stimulate them to start exploring the use of these methods and tools in their day-to-day practice. The paper also discusses how today's Web is rapidly evolving into a much more intensely immersive, mixed-reality and ubiquitous socio-experiential Metaverse that is heavily interconnected through various kinds of user-created mashups