Facebook: An Innovative Influenza Pandemic Early Warning System
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Abstract
Background: The common influenza virus imposes global monetary and productivity costs and cause mortality among the vulnerable. Novel influenza viruses like H5N1 can spread rapidly in an increasingly globalized world. Surveillance is crucial to identify and effectively contain outbreaks. In most developed countries traditional sentinel monitoring with virological sampling has a 1-2 week reporting lag. Developing countries are less well co-ordinated. Facebook an online social networking site with 175 million users worldwide has great potential as a global real-time pandemic early warning system.
Objective: To conduct a pilot study on the effectiveness of Facebook as an influenza pandemic early warning system.
Methods: A comprehensive literature search was performed using MEDLINE, ISI Web of Knowledge, INSPEC, SCOPUS and other relevant databases. Non-published works were searched using Google and Google Blog Search. Separate literature searches were performed for a suitable influenza case definition.
No published literature has assessed the use of online social networks in disease outbreaks. However our search identified Gripenet, a European-wide initiative assessing real-time influenza surveillance of volunteers though a website using email notifications. Weaknesses of this type of system include: low participation, participation reliant on traditional media and a complicated case definition for influenza.
A participant is defined as having influenza-like-illness (ILI) if they have had fever, cough and fatigue in the past week. This case definition by Thursky was chosen of its simplicity, fair sensitivity (43.5-75.1%), specificity (46.6-80.3%) and positive predictive value (23.3-59.7%).
The Influenza Tracking Project (ITP), a Facebook application was built using PHP and MYSQL. Enrolment requires an initial demographic questionnaire and informed consent. Subsequently, participants receive weekly email reminders to complete a short 15 seconds questionnaire asking: in the past week have you had fever, cough, fatigue or none of the symptoms. On submission of the questionnaire, participant IP addresses are automatically collected and are translated by geolocation software identifying the city where the participant assessed Facebook. The ratio of the number of participants with ILI divided by the number of participants without ILI symptoms will be used to compare cities and countries. The resulting data will be displayed on a colour coded geographical map showing the severity of outbreaks of ILI. This ratio will be compared across time and against different cities or countries.
External recruitment of participants are from traditional (newspaper, radio and TV) and non-traditional (blogs, website) sources. Internal growth will be maintained using Facebook features of "newsfeeds", "invitations" and "profile badges". These are Facebook equivalent of real world methods of social persuasion or "word of mouth", driving an organic participation growth.
Results: The ITP has completed beta testing with 97 total users with a median of 8 days between filled weekly questionnaires. We expect 300-500 total users by the time of the Medicine 2.0 conference with full results and analysis.
Objective: To conduct a pilot study on the effectiveness of Facebook as an influenza pandemic early warning system.
Methods: A comprehensive literature search was performed using MEDLINE, ISI Web of Knowledge, INSPEC, SCOPUS and other relevant databases. Non-published works were searched using Google and Google Blog Search. Separate literature searches were performed for a suitable influenza case definition.
No published literature has assessed the use of online social networks in disease outbreaks. However our search identified Gripenet, a European-wide initiative assessing real-time influenza surveillance of volunteers though a website using email notifications. Weaknesses of this type of system include: low participation, participation reliant on traditional media and a complicated case definition for influenza.
A participant is defined as having influenza-like-illness (ILI) if they have had fever, cough and fatigue in the past week. This case definition by Thursky was chosen of its simplicity, fair sensitivity (43.5-75.1%), specificity (46.6-80.3%) and positive predictive value (23.3-59.7%).
The Influenza Tracking Project (ITP), a Facebook application was built using PHP and MYSQL. Enrolment requires an initial demographic questionnaire and informed consent. Subsequently, participants receive weekly email reminders to complete a short 15 seconds questionnaire asking: in the past week have you had fever, cough, fatigue or none of the symptoms. On submission of the questionnaire, participant IP addresses are automatically collected and are translated by geolocation software identifying the city where the participant assessed Facebook. The ratio of the number of participants with ILI divided by the number of participants without ILI symptoms will be used to compare cities and countries. The resulting data will be displayed on a colour coded geographical map showing the severity of outbreaks of ILI. This ratio will be compared across time and against different cities or countries.
External recruitment of participants are from traditional (newspaper, radio and TV) and non-traditional (blogs, website) sources. Internal growth will be maintained using Facebook features of "newsfeeds", "invitations" and "profile badges". These are Facebook equivalent of real world methods of social persuasion or "word of mouth", driving an organic participation growth.
Results: The ITP has completed beta testing with 97 total users with a median of 8 days between filled weekly questionnaires. We expect 300-500 total users by the time of the Medicine 2.0 conference with full results and analysis.
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