On any given day, virtual red, orange and yellow push pins across a global electronic map serve as visual cues to the places wildlife-to-human disease outbreaks might be emerging.
On a Thursday in late February, for example, the new open-access online mapping tool, known as HealthMap.org/predict, showed activity across Mexico, Latin America, Africa’s midsection and parts of Asia. News stories and scientific reports of tuberculosis in the Democratic Republic of Congo, foodborne illness in Malaysia and avian influenza in Vietnam were filtering through the tracking system — part of an effort to harness the power of the public, the Internet and the best available science to predict and possibly even prevent widespread disease.
Funds from the U.S. Agency for International Development’s Emerging Pandemic Threats program were used to create HealthMap.org/predict as well as to support disease surveillance in more than 20 countries and local media surveillance.
A stray dog rests near a temple in Bali in August. The Indonesian government has undertaken a campaign to vaccinate the country’s many stray dogs against rabies following an outbreak that has killed more than 100 people since 2008. Monitoring global wild-life diseases such as rabies is the goal of a new tracking system.
Photo by Sonny Tumbeleka, courtesy Getty Images
“It’s about looking upstream for pathogens and being able to head them off at the pass,” said Damien Joly, PhD, a wildlife epidemiologist with the Wildlife Conservation Society, one of the many groups working on the mapping project. “Let’s face it. As a discipline, we’re not very good at predicting disease emergence. A big part of the project is to improve the science and better predict what happens.”
The system focuses on wildlife because a 2008 study in Nature, headed by a scientist with the Zoological Society of London, estimated 70 percent of emerging zoonotic infections originate in wild animals.
The new website uses a platform known as HealthMap.org to bring together myriad data sources into an easily understandable view on what is happening in wildlife-to-human infectious disease worldwide. Co-founded several years ago by John Brownstein, PhD, HealthMap.org automatically monitors more than 50,000 Web sources every hour, from Google News to eyewitness reports to official records from the World Health Organization.
“We’ll crawl the Web like Google does, but with the idea of looking at infectious diseases,” said Brownstein, a research scientist with Children’s Hospital in Boston and assistant professor at Harvard Medical School.
The system depends not only on an automated process but also on votes from people mining the data, who help determine if online “chatter” about a specific outbreak is of high or low importance. He said the more people involved, the more robust the output.
“It’s disseminating information, but also, the more input we get, the better the surveillance,” Brownstein said. “The site is geared toward raising awareness about emerging diseases in your local area or around the world. We developed the site with public health professionals in mind so they can be aware of what might happen next in their neck of the woods.”
The Health Map.org computer-sifted data are joined with results of other emerging disease risk trackers developed by EcoHealth Alliance, a biodiversity conservation group formerly known as Wildlife Trust, and those results then help form and modify field surveillance activities in places where wildlife and humans come together. The Predict project launched in 2009 with funding from the U.S. Agency for International Development as part of the agency’s Emerging Pandemic Threats program. The new online mapping tool is the result of a collaboration between a multitude of public and private groups interested in better response to novel infectious diseases.
A March graphic from HealthMap.org shows possible wildlife-related infectious disease cases being tracked in South America.
Graphic courtesy HealthMap.org/Predict
“Often, we’ll see a blip where we see wildlife getting sick, and then, a few weeks later, people get sick,” said Jonna Mazet, DVM, PhD, MPVM, director of the Predict project and the University of California Davis’ One Health Institute in the School of Veterinary Medicine. “It helps us to protect the public’s health if we’re looking early at the animal.”
So far, the system has tracked an infection among hunters in the Democratic Republic of Congo, yellow fever in Uganda and an outbreak of Nipah virus in Bangladesh.
Part of the fascinating aspect of the project is the merging of cutting-edge technology with low-tech approaches. Local drivers in Tanzania and Cambodia, when not assisting field teams by driving them to and from research locations, scan local newspapers and report in on disease stories.
“It’s about developing an understanding of the disease systems any way we can,” Joly said. “It’s not always high-tech.”
The Predict project has gained praise from those working to promote the “one health” movement, an effort to integrate human, animal and environmental health.
Marguerite Pappaioanou, DVM, PhD, executive director of the Association of American Veterinary Medical Colleges and a member of the One Health Commission, a nonprofit group that spotlights the connections between human, animal and environmental health, is one of many in the public health world who believes better communication between disciplines could translate into better health.
For example, instead of waiting until humans fall ill from an infection, tracking animal health could pinpoint an emerging infection before it devastates a region or even a local community.
Oftentimes, the response to emerging diseases, even those that are mainly a local issue, “leads to billions of dollars being spent in their control,” Pappaioanou said.
“They result in just a huge amount of anxiousness and fear, because of morbidity and mortality but also the cost of control both in human and animal populations,” she said.
The Predict program combines digital surveillance with on-the-ground field confirmation to zero in on emerging infections as they happen, said Mazet of the University of California Davis. She credits USAID with driving the project using the best possible science. Using a model of likely disease emergence “hotspots,” workers are placed in areas where humans are most likely to interact with wildlife within those hotspots. Such locations may be near local production of palm oil near bat colonies, for example. The project also targets species that in the past have carried viruses likely to spill over into humans, such as bats, which are believed to be the origin of Severe Acute Respiratory Syndrome, better known as SARS.
“If we do our job right, we are never going to seem very successful, because hopefully nothing will start up,” Mazet said. We’re doing the best we can, but the world is a random place and things are likely to start up. But with this new system, we hope we’ll catch them very early.”
More information on Predict, the USAID Emerging Pandemic Threats Program and the HealthMap tool is available at www.healthmap.org/predict.
- Copyright The Nation’s Health, American Public Health Association
