The HealthMap infrastructure was used to track suspected or confirmed cases or deaths, as well as cases ruled out or not identified as H1N1, based on formal and informal reports, from the World Health Organization and U.S. Centers for Disease Control to news reports and blog activity.
Between April 1 and Dec. 31 2009, researchers analyzed more than 87,000 reports, revealing in retrospect insight to the epidemiology of H1N1 spread around the world, such as how quickly the virus spread, where and how.
The researchers also calculated the time elapsed between suspected and confirmed cases of H1N1 by country, finding a "significant" relationship between a country's national gross domestic product and its robustness of public health infrastructure.
"We found that countries with high GDP demonstrated a short lag in reporting and were confirming cases in a few days, whereby countries with low GDP could experience lags of up to 85 days," said John Brownstein, co-founder of HealthMap and a professor at the hospital.
According to the research, several factors contributed to lagging information during the pandemic:
- Deficiencies in public health infrastructures.
- Political pressures (trade, tourism).
- Intense media coverage, which spurred many folks to get tested unnecessarily at the onset.
"Syndromic surveillance" is the seed of what could become real-time surveillance of health data -- from Lyme disease to rabies to E. coli to influenza -- using electronic medical records.
The challenge: ensuring that people and nations sign up for electronic health records and make that information readily available.