Early warning system for illness outbreaks

by Vince Dixon

NCSA partners with health organizations to develop INDICATOR, a tool to catch outbreaks and help formulate response plans.

Typically, local clinics send reports of illnesses and symptoms to state and national organizations like the Centers for Disease Control. With this method, “the local people who are collecting the data often don’t see the results until it is too late to take any action,” says Ian Brooks, leader of the Health Sciences Group (HSG) at NCSA. “Although there are existing systems that collect information on infectious diseases, they tend to be top down.”

By contrast, INDICATOR, an open-source biosurveillance program developed by HSG in collaboration with the Champaign-Urbana Public Health District and Carle Hospital, is driven by the local community. It collects anonymized data from area schools, hospitals, and clinics. When unusual patterns are detected by the analysis algorithm WSARE, the system pushes out an alert to INDICATOR team members and to the public health district. This local focus ensures a quicker response time, Brooks says.

NCSA research programmer Wendy Edwards says HSG will link surveillance and modeling in INDICATOR so communities can not only detect disease outbreaks, but also develop strategies to address them.

INDICATOR has already proven its worth in Champaign-Urbana, Illinois. During last fall’s shortages of H1N1 vaccine, INDICATOR detected unusual student absences and sent an alert, enabling the public health district to revise its distribution strategy to address the apparent outbreak among schoolchildren, says Awais Vaid, a CUPHD epidemiologist.

“Our goal is that by the time all the data sources start coming in and are analyzed well, it will buy us at least a few days of time before the actual outbreak hits the community,” Vaid says. “This system will give us some time to alert community providers to prepare ourselves for something abnormal so that we can plan and respond better.”

Now thanks to additional funding from Carle and from the University of Illinois’ new Center for One Health, HSG plans to expand INDICATOR to cover a six- or seven-county area in Illinois and to include animal as well as human data. They will be working with Marilyn Ruiz, a clinical associate professor of pathobiology in the College of Veterinary Medicine who has developed a GIS-based system to map health facilities, outbreaks, etc.

Combining human and animal data is important, Brooks says, because “something like 70 percent of infectious diseases have an animal component.

“Here’s an example—What is the first indicator of the summer that there will be a problem with West Nile? It’s when the crows start dropping out of the sky. Ignoring the animal side just doesn’t make sense.”

Additional reporting by Trish Barker

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