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Chief innovation officer on Zika virus tracking technologies

John Brownstein, chief innovation officer at Boston Children's, is no stranger to using technology to track diseases. He shares his insights on Zika virus tracking technologies.

Now that the Zika virus has been declared a global health emergency by the World Health Organization, those in healthcare have kicked it into high gear to educate the public, figure out how to track the virus and decide what role technology can play. SearchHealthIT spoke with John Brownstein, chief innovation officer at Boston Children's Hospital, about Zika virus tracking technologies. Brownstein has tracked diseases using technology before. For instance, he has used technology to track dengue fever, which, like the Zika virus, also is spread by mosquitoes. Brownstein is part of the team that created HealthMap, a global surveillance system for emerging diseases that mines thousands of online sources and uses machine learning to uncover disease events.

I read recently that technology may not be that helpful in tracking the Zika virus. What do you think? And what tracking technologies do you think will be helpful?

John Brownstein: The work that [HealthMap has] done on surveillance of emerging diseases has included vector-borne diseases, and, in fact, one of the major use cases that we have is actually around dengue surveillance, and dengue is actually the relative of Zika. We've done a lot over the years around tracking new areas where dengue is emerging, understanding dengue outbreaks with ... Google's surveillance system where people are searching online around symptoms of dengue. We have also been doing participatory surveillance. So crowd-sourcing technologies to get people to report in symptoms and very similarly we can do the same for Zika.

Now, of course, it's a mosquito-borne virus, but humans are ultimately the ones who are getting ill from Zika, and so you can do human-based surveillance. Now it's not always the most ideal to do human surveillance for vector-borne diseases, but in the case of one where there's no animal reservoir, it's actually not terrible. So we are spending a lot of time with our health net system data mining all sorts of different sources. ... We've actually been tracking Zika with our data mining technology since 2014 where we've seen emergence of a problem coming across the Pacific.

So surveillance has been key, and, in fact, we have our special Zika page where we track Zika across the Americas, and that has been helpful. Now it has been challenging in that so many cases are either undiagnosed because they're subclinical or the disease looks like other types of diseases. So it is challenging from a surveillance perspective, but it still provides some sense of what's happening. So technology has a role. Like any other major event, [technology is] useful, but it doesn't necessarily help us get the full picture.

Can you tell me more about the tracking technologies HealthMap is using or other technologies that would be useful? You mentioned crowdsourcing technologies, for example.

Brownstein: HealthMap is a data mine tool, so we mine what reporters are saying, blogs, chatrooms, people, clinicians, public health agencies, basically try to crawl the Web looking for any signs of disease activity coming from people discussing these issues online, and basically filtering out noise and tagging disease and location, we're able to create essentially a disease map for the world in real time, and so we can do that specifically for Zika in the same way.

So that's exactly what we've done. We've also run another project called "Flu Near You," which has a crowdsourcing system where we have 100,000 people in the system reporting their symptoms on a weekly basis. So we ask people how they're feeling, and they report their symptoms, and this has been incredibly paradigm shifting because we can bypass the traditional flow of the public health data and just engage citizens to provide us information about their symptoms that we can then locate and look at particular diseases. So for instance in Puerto Rico we can use this system to look at dengue ... and other diseases, and we're adopting this system for Zika now. But the idea of using mobile-based crowdsourcing technologies where people take a few seconds every week telling us how they're feeling can be a very powerful surveillance tool for the public health community.

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