Using social media for disease surveillance
August 18th, 2011
12:00 PM ET

Using social media for disease surveillance

Editor's Note: Dr. John Brownstein works at the Children’s Hospital in Boston on public health surveillance. This post is part of the Global Innovation Showcase created by the New America Foundation and the Global Public Square.

By John Browstein – Special to CNN

In late 2002, a financial report from a Chinese pharmaceutical company noted a strange increase in emergency room visits in Guangdong Province for acute respiratory illness. A flurry of local news reports of a respiratory disease among healthcare workers emerged, while online there was buzz of an unusual outbreak in Guangzhou. It took several long weeks before the government announced the illnesses were due to the severe acute respiratory syndrome, or SARS. If harnessed properly, early epidemic intelligence collected online could have helped contain what later became a global pandemic.

Since that time, the Internet has fundamentally changed global health surveillance—by circumventing censorship, dramatically reducing the time required to recognize outbreaks and supporting wide distribution of health information.  We are now in an era where epidemic intelligence flows not only through government hierarchies but also through informal channels, ranging from press reports to blogs to chat rooms to analyses of Web searches. Collectively, these sources provide a view of global health that is fundamentally different from that yielded by disease reporting in traditional public health infrastructures.

While the concept of Internet-based surveillance has now gained broad recognition, the concept itself is not new. Organizations have been working within this paradigm for the last 15 years. ProMED, a publicly available reporting system based on a trusted social network of ‘disease detectives,’ started in 1994. In 1997, the Global Public Health Intelligence Network (GPHIN) was launched. GPHIN software retrieves relevant articles from news aggregators every 15 minutes and disseminates that information to government subscribers. ProMED and GPHIN’s state of the art reporting techniques proved crucial in the early stages of the SARS outbreak.

More recently, the explosion of online news and social media has brought a new era of disease surveillance.  In 2006, working in the Computational Epidemiology group at Children’s Hospital Boston and Harvard Medical School, Clark Freifeld and I developed the HealthMap system: an online platform that mines informal sources for disease outbreak monitoring. The freely available Web site and mobile app 'Outbreaks Near Me' deliver real-time intelligence on a broad range of emerging infectious diseases for a diverse audience, which includes local health departments, governments, clinicians and international travelers.

HealthMap is unique in that it brings together disparate data sources, including online news aggregators, eyewitness reports, expert-curated discussions and validated official reports, to achieve an intuitive and comprehensive view of the current global state of infectious diseases and their effect on human and animal health. Through an automated process that updates 24/7/365, the system monitors, organizes, integrates, filters, visualizes and disseminates online information about emerging diseases in nine languages, facilitating early detection of global public health threats.

Check Out: More from the "Global Innovation Showcase" created by the New America Foundation and the Global Public Square.

These informal data are already changing the public health landscape. Nowhere was this clearer than with the 2009 emergence of the novel influenza A (H1N1) virus. In March and early April of that year, while much of the world was focusing on the threat of avian influenza originating in Asia, HealthMap identified and reported evidence of an epidemic of acute respiratory infections in Veracruz, Mexico. This report came weeks in advance of more traditional reporting including laboratory confirmation of the novel strain. While epidemic intelligence systems still need to be fine tuned to specify when these signals require special attention among the many daily reports of mysterious respiratory illness, these systems nonetheless played a crucial situation awareness role in the tracking of H1N1 as it crossed the globe.

Cholera's emergence in Haiti provides another example of the value of these data streams provide to the global health community. Given the difficulties of obtaining real-time detailed health information in a crisis setting, HealthMap in collaboration with other international organizations including CrisisMappers and Humanity Road deployed a tool to integrate information on the developing cholera outbreak. The web resource ( mapped informal outbreak reports from news and social media as well as key information on the availability of healthcare and clean water facilities. Broadly, these freely available internet tools that collect, map and exchange epidemic intelligence may be rapidly deployed during future humanitarian emergencies.

After 5 years in operation, HealthMap is now moving to its next iteration, providing on-demand locally contextualized information on health events ( Just as the weather channel provides details on your daily forecast, HealthMap now provides users with their own personal view of disease circulating in their location.

HealthMap is part of a growing landscape of NGOs and government organizations working in the digital disease detection field. Other similar services are Argus, EpiSPIDER, BioCaster, MediSys, and the Wildlife Disease Information Node.  Beyond web mining, movement toward “anytime, anywhere” technologies is providing new avenues for surveillance.  Even Twitter and Facebook are now playing an emerging role in the early detection of epidemics.  Social networking sites for clinicians and patients (such as PatientsLikeMe) are unproven but offer promising methods for harnessing collective wisdom for detection of emerging disease.  These ubiquitous websites and mobile apps allow for seamless real-time communication on health and personal disease status.

When Internet-based systems first appeared on the public health scene, they were criticized for the possibility of false reports, lack of specificity, and sensitivity to external forces such as fickle media interest.  Though these problems are recognized and accounted for as best as possible, these criticisms are still valid. But despite the possibilities for error, internet-based epidemic intelligence systems are invaluable resources for information on emerging diseases because of their ease of use, flexibility, transparency and sensitivity. Though these systems began on the fringes, in the span of a few years, they have become essential tools in the worldwide fight against public health threats.

The views expressed in this article are solely those of John Browstein. Visit for more pieces on the subject..

Post by:
Topics: Global • Health • Innovation

soundoff (21 Responses)
  1. Heather

    the links don't appear to be working

    August 18, 2011 at 1:34 pm | Reply
  2. Jennifer

    If there are not articles being published in the region where I live does that mean there are no outbreaks of any disease in my area?

    August 18, 2011 at 2:33 pm | Reply
  3. Media room design

    Blogs are so informative where we get lots of information on this topic. Nice job keep it up!!
    Nice blog on Media room design.
    Keep sharing more & more.....

    August 19, 2011 at 7:03 am | Reply
  4. noel brei

    Sounds like a valuable resouce for anyone with children and for adults too.Great work John!

    August 21, 2011 at 8:26 am | Reply
  5. marketing of facebook

    I do agree with all of the ideas you have presented for your post. They are very convincing and can certainly work. Still, the posts are too quick for starters. Could you please lengthen them a little from next time? Thanks for the post.

    May 24, 2012 at 7:50 pm | Reply
  6. cctv jogja

    I have been reading your website for several days, genuinely like what you posted. By the way, I am conducting an analysis regarding this topic. Do you occur to know any other excellent blogs or forums exactly where I may well locate out far more? several thanks. cctv camera di jogja

    June 17, 2012 at 2:20 am | Reply
  7. YouLikeBots - Social Exchange Network

    I've been exploring for a little for any high-quality articles or blog posts on this sort of house . Exploring in Yahoo I eventually stumbled upon this web site. Reading this information So i'm happy to convey that I have an incredibly just right uncanny feeling I came upon just what I needed. I such a lot indubitably will make certain to do not forget this site and provides it a look on a continuing basis.

    March 7, 2013 at 10:13 pm | Reply
  8. Roy Heilmann

    In June 2009, the World Health Organization declared the new strain of swine-origin H1N1 as a pandemic. This strain is often called swine flu by the public media. This novel virus spread worldwide and had caused about 17,000 deaths by the start of 2010. On August 10, 2010, the World Health Organization declared the H1N1 influenza pandemic over, saying worldwide flu activity had returned to typical seasonal patterns.,;

    Most up-to-date brief article on our web blog

    May 13, 2013 at 8:59 am | Reply
  9. Leila Pellicone

    The human respiratory system not only provides oxygen to each cell of the body but also removes body wastes, filters out infectious agents, and provides air needed for speech. Although the lungs are able to with stand abuse in the form of smoke and other pollutants, a number of disorders impair its function. Some of these maladies are temporary and relatively harmless; others may be life-threatening. Any chronic breathing problem or other cough should be checked promptly. Take care of your lungs and they will take care of you.;..`*

    Brand new post on our very own homepage <

    July 2, 2013 at 5:44 am | Reply
  10. Lucio Hoeg

    According to the World Health Organization (WHO), it is possible for novel coronavirus, a new coronavirus that has killed at least 18 people in the Middle East and Europe, to be passed between humans, but only after prolonged contact. So far, however, there is no evidence that the virus is able to sustain generalized transmission in communities, a scenario that would raise the specter of a pandemic.*`^-

    Take a look at the newest post on our personal blog site

    July 3, 2013 at 4:30 am | Reply
  11. VirusCancerKiller

    Relax! – Expect no infections at all around the world once and for all – Traveling around the world can be absolutely carefree, for everybody will stay absolutely healthy all the time – I got the power (and everybody can possess it) to destroy any pathogens instantly, to curb any global pandemics and to erase any diseases from the face of the Earth in a matter of days – Any threat worldwide will be completely avoided, once everybody (kids and adults) start doing my discovery (the greatest one of all time on Earth and maybe in the Universe) – The WVCD – The Weapon of Virus and Cancer Destruction – By far more powerful than the human immune system, keeping it intact all the time, for any pathogens are killed the moment they touch us – Just an exercise for a minute a day – The cure and prevention of any diseases, known on Earth for millions of years – Infections, Cancers, Diabetes, MS, Alzheimer's, Parkinson's Disease, Cardiovascular Diseases, Chronic Diseases and Strokes – Even Tibetans and Yoga don't know how to stay absolutely healthy all the time – Everybody (kids and adults) will stay that way, for the WVCD supplies every cell of our bodies with enough oxygen, that kills any pathogens the moment they touch us and prevents us from any diseases – The price of the WVCD for the whole world is 5 billion EURO – Just 25 million EURO per country – Once I am paid the money, everybody (kids and adults) will know how to stay absolutely healthy all the time – Never getting sick of any diseases even for a second.

    August 19, 2015 at 5:53 am | Reply
  12. oxfordshire travel agency

    I like this web site very much, Its a really nice position to read and obtain information. "There is no exercise better for the heart than reaching down and lifting people up." by John Andrew Holmes.

    December 9, 2015 at 8:20 am | Reply
  13. Bo Bingley

    Do you normally do post like this? Great stuff

    June 17, 2016 at 10:10 am | Reply
  14. sac a dos old skool ii

    It is hard not to get excited about either Widell or Barnes making it to the team, as we all remembe.
    sac a dos old skool ii

    May 17, 2018 at 10:58 pm | Reply
  15. adidas zx flux personalizza

    That is not great, but decent when you compare it to Baez, who struck out 25.
    adidas zx flux personalizza

    June 4, 2018 at 11:13 pm | Reply


    How Are You Today?I found you upon web and I in point of fact liked your work.

    Are You Heard ThisOne Clicks Come From Different Social Source?

    This is a unconditionally easy internet traffic system,
    One-Click Traffic System

    This Traffic come From Facebook,Twitter , Social Media Etc...


    December 5, 2019 at 8:29 pm | Reply

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.