Get Ready for BioSurveillance of Your Preschooler’s Health

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Uni­ver­si­ty of Michi­gan research shows web-based sys­tem could help improve detec­tion and response to spread of illnesses. 

Argus biosurveillance system - CDC

Argus bio­sur­veil­lance sys­tem — CDC

There is grow­ing trend toward the use of “bio­sur­veil­lance” — Web-based sys­tems to track pub­lic health, many times with an added pre­dic­tive mod­el . As you’ll see in the Uni­ver­si­ty of Michi­gan press release below, a famil­iar sales pitch is employed to assert that the only way to keep the pub­lic safe is through per­va­sive sur­veil­lance … now includ­ing preschoolers.

With Ebo­la tak­ing cen­ter stage as the lat­est threat to human­i­ty, along with new con­cerns over enterovirus EV-D68 which is afflict­ing chil­dren in increas­ing num­bers, the sur­veil­lance state is not let­ting a sin­gle cri­sis go to waste.

Recent announce­ments by social media com­pa­nies also indi­cate the arrival of full-scale health sur­veil­lance. Twit­ter’s “Chat­ter­Grab­ber” is a “machine-learn­ing algo­rithm” that will har­vest com­mu­ni­ca­tions for “tick­borne dis­eases, such as Lyme dis­ease, pub­lic sen­ti­ment involv­ing vac­cines …serv­ing as an ear­ly warn­ing sys­tem for pub­lic health offi­cials through sus­pi­cious tweets or con­ver­sa­tions.” And Face­book is ” explor­ing cre­at­ing online ‘sup­port com­mu­ni­ties’ that would con­nect Face­book users suf­fer­ing from var­i­ous ailments…also con­sid­er­ing new ‘pre­ven­ta­tive care’ appli­ca­tions that would help peo­ple improve their lifestyles.”

Embed­ded in all of these mis­sions, nat­u­ral­ly, is a dri­ve to ensure a wider adop­tion of vac­cines, per­haps mak­ing them manda­to­ry under med­ical mar­tial law . As the cli­mate of fear begins to hit a fever pitch, we would do well to con­sid­er which is more fright­en­ing: the virus of the week or the per­ma­nent solu­tions cur­rent­ly being offered.

Press Release:

A web-based sys­tem that allows preschools and child care cen­ters to report ill­ness­es to local pub­lic health depart­ments could improve the detec­tion of dis­ease out­breaks and allow resources to be mobi­lized more quick­ly, accord­ing to Uni­ver­si­ty of Michi­gan research to be pre­sent­ed Sat­ur­day, Oct. 11 at the Amer­i­can Acad­e­my of Pedi­atrics (AAP) Nation­al Con­fer­ence & Exhi­bi­tion in San Diego.

Researchers who designed the bio­sur­veil­lance sys­tem will describe how it can be used to track ill­ness trends and improve pub­lic health response to out­breaks dur­ing a pre­sen­ta­tion at 2:09 p.m. PDT in Mari­na Ball­room Salon E at the San Diego Mar­riott Marquis.

For exam­ple, if cer­tain child care cen­ters are report­ing the begin­ning of stom­ach flu (vom­it­ing and diar­rhea), oth­er cen­ters can start tak­ing steps to thor­ough­ly clean to kill any virus­es before symp­toms occur or before a major out­break takes place,” says Andrew N. Hashikawa, M.D., F.A.A.P., a pedi­atric emer­gency physi­cian at the Uni­ver­si­ty of Michi­gan’s C.S. Mott Chil­dren’s Hospital.

In addi­tion, if child care providers see that larg­er cen­ters in their com­mu­ni­ty are report­ing flu-like ill­ness, they can use the data to empha­size to par­ents the need to have their chil­dren immu­nized against influen­za soon­er rather than lat­er, says Hashikawa, who also is assis­tant pro­fes­sor in the Depart­ment of Emer­gency Med­i­cine and Pedi­atrics at the Uni­ver­si­ty of Michi­gan Med­ical School.

Chil­dren under age 5 gen­er­al­ly become sick ear­li­er and more fre­quent­ly than school-aged chil­dren and adults because their immune sys­tems are under­de­vel­oped. Young chil­dren often are respon­si­ble for spread­ing virus­es to the rest of the community.

Pre­vi­ous­ly some pub­lic health depart­ments have found that school absen­teeism as a mark­er for ill­ness was impre­cise, delayed, and unavail­able dur­ing sum­mer and win­ter breaks.

How­ev­er, child care or preschool absences are typ­i­cal­ly more like­ly to be asso­ci­at­ed with ill­ness and most young chil­dren con­tin­ue to need child care for most of the year,” says Hashikawa, a mem­ber of the U‑M Insti­tute for Health­care Pol­i­cy and Innovation.

Most pub­lic health depart­ments do not elec­tron­i­cal­ly track influen­za or stom­ach ill­ness­es in preschools and child care cen­ters settings.

Most ill­ness report­ing meth­ods used by many pub­lic health depart­ments are slow, paper-based and inef­fi­cient,” says Hashikawa.

To improve report­ing, Hashikawa and his col­leagues cre­at­ed a com­put­er­ized sys­tem and test­ed it at four ear­ly learn­ing cen­ters in Michi­gan. Staff were trained to use the sys­tem dai­ly to report any ill child. No con­fi­den­tial or iden­ti­fy­ing infor­ma­tion was col­lect­ed. They entered data on ill­ness type and symp­toms in sev­en cat­e­gories com­mon­ly seen in preschool­ers: fever, influen­za-like ill­ness, pink eye, stom­ach ill­ness­es (gas­troen­teri­tis), cold or res­pi­ra­to­ry symp­toms, ear infec­tions and rash. They also entered the age range of the ill child (infant, 0–12 months), (tod­dler, 13–35 months) or (preschool­er, 36–59 months), dai­ly atten­dance at their cen­ter, and action tak­en (e.g., child brought to a physician).

Researchers sent data elec­tron­i­cal­ly to the pub­lic health depart­ment week­ly or more fre­quent­ly if spikes in ill­ness cas­es were seen.

Results showed cen­ters report­ed 188 indi­vid­ual episodes of ill­ness from Dec. 10, 2013, through March 28, 2014. Near­ly 15 per­cent were infants, 32 per­cent were tod­dlers and 54 per­cent were preschool­ers. The most com­mon ill­ness­es report­ed were gas­troen­teri­tis (37 per­cent), fever (31 per­cent), cold (17 per­cent) and influen­za (3 percent).

Data also revealed an unusu­al­ly large increase in gas­troen­teri­tis cas­es dur­ing a two-day peri­od, which was com­pa­ra­ble to a coun­ty­wide spike among schools report­ed three weeks later.

Pre­lim­i­nary data sug­gest that using the online bio­sur­veil­lance in child care cen­ters and preschools gives us an ear­li­er detec­tion and warn­ing sys­tem because the younger chil­dren appeared to become sick first com­pared to mid­dle school and high school aged chil­dren with­in the com­mu­ni­ty,” says Hashikawa.

To view the abstract, “Imple­men­ta­tion of Web-Based Sur­veil­lance of Ill­ness in Ear­ly Learn­ing Cen­ters: A Pilot Study,” vis­it