On who’s sick where & when

by Janet A. Ginsburg

Really? I’m not sure knowing that something is going around would have put my mind at ease, especially with that appendicitis option. And what one should do with the knowledge of a stomach virus in circulation is a little fuzzy: Wash your hands more often?  Carry an extra packet of Kleenex and a bigger bottle of hand-sanitizer? Try harder to avoid sick people? Those are always good moves.

Nonetheless, WhoIsSick has tapped into a very interesting idea: Health surveillance by the people, for the people.

Connecting the epidemiological dots of an outbreak isn’t easy, but it’s also not the point of WhoIsSick. Although data on six broad symptom categories --  muscle aches, stomach aches, headaches, fevers, coughing,  and runny noses – are gathered, the site’s goal is simply to point how where there are outbreaks, not what caused them. Like the oh so aptly-named Twitter website, data are provided voluntarily from people who feel compelled to account for and share their every moment. And it is rather amazing to know that nearly half the 105 responders in the greater Chicago Metropolitan area over the last 24 hours have had coughs or runny noses, while in Phoenix, there are about as many coughs as muscle aches among the 72 ailing. Statistically, it’s utterly meaningless. But given more data, it could have meaning.

Meanwhile, there is the promise and potential to ponder. Would an food-borne disease outbreaks such as the e.coli lettuce disaster a few months ago have been more quickly contained if people had a way to post information about their illnesses? For as long as I’ve been reporting these kinds of stories, the CDC stats have remained mysteriously stagnant but still stunning: an estimated 76 million cases of foodborne illness in the U.S. every year, resulting in 325,000 hospitalizations, and 5000 deaths. The vast majority of us simply suffer through alone in our bathroom-bound misery. Now there’s a way to share the experience without getting anyone else sick.

Likewise, if pet-owners had had a way to report on their sick puppies and kitties with kidney failure, would the investigation into tainted pet food have begun sooner?

Tracey McNamara, the veterinary pathologist who helped link dead crows to sick people leading to the initial diagnosis of West Nile Virus in New York, has long argued that we need to tap into the vast wealth of knowledge of people who spend quality time with animals: zookeepers, wildlife rehabilitators and pet-owners. The majority of human diseases are zoonotic, meaning they infect multiple species, including humans (West Nile, Bird Flu, SARS, Plague, Hanta virus, Lyme Disease, etc.). Lucky for us and not-so-lucky for them, animals are natural disease sentinels, but we’ve had precious few ways to mine into the information easily.

Surveillance projects such as The Zoo Network (which McNamara helped set up ), or a pet health database developed at Purdue University, combine diagnostic depth with reporting breadth. Clearly, diagnostics are important, but in the short term, breadth may be even more important than depth in quickly identifying problems requiring urgent attention.

Wildlife rehabilitators, which range from well-established institutions to mom-and-pop operations, currently have no meaningful way to report on what they see in the field. An influx of sick raptors, for example, could indicate an outbreak of West Nile or a related virus, or an environmental toxin. Either way, probably worth looking into.

WhoIsSick.org asks the right question. The trick will be in making sense of the answers.