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Google Flu Trends effective surveillance tool for EDs

Dugas AF. Clin Infect Dis. 2012;doi:10.1093/cid/cir883.

City-level Google Flu Trends data correlated with influenza activity, including the number of patients visiting the ED with influenza and influenza-like illness, as well as patient-volume, according to Andrea Freyer Dugas, MD, and colleagues.

As previously reported in Infectious Diseases in Children, Google Flu Trends is an application developed by Google and the CDC that mines website search data for patterns that assist public health officials in tracking influenza outbreaks.

Between January 2009 and October 2010, a team of researchers led by Dugas, of the department of emergency medicine at Johns Hopkins University, pooled weekly data to assess the relationship between city-level Google Flu Trends for Baltimore with actual cases of influenza and patient volume in an ED in the city.

According to the researchers, Google Flu Trends correlated with the number of positive influenza test results in the adult ED (r=0.876) and the pediatric ED (r=0.718); the number of influenza-like illnesses in the adult ED (r=0.885) and the pediatric ED (r=0.652); and the volume of patients (r=0.649) and those leaving without being seen (r=0.641) in the pediatric ED.

“This study indicates that organizations such as hospitals, EDs and public health departments can use Google Flu Trends to harness the data of millions of basic Internet searches to understand influenza in their community and plan how to best respond,” Dugas told Infectious Diseases in Children.

Disclosure: This research was funded by the Department of Homeland Security (PACER: National Center for Study of Preparedness and Catastrophic Event Response [grant 2010-ST-061-PA0001]).

Public health surveillance of communicable diseases is struggling to catch up to advantages of technology available in the 21st century. How can we quickly and accurately determine “what is going around?” Understandably, the annual onslaught of influenza has been the focus of substantial recent attention. Our children constantly remind us that the internet has the answer to everything, so it comes as no surprise that investigators have tapped into this resource to track the annual comings and goings of influenza. Already in 2009, Ginsberg and his colleagues at Google monitored search engine queries regarding influenza and reported that influenza outbreaks could be detected early and accurately in various regions of the United States by such tracking (Nature 2009; 457:1012-4). Other investigators have followed-up with more or less success, usually more.

The authors of the current study used retrospective data from Google Flu Trends from Baltimore to “drill down” to see how well they correlated with influenza isolates and a number of measures of emergency room utilization and crowding. In short, the correlation was pretty good, especially for pediatric patients. Understandably, it also was timelier than data from the CDC’s Sentinel Provider Network. The authors make the point that such internet-based surveillance could augment current surveillance activities, thus giving ERs, public health authorities, hospitals and clinicians more time to implement responses to oncoming influenza. The future is here (and our kids were right — at least about this).

William Schaffner, MD
NFID President
Vanderbilt University School of Medicine
Nashville

Disclosure: Dr. Schaffner reports no relevant financial disclosures.

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