title: Major infection events over 5 years: how is media coverage influencing online information needs of health care professionals and the public?
abstract: BACKGROUND
  The last decade witnessed turbulent events in public health. Emerging infections, increase of antimicrobial resistance, deliberately released threats and ongoing battles with common illnesses were amplified by the spread of disease through increased international travel. The Internet has dramatically changed the availability of information about outbreaks; however, little research has been done in comparing the online behavior of public and professionals around the same events and the effect of media coverage of outbreaks on information needs.
  
  
  OBJECTIVE
  To investigate professional and public online information needs around major infection outbreaks and correlate these with media coverage. Questions include (1) How do health care professionals' online needs for public health and infection control information differ from those of the public?, (2) Does dramatic media coverage of outbreaks contribute to the information needs among the public?, and (3) How do incidents of diseases and major policy events relate to the information needs of professionals?
  
  
  METHODS
  We used three longitudinal time-based datasets from mid-2006 until end of 2010: (1) a unique record of professional online behavior on UK infection portals: National electronic Library of Infection and National Resource of Infection Control (NeLI/NRIC), (2) equivalent public online information needs (Google Trends), and (3) relevant media coverage (LexisNexis). Analysis of NeLI/NRIC logs identified the highest interest around six major infectious diseases: Clostridium difficile (C difficile)/Methicillin-resistant Staphylococcus aureus (MRSA), tuberculosis, meningitis, norovirus, and influenza. After pre-processing, the datasets were analyzed and triangulated with each other.
  
  
  RESULTS
  Public information needs were more static, following the actual disease occurrence less than those of professionals, whose needs increase with public health events (eg, MRSA/C difficile) and the release of major national policies or important documents. Media coverage of events resulted in major public interest (eg, the 2007/2008 UK outbreak of C difficile/MRSA). An exception was norovirus, showing a seasonal pattern for both public and professionals, which matched the periodic disease occurrence. Meningitis was a clear example of a disease with heightened media coverage tending to focus on individual and celebrity cases. Influenza was a major concern during the 2009 H1N1 outbreak creating massive public interest in line with the spring and autumn peaks in cases; although in autumn 2009, there was no corresponding increase in media coverage. Online resources play an increasing role in fulfilling professionals' and public information needs.
  
  
  CONCLUSIONS
  Significant factors related to a surge of professional interest around a disease were typically key publications and major policy changes. Public interests seem more static and correlate with media influence but to a lesser extent than expected. The only exception was norovirus, exhibiting online public and professional interest correlating with seasonal occurrences of the disease. Public health agencies with responsibility for risk communication of public health events, in particular during outbreaks and emergencies, need to collaborate with media in order to ensure the coverage is high quality and evidence-based, while professionals' information needs remain mainly fulfilled by online open access to key resources.
authors.affiliation: Department of Computer Science, National Resource for Infection Control NRIC, University College London, London, United Kingdom. P.Kostkova@ucl.ac.uk
authors.forename: Patty
authors.initials: P
authors.lastname: Kostkova
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.forename: Sue
authors.initials: S
authors.lastname: Wiseman
authors.forename: Julius R
authors.initials: JR
authors.lastname: Weinberg
mesh_terms: D004196:Disease Outbreaks; D006282:Health Personnel; D006801:Humans; D007239:Infections / Q000453:epidemiology*; D020407:Internet; D008402:Mass Media; D011639:Public Opinion; D006113:United Kingdom / Q000453:epidemiology
keywords: data mining; infectious outbreaks; information seeking behavior; online information needs; weblogs analysis