title: Internet and free press are associated with reduced lags in global outbreak reporting.
abstract: BACKGROUND
  Global outbreak detection and reporting have generally improved for a variety of infectious diseases and geographic regions in recent decades. Nevertheless, lags in outbreak reporting remain a threat to the global human health and economy. In the time between first occurrence of a novel disease incident and public notification of an outbreak, infected individuals have a greater possibility of traveling and spreading the pathogen to other nations. Shortening outbreak reporting lags has the potential to improve global health by preventing local outbreaks from escalating into global epidemics.
  
  
  METHODS
  Reporting lags between the first record and the first public report of an event were calculated for 318 outbreaks occurring 1996-2009. The influence of freedom of the press, Internet usage, per capita health expenditure, and cell phone subscriptions, on the timeliness of outbreak reporting was evaluated.
  
  
  RESULTS
  Freer presses and increasing Internet usage correlate with reduced time between the first record of an outbreak and the public report. Increasing Internet usage reduced the expected reporting lag from more than one month in nations without Internet users to one day in those where 75 of 100 people use the Internet.
  
  
  CONCLUSIONS
  Advances in technology and the emergence of more open and free governments are associated with to improved global infectious disease surveillance.
authors: Florida State University College of Medicine, Tallahassee, Florida, USA.
authors: Lindsey
authors: L
authors: McAlarnen
authors: Department of Ecology and Evolutionary Biology, Brown University, Providence, Rhode Island, USA.
authors: Katherine
authors: K
authors: Smith
authors: Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors: John S
authors: JS
authors: Brownstein
authors: Environmental Change Initiative & Dept. of Biological, University of Notre Dame, Notre Dame, Indiana, USA.
authors: Christopher
authors: C
authors: Jerde
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