title: Surveillance for Neisseria meningitidis Disease Activity and Transmission Using Information Technology.
abstract: BACKGROUND
  While formal reporting, surveillance, and response structures remain essential to protecting public health, a new generation of freely accessible, online, and real-time informatics tools for disease tracking are expanding the ability to raise earlier public awareness of emerging disease threats. The rationale for this study is to test the hypothesis that the HealthMap informatics tools can complement epidemiological data captured by traditional surveillance monitoring systems for meningitis due to Neisseria meningitides (N. meningitides) by highlighting severe transmissible disease activity and outbreaks in the United States.
  
  
  METHODS
  Annual analyses of N. meningitides disease alerts captured by HealthMap were compared to epidemiological data captured by the Centers for Disease Control's Active Bacterial Core surveillance (ABCs) for N. meningitides. Morbidity and mortality case reports were measured annually from 2010 to 2013 (HealthMap) and 2005 to 2012 (ABCs).
  
  
  RESULTS
  HealthMap N. meningitides monitoring captured 80-90% of alerts as diagnosed N. meningitides, 5-20% of alerts as suspected cases, and 5-10% of alerts as related news articles. HealthMap disease alert activity for emerging disease threats related to N. meningitides were in agreement with patterns identified historically using traditional surveillance systems. HealthMap's strength lies in its ability to provide a cumulative "snapshot" of weak signals that allows for rapid dissemination of knowledge and earlier public awareness of potential outbreak status while formal testing and confirmation for specific serotypes is ongoing by public health authorities.
  
  
  CONCLUSIONS
  The underreporting of disease cases in internet-based data streaming makes inadequate any comparison to epidemiological trends illustrated by the more comprehensive ABCs network published by the Centers for Disease Control. However, the expected delays in compiling confirmatory reports by traditional surveillance systems (at the time of writing, ABCs data for 2013 is listed as being provisional) emphasize the helpfulness of real-time internet-based data streaming to quickly fill gaps including the visualization of modes of disease transmission in outbreaks for better resource and action planning. HealthMap can also contribute as an internet-based monitoring system to provide real-time channel for patients to report intervention-related failures.
authors.affiliation: Global Clinical Sciences, Novartis Vaccines Srl, Siena, Italy.
authors.forename: S Sohail
authors.initials: SS
authors.lastname: Ahmed
authors.affiliation: Global Clinical Sciences, Novartis Vaccines Srl, Siena, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Oviedo-Orta
authors.affiliation: Children's Hospital Informatics Program at the Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Computational Epidemiology Group, Boston, Massachusetts, United States of America.
authors.forename: Sumiko R
authors.initials: SR
authors.lastname: Mekaru
authors.affiliation: Children's Hospital Informatics Program at the Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Computational Epidemiology Group, Boston, Massachusetts, United States of America.
authors.forename: Clark C
authors.initials: CC
authors.lastname: Freifeld
authors.affiliation: Drug Safety and Epidemiology, Novartis Pharma AG, Basel, Switzerland.
authors.forename: Gervais
authors.initials: G
authors.lastname: Tougas
authors.affiliation: Children's Hospital Informatics Program at the Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Computational Epidemiology Group, Boston, Massachusetts, United States of America; Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, United States of America.
authors.forename: John S
authors.initials: JS
authors.lastname: Brownstein
mesh_terms: D005843:Geography; D006801:Humans; D008490:Medical Informatics / Q000379:methods*; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000635:transmission*; D022401:Meningococcal Vaccines / Q000276:immunology; D009345:Neisseria meningitidis / Q000502:physiology*; D011159:Population Surveillance; D012703:Serotyping; D014481:United States / Q000453:epidemiology
chemical_list: D022401:Meningococcal Vaccines