The future of managing outbreaks using digital technologies
Start your answers with T1, T2, T3, T4 or CT for transcript purposes.
Answer only after the moderator prompts. Questions will be prompted every 10 minutes, but keep answers coming using the relevant T and number. Both panel experts and public attendees are encouraged to participate.
Use the #hcsmSA hashtag in all tweets so you are visible to others in the chat.
T1: Which diseases fall under the outbreak umbrella and how do they spread?
T2: What are the greatest challenges to managing disease outbreaks currently?
T3: How do you think technologies like social media, digital platforms or mobile apps could help to manage outbreaks?
T4: What other issues do you think are important to closing gaps in managing disease outbreaks?
(e.g. digital literacy, access to ICT’s, financial resources, etc.)
T5: Which stakeholders should play a more active role in managing disease outbreaks? How or why?
CT (Closing Thoughts): Is there anything you feel is important to add to this conversation?
Join us for a 60-minute Twitter chat with our panel experts. All stakeholders locally and globally are welcome.
Our public transcript will be recorded by Symplur.
Video Credit: TedX – Bill and Melinda Gates Foundation
For many citizens the word “outbreak” might seem like a distant problem for some other person living in the developing world, but the truth is, no one is exempt. Large outbreaks known as epidemics and pandemics are becoming more frequent and many serious infections have emerged in the past decade than ever before.  Some of these diseases include the Ebola Virus, Lassa Fever, Crimean-Congo Haemorrhagic Fever, Yellow Fever, Zika, Chikungunya, Avian and other zoonotic Influenza, Seasonal Influenza, Pandemic Influenza, Middle-East Respiratory Syndrome (MERS), Cholera, Monkeypox, Plague, Leptospirosis and Meningococcal Meningitis. In fact, even the sometimes fatal but undervalued Measles Virus made a strong re-emergence during 2017 in South Africa which required a massive public vaccination campaign to help health authorities contain it. 
These days with our interconnectedness of travel and trade we can get from the most remote villages anywhere in the world to home within 36 hours. Migrating humans, animals and food can certainly carry microbial “passengers” as they cross our borders. This means increasing globalisation gives infectious diseases a good opportunity to spread fast. However, the impact of globalisation is much more complex than simply travel or trade, a World Health Organisation report nominated several additional factors that can worsen the spread of infectious diseases which include changes to the environment, demography, economy and technology. 
Traditional disease surveillance relies on data obtained from doctors, hospitals or laboratories through formal reporting systems. This yields valid and accurate data about emerging outbreaks and the impact of control strategies such as vaccinations, but it’s often not timely.  Take the 2014 outbreak of Ebola, for example, there was an exponential rise of cases between July and October, with each case resulting in two new cases, or effectively doubling in each generation *(every few days, depending on variations in incubation period) – so 10 cases becomes 20, 20 becomes 40, and so on . Without a rapid response and a robust data surveillance system to track those numbers, disease outbreaks like Ebola could easily spiral out of control. Diagnostics are also crucial to mitigate the effect of disease outbreaks. For instance, in the West Africa Ebola outbreak, diagnostics and diagnostic response were critical factors in the absence of interventions. Earlier diagnosis could have controlled 30-70% of cases. 
The role of big data and disease outbreak surveillance
In the context of a health crisis with a potentially global consequence, the word ‘data’ may not be one of the first to trip off the tongues of many, but the information we collect in an epidemiological study is critical to public health research and evidence-based prevention, treatment, and care. In a disease outbreak, we need to bring speed, accuracy, and an in-depth academic and clinical knowledge base to this process. Focusing on existing digital technologies which are being researched to track disease outbreaks such as social media, one has to question the reliability of data based on various circumstances such as social bots which are used to disseminate mass communication on platforms like Twitter. A second issue to consider is how the standardisation of hashtags could play a role in disease outbreak research, public information dissemination and communication. Hashtags are a kind of metadata marked by the prefix #, sometimes known as a “hash” symbol. This form of tagging is used on microblogging and social networking services such as Twitter, Facebook, Google+, Linkedin and Instagram, but it is also being used on some search engines. 
Hashtag data is also important to monitor during an outbreak which is demonstrated in the image below that shows the public conversations on Twitter using the #Listeriosis hashtag. One particular spike recorded on the Symplur Signals hcsm analytics platform showed 89 900 tweets between 03 March 2018 – 08 March 2018, which was the period when the South African National Department of Health announced the source of the biggest Listeriosis outbreak globally which they suspected was a locally-produced meat product called polony.  But, digital technologies don’t stop at the web and social media, full digitisation of health will include mobile apps, wearables, digital platforms and Electronic Health Records (EHR) all working harmoniously to generate data if the promise of Artificial Intelligence (AI) for outbreaks  can ever come to fruition. In addition to that, digital devices and robots can’t generate data without quality human input. In a perfect digital health world that should mean all stakeholders including healthcare providers and workers, e-patients, civil society and when it comes to infectious disease outbreaks, a much broader mix of economic stakeholders that shouldn’t be ignored so that system remains sustainable.
The chat session is open to everyone to participate, however, our panel experts bring a unique set of perspectives relating to the topic.
Dr Niniola Soleye – @drasatrust
Niniola is the Managing Director of the Dr Ameyo Stella Adadevoh (DRASA) Health Trust, an NGO in Nigeria focused on outbreak preparedness and health system strengthening. DRASA was founded in memory of the late Dr Adadevoh who correctly identified and contained Nigeria’s first Ebola patient, helping prevent a massive outbreak in Africa’s most populous country. DRASA’s work involves education and training, resource development, and advocacy and policy across the community, health facility, and state/national levels.
Niniola previously worked at Management Sciences for Health (MSH), a global health organization operating in more than 50 countries with a focus on priority health issues such as HIV & AIDS, tuberculosis, malaria, maternal and child health, family planning and reproductive health, and chronic non-communicable diseases. Prior to joining MSH, Niniola worked at a brand agency Paragraph for three years while also serving on the core team of Keiyo Soy, a Kenyan NGO focused on water, sanitation, and hygiene (WASH) projects as well as medical outreach programs. She holds a BA in cognitive science/neuroscience from the University of Pennsylvania.
Heidi Albert – FindDX – @FINDdx
Foundation for Innovative New Diagnostics | FIND · South Africa
FIND South Africa is an international nonprofit organisation that enables the development and delivery of diagnostic tests for diseases of poverty. Diagnosis is the first step on the path to treatment and the foundation of disease control and prevention. As William Osler, sometimes described as the father of modern medicine, said in 1892: “There are three phases to treatment: diagnosis, diagnosis and diagnosis.” Diagnostic tests guide clinical decision-making. By helping to ensure the use of appropriate treatments, diagnostics improve the efficiency of health care spending and help us to fight antimicrobial resistance by guiding the appropriate use of antibiotics. Diagnostic tests are also the foundation of disease surveillance and elimination.
Dr Rodney Rohde – @RodneyRohde
Dr Rodney E. Rohde is an Advisory Board member of InfectionControl.tips and Professor, Research Dean and Chair of the Clinical Laboratory Science Program (CLS) in the College of Health Professions of Texas State University, where he spends a great deal of time mentoring and coaching students in this sometimes mysterious and vague path. He has been recognized with teaching excellence at both Texas State and Austin Community College. Dr Rohde’s background is in public health and clinical microbiology, and his PhD dissertation at Texas State was aligned with his clinical background: MRSA knowledge, learning and adaptation. His research focuses on adult education and public health microbiology with respect to rabies virology, oral rabies wildlife vaccination, antibiotic-resistant bacteria, and molecular diagnostics/biotechnology. He has published a book on MRSA stories, over 50 research articles, book chapters and abstracts and presented at more than 100 international, national and state conferences. In 2015, Dr Rohde received the Cardinal Health #urEssential Award as Champion of the CLS Profession, named a Top 20 Professor of CLS and received the Texas State Mariel M. Muir Mentoring Award. Likewise, he was awarded the 2015 and the 2012 Distinguished Author Award and the 2014 and 2007 ASCLS Scientific Research Award for his work with rabies and MRSA, respectively. Learn more about his work here. Dr Rohde is the past President of the Texas Association for Clinical Laboratory Science (TACLS) and has been involved in licensure efforts in Texas since 2007. In 2017, Dr Rohde became a Fellow of the Association of Clinical Scientists and was honoured as a TEDx Speaker and Global Fellow of the Global Citizenship Alliance.
Kerrigan McCarthy – @Kerrigan_NICD
Kerrigan McCarthy is the Head of the Outbreak Response Unit and the Acting Head of the Division of Public Health, Surveillance and Response, of the National Institute for Communicable Diseases. She has a unique combination of public health, laboratory specialist, social science and clinical infectious diseases work experience within the South African public and NGO sectors. After graduating from the University of the Witwatersrand with MBBCh (1995), and obtaining a specialist qualification in Microbiology (FCPath (Micro) in 2002, she served as Head of the Mycology Unit at the National Institute of Communicable Diseases (NICD) 2002-7, where with the GERMS-SA surveillance network, she established national surveillance for cryptococcal disease, fungal susceptibility testing, and fungal molecular epidemiology. In 2007 she moved into the NGO sector to assume responsibility for TB/HIV integration in PEPFAR funded projects in the City of Johannesburg and facilitate investigator-led implementation science research agenda related to TB diagnostics, TB case-finding and INH prophylaxis. In 2011, Kerrigan moved to the Aurum Institute, as Scientist and Co-ordinator of the XTEND study – a pragmatic randomised controlled trial of Xpert vs smear for TB diagnosis in 40 clinics across 4 SA provinces.
From 2005-2015, Kerrigan provided clinical service at Nazareth House, Johannesburg for persons living with HIV, including ART initiation and management of a 22-bed in-patient hospice. Kerrigan graduated with an MPhil (theology) in 2012 with a dissertation entitled ‘A theology of healing for contemporary South Africa -a phenomenological and multidisciplinary approach from the perspectives of Western medicine, African Traditional Religion and Christian theology.” Currently, as Head of the Outbreak Response Unit at the NICD, Kerrigan manages a team of persons who support national, provincial and district government with regard to outbreak investigation. She has overall responsibility for the NICD Public Health Emergency Operations Centre in accordance with the International Health Regulations.
Iyobosa Victor Omoregbee – @iyobosa
Iyobosa Victor Omoregbee majored in Biochemistry from the College of Medicine, the University of Ibadan, Nigeria graduating in 2003. He worked with a couple of marketing firms including EXP Momentum, a South-African agency in Nigeria. In 2010, he started on his own as an independent consultant with the name IVO Consulting. His niche includes social innovation to promote healthpreneurship, and his clients include startups and existing businesses that are seeking value-add. Iyobosa has also served as a local coordinator of HealthCamp Nigeria – a user-organized “un-conference” that brings consumers, health providers, industry experts and ICT professionals together for a one-day event to exchange ideas. Iyobosa is a firm supporter of the participatory medicine model as well as patient empowerment which he promotes in Nigeria. He is the founder of the healthcare social media Nigeria (#hcsmNG) community which he has presented about at events like SMWLagos (Social Media Lagos) and is also co-founder of the African community (#hcsmAFRICA).
Dr Claudia Pagliari – @EeHRN
Dr Pagliari is a senior lecturer and researcher within the Usher Institute, where she leads a research programme on eHealth and directs the MSc in Global eHealth at the Edinburgh University. With a background in social science and health technology assessment, her research is highly interdisciplinary and covers many areas of eHealth and the digital society. This includes the study and evaluation of emerging innovations (for example: direct-to-consumer genetic testing, therapeutic robots, apps), large-scale health IT programmes (for example: human resource information management systems, administrative data research, e-Government), new forms of data for science (for example: social media and crowdsourcing), technologies for global health system strengthening and ethical and responsible research and innovation.
She collaborates with colleagues from across the university, including the Edinburgh Medical School, the Business School and the Schools of Informatics and Health in Social Sciences, as well as a network of international researchers, NGO’s and others. She is a member of the Global Health Academy, the Institute for Science, Technology and Innovation, the Social Informatics Cluster, and the Edinburgh Crowdsourcing and Citizen Science Group and convenes the interdisciplinary research groups in eHealth and digital disease surveillance.
Claudia holds a first class degree in Psychology from the University of Ulster and a PhD in Psychology from the University of Edinburgh. She was elected Fellow of the Royal College of Physicians of Edinburgh in 2010. She is a member of the UK College of Experts in Health Informatics, the British Computer Society, the UK Council for Health Informatics Professionals (level 3), and has held advisory roles with the American Health Information Management Association, the European Commission (scientific expert) and other agencies and is regularly invited as a conference keynote speaker.
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