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EPIDEMICS
WHO pandemic probe focuses on media, Internet role

Twitter could act as early warning system for epidemics: experts
Vienna (AFP) April 13, 2010 - The micro-blogging site Twitter could act as an early warning system for epidemics, a team of experts at London's City University found in a new study published on Tuesday. According to a team of interdisciplinary experts, around three million messages -- or so-called "tweets" -- posted in English on Twitter between May and December 2009 contained the word "flu". Their study was presented to the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) being held in Vienna this week. "The numbers of tweets we collected by searching by keywords such as 'flu' or 'influenza' has been astronomical," one of the study's co-authors, Patty Kostkova, told AFP. "What we're looking at now is, what is the potential of this enormous data set for early warning systems. Because it's a real time media, it can call for an immediate response if required." Among the so-called "tweets", the experts counted 12,954 messages containing the phrase "I have swine flu" and 12,651 saying "I've got flu". They also counted the frequency of other terms, such as "H1N1" and "vaccine".

Kostkova's team is working together with the European Centre for Disease Prevention and Control (ECDC) and Britain's National Health Service in the run-up to the 2012 Olympic Games in London. Twitter would enable the NHS, for example, to better assess resources and provide visitors with information such as the nearest doctor, dentist or emergency services. In Geneva on Tuesday, the World Health Organisation found that the Internet had a disruptive impact on the handling of the flu pandemic by fanning speculation and rumour. WHO influenza chief Keiji Fukuda told 29 health experts reviewing the international response to the pandemic that the Internet had added a new dimension to flu alerts over the past year. While it meant information about swine flu became more widely available, it also produced "news, rumours, a great deal of speculation and criticism in multiple outlets," including blogs, social networking and websites, he said. "Anti-vaccine messaging was very active, made it very difficult for public health services in many countries," Fukuda said as a nine-month review of the A(H1N1) flu pandemic got under way. Kostkova countered that monitoring Twitter messages would help recognise the population's worries and could be useful in detecting the start of an epidemic. But she insisted that existing disease surveillance systems were still better for monitoring the subsequent spread of an epidemic.
by Staff Writers
Geneva (AFP) April 13, 2010
The Internet had a disruptive impact on the handling of the flu pandemic by fanning speculation and rumours, officials said as a world health probe on Tuesday examined communications on swine flu.

World Health Organisation influenza chief Keiji Fukuda told 29 health experts reviewing the international response to the pandemic that the Internet had added a new dimension to flu alerts over the past year.

While it meant information about swine flu became more widely available, it also produced "news, rumours, a great deal of speculation and criticism in multiple outlets," including blogs, social networking and websites, he said.

"Anti-vaccine messaging was very active, made it very difficult for public health services in many countries," Fukuda said as a nine-month review of the A(H1N1) flu pandemic got under way.

Several governments have been trying to cancel orders for hundreds of millions of dollars' worth of special swine flu vaccines.

Mass vaccination campaigns in Europe last year fell flat amid public doubts about the value of immunisation because of milder than expected swine flu symptoms, speculation about the safety of the vaccine and concern about the influence of the pharmaceutical industry.

Fukuda also pinpointed the speed with which information spread and its influence on "volatile" public opinion, admitting that the WHO had struggled to find the "right tempo" for communications.

"We saw confusion over many of the words and phrases used in the pandemic," he added.

While the Internet is regarded as an essential conduit for information, many members of the health community believe it has also amplified the impact of sensationalist claims or blogging by self-styled experts, with little in the way of checks or balances.

Examples cited included a six-part video by a Spanish nun debunking the threat of A(H1N1) flu posted online, websites dedicated to "fake pandemic" claims, or the global reach of rumours exchanged by e-mail or social networking chatter.

Former WHO infectious diseases chief David Heymann told AFP that public health community had to take into account a "new factor" with the Internet and social networking.

"It's very difficult to correct any misperception," said Heymann, now chairman of the Health Protection Agency in Britain and a researcher on global health strategy.

Several governments on Monday urged the review to look at the broad issue of communications in the pandemic.

France indicated that authorities had struggled with the speed with which information got around, and suggested that some WHO recommendations had come too late.

"It emerged that the media timescale was far shorter than the political and administrative timescale, which may have complicated national decision making," a French delegate told the panel.

The WHO's International Health Regulations Review Committee Tuesday set communications as one of its five core subjects, with a first examination later in the day.

"Media should be one part of the communications strategy" review, panel member Tjandra Aditama, of Indonesia's health ministry, said earlier.

The review panel's final overall report on the handling of the pandemic is due by January 2011, a WHO spokesman said.

earlier related report
Severity doubts and fear hit pandemic response: WHO panel
Geneva (AFP) April 12, 2010 - Experts carrying out a world health probe said Monday fear and the lack of a clear severity assessment had hampered the response to the swine flu pandemic over the past year.

The issues were raised by several of the 29 experts in their inaugural meeting to examine the controversial response to the first flu pandemic of the 21st century.

"We want to know what worked well. We want to know what went wrong and ideally why," World Health Organisation Director-General Margaret Chan told the panel of external specialists meeting in Geneva.

"We want to know what can be done better and ideally how," she added, nearly a year after a global alarm was raised over the new swine flu strain uncovered in the Mexico and the United States.

Swine flu has affected 213 countries or territories since April 2009, leaving 17,700 people dead, WHO data showed.

The WHO probe was set up following accusations that the agency-led international reaction to A(H1N1) influenza, including a pandemic declaration last June, was overblown and may have been tainted by commercial interests.

Panel members and officials said that sporadic outbreaks of more lethal bird flu had boosted pandemic preparations, including stronger International Health Regulations enforced in 2007 and the stockpiling of anti-viral drugs before swine flu appeared.

Nonetheless, the 60 percent death rate for H5N1 bird flu had also raised expectations about the severity of a new pandemic virus.

Australian infectious diseases specialist John Mackenzie said that public reaction became guarded when the new A(H1N1) swine flu virus turned out to be far less lethal even though the WHO had declared a pandemic.

"It was to our disbenefit in a sense," he told his colleagues.

"It wasn't that mild when you see the number of deaths in the young, but the customer expected it to be much more severe," said Mackenzie, who has been closely involved in determining the response to the swine flu pandemic.

Professor Harvey Fineberg of Washington's Institute of Medicine, who was appointed chairman of the WHO panel, said it was "a very central problem."

Several of the health specialists, who are mainly attached to public authorities, also raised the need for an additional severity assessment in the flu alert rulebook approved by the 193 WHO member states.

The six phase international alert system culminates with a pandemic, which primarily denotes global geographic spread, an issue that led to "confusion" or "irritation", the panel heard.

Kuku Voyi, a public health professor at South Africa's University of Pretoria, suggested a "bandwidth" of severity could allow a better response.

But there were warnings that the impact of swine flu varied in different settings, with a greater threat to impoverished countries or among groups such as pregnant women or the young.

Many Western countries welcomed the WHO's swift leadership but called for a reassessment of the flu alert phases and severity criteria, and the need for consistent and clear communications.

Kenya and India urged the panel to consider obstacles for poor countries' access to medicines and vaccines, noting that rich countries had priority on pandemic orders because of their wealth.

"That is not a situation that should be tolerable at all, especially with a global problem," Kenya's delegate said.

Chan promised an "independent, credible and transparent" examination by the International Health Regulations Review Committee over the next nine months, "without a straitjacket".

Parliamentarians conducting a Council of Europe probe have criticised the transparency of decision-making and especially the potential weight of the pharmaceutical industry in a decision on vaccination.

Several governments sought to cancel mass orders of hundreds of millions of dollars worth of swiftly developed special pandemic vaccines after fears about the severity of swine flu waned.



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