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Akron Univ. School of Law

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Friday, May 1, 2009

Early Warning of Flu Missed . . . .

McClatchy News reports that one biosurveillance firm noticed an uptick in respiratory illness in Mexico and tried to alert various health authorities but without results.  Les Blumenthal writes,

A Washington state biosurveillance firm raised the first warning about a possible outbreak of swine flu in Mexico more than two weeks before the World Health Organization offered its initial alert about a public health emergency of international concern.   Both federal and international health officials had access to the warning from Veratect Corp. Later e-mails calling attention to the company's subsequent report that the disease was possibly spreading in Mexico were sent to 10 officials of the Centers for Disease Control and Prevention, said Robert Hart, the company's chief executive.  Hart said he wasn't sure why health officials didn't act sooner.  "They have a lot of other responsibilities," Hart said on Thursday. "But every day makes a difference."

CDC officials in Atlanta said they were aware of Veratect's claims and hadn't been working with the company.  "We have nothing to add about their claims," said CDC spokesman Llelwyn Grant, adding that the CDC and other public health agencies had plans in place to deal with a flu pandemic and responded rapidly once they became aware of the Mexican outbreak.

Veratect, based in Kirkland, Wash., uses a technique known as "data mining" to automatically search tens of thousands of Web sites daily for early signs of looming medical problems or civil unrest anywhere in the world. Anything of interest is turned over to a team of 35 analysts to determine its significance and to post on the company's Web site. The company markets access to its Web site to government agencies, businesses and others and has tried unsuccessfully to sell its service to the CDC, the World Health Organization and the Department of Homeland Security. . . .

On April 6, 18 days before the WHO issued its alert, Veratect reported on its Web site a strange outbreak of respiratory disease in La Gloria, Mexico, noting that local residents thought the outbreak was linked to contamination from pig breeding farms nearby.

Hart said the information was available to the CDC and many state and local health authorities. The company's server showed an epidemiologist at the Pan American Health Organization, which is part of the World Health Organization, looked at the message about the La Gloria outbreak twice, on April 10 and 11, Hart said. . . .

Hart said he wasn't critical of the CDC or other health organizations, adding that what was needed was an effective global health monitoring system that Veratect should be a part of.  "Hindsight is great and it's hard to say whether (the delay) altered anything," he said. "The only way to stop anything like this is to break the cycle."  Others, however, cautioned that the use of data mining to track a possible disease outbreak was untested and said a number of questions about its effectiveness remained unanswered.  "This approach is not yet vetted," said Dr. Marguerite Neill, an infectious disease specialist at Brown University and a spokeswoman for the Infectious Disease Society of America. "It is an interesting idea, but we haven't used it before."

Neill said the problem with using information picked up through data mining was determining whether it was just an indication of a routine disease outbreak or something much more serious.  "It needs to be put in a clinical or epidemiological context," she said. "I'm not sure Veratect can do that."

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