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The First Disease Forecasting Center in the World... For Haiti

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On January 12, 2010 at 4:53 pm, a 7.0 magnitude earthquake struck Haiti, destroying most of the infrastructure of Port-au-Prince, including many government buildings. An estimated three million people were affected by the quake and over one million are homeless. Approximately 26 minutes after the event, the Praecipio International Intercept Team received a Red Alert from the Global Disaster Alert and Coordination System (GDACS) regarding the event in Haiti. We immediately activated operational biosurveillance support activities and stood the watch as volunteers.

We are practitioners of a new professional discipline called operational biosurveillance. More akin to disaster sociology than public health, we monitor social indicators of infectious disease crises and disasters. After 12 years, nearly a quarter million events, more than 250 pathogens, and nearly every country on earth including Antarctica, we have become tuned to the pulse of the planet. We are the same team that provided warning of the 2009 H1N1 pandemic.

Praecipio was able to rapidly conduct a "radar sweep" using the Internet and by monitoring Twitter feeds across 6 languages for the island of Hispaniola, which includes the countries of Haiti and Dominican Republic. We knew instantly from media, blogs, and SMS traffic what was being documented in terms of infectious disease. Consultation with peer-reviewed academic literature enabled us to construct a baseline for several diseases of concern and issue the first infectious disease forecast report in the world, for Haiti, on January 17, 2010.

It has always been our dream to model our discipline after weather forecasters. On January 17th, we achieved this dream, and since then have produced multiple forecasts designed to flag potential infectious disease crises that could inundate and collapse the very fragile medical infrastructure in Haiti's quake-affected areas.

After the January 17th report, we planned a ground deployment to Port-au-Prince. From a cold start at the airport on Day 1, we made contact with every major NGO and relevant Haitian Ministry within 10 days. We were able to develop a complete ground verification assessment within a week spanning all major infectious diseases for humans and animals. One week after returning, we had signed up over 160 individuals, including Haitian medical providers, into a Google group that became the hub for community-based reporting of disease events as well as training we provide to them in our discipline. Courtesy of the Google-funded InSTEDD, we also created a Geochat SMS group to support emergency communications.

In two weeks, Haiti became the first country in the world with a National Weather Service-like infectious disease-forecasting center, the Haiti Epidemic Advisory System (HEAS):

The HEAS has analyzed over 90,000 SMS text messages, thousands of media articles and blog entries, and processed dozens of direct observation ground reports from HEAS reporters in Port-au-Prince. Events such as suspect outbreaks of meningitis, measles, malaria, and diarrhea have been reported. Perhaps the greatest achievement of the HEAS was to see the major NGOs forward-position medical countermeasures based on HEAS advisories stating we are at a maximum level of risk now for a pediatric diarrheal disease crisis. A couple of days ago we posted an advisory for malaria because of one the partners reported a substantial increase in malaria prevalence since the quake. This is the first time in history, as far as we know, where a National Weather Service-like disease forecasting system drove activation of preparedness measures to save lives.

Presently, we are at a state of maximum alert. But the HEAS is without funding. This situation represents an emergency, and funding is needed to:

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" Continue stockpiling medical countermeasures in preparation for potential crisis conditions;

" Expand and maintain the informal contact network to support tactical early warning and situational awareness;

" Deploy Intercept Teams to provide rapid response support, rapidly evaluate events of interest, and forward information back to the Haitian Ministry of Health; and

" Teach a new cadre of Haitian operational biosurveillance analysts for sustainability in Haiti.

The future is promising for Haiti if we aggressively seize the opportunity to teach Haitians a new discipline that is rooted in rumor surveillance behavior as old as humanity. Haiti can be the first country in the world to anticipate and proactively intervene outbreaks and epidemics and serve as a model for the rest of the world. But now there is an imminent crisis on our hands, where large numbers of children may die from infectious disease.

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Now we have an opportunity to act decisively for the love of Haiti.

James M. Wilson V, M.D.

Executive Director, Praecipio International

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James M. Wilson V, MD received a Bachelor of Science in Applied Biology at the Georgia Institute of Technology, his medical doctorate from the University of Cincinnati College of Medicine, and trained as a pediatrician at Georgetown University (more...)
 

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