January 31, 2012 11:52 am
Updated: March 24, 2013 7:22 pm

Canadian researchers develop disease outbreak surveillance

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TORONTO – In the summer of 2003, Dr. Kamran Khan moved to Toronto just as the city was hit with a burgeoning pandemic of Severe Acute Respiratory Syndrome (SARS).

Khan, now an infectious disease physician and scientist at St. Michael’s Hospital in Toronto, had just completed his studies at Cornell, Columbia and Harvard universities when cases of SARS migrated from Guangdong province in China to Ontario.

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“I saw how this tiny little virus brought this city to its knees, killing 44 people and leaving Toronto with $2 billion in bills,” Khan told Global News.

But amid the medical community’s reaction to the growing epidemic, Khan was inspired, taking note of how quickly the virus travelled the globe.

“I realized the reality of our world today, and the reality of it in the future is different from what I had seen up until that point in time.”

Disease outbreaks, such as SARS, can easily spread from one person to another, especially in mass gatherings, Khan said, pointing to the 2012 London Olympics as a key example.

That’s why British authorities are working with Khan and colleagues at Harvard University, who are combining their technologies in global disease surveillance.

In the months leading up to the summer Olympics, officials will monitor potential outbreaks using Bio.Diaspora, a system developed by Khan, along with HealthMap.org, another internet-based intelligence system pioneered by Montreal-native John Brownstein of Harvard University.

The details from the international team’s global outbreak tracking system were published this month in the scientific journal The Lancet Infectious Diseases. It’s the first to anticipate an outbreak in real time instead of reacting to potential outbreaks.

“We didn’t anticipate SARS and we saw how that unfolded but if we can anticipate an outbreak, we have a much better chance of controlling it before it gets out of hand,” Khan said.

Khan said that so far, there are two methods for tracking outbreaks – through traditional and digital surveillance.

Through traditional surveillance, a physician might note symptoms of a disease that must be reported to public health officials. The method is accurate but the process is lengthy.

“You run tests, wait for results to come back, send it to the health department and they might start taking time before they take note of a pattern going on,” Khan said.

“By that time, you may be well into a course of an outbreak before you even realize something is happening. We saw that a bit with SARS – there was a movement underway before we even knew what hit us,” he said.

Through digital surveillance, academics set up programs that are constantly scanning the Internet, searching for sets of keywords that could point to potential outbreaks.

While the technology was in its early stages during SARS, researchers recorded an increase in respiratory infections in the lead up the pandemic.

During H1N1, which swept the nation in 2009, systems detected an “unusually long flu season” in Mexico about three weeks before the pandemic spread.

“The challenge with theses systems is they’re timely and they’re rapid. There are crawlers looking through the web, but there is a lot of noise. How do you know what chatter is an early warning that maybe there’s an outbreak underway?”

While Harvard’s HealthMap.org trawls the web, Khan’s Bio.Diaspora technology helps to predict the spread of an outbreak.

Khan’s efforts have been dedicated to understanding how billions of people move worldwide. So far, he’s studied thousands of airports, hundreds of airlines and the movements of about two billion passengers each year.

“The rules that govern how infectious diseases spread are largely the same rules that govern how people like you and I travel around the world because we’re the ones who are actually the carriers,” he explained.

The Hajj pilgrimage to Mecca in Saudi Arabia in 2001 resulted in 10 deaths linked to a meningitis outbreak. There was an influenza outbreak during World Youth Day in Australia in 2008.

Khan and his colleagues hope their surveillance in the months leading up to the Olympics will help British officials prepare in case an outbreak reaches London’s crowds and makes its way around the world.

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