Free or low-cost sources of unstructured information, such as Internet news and online discussion sites, provide detailed local and near real-time data on disease outbreaks, even in countries that lack traditional public health surveillance. To improve public health surveillance and, ultimately, interventions, we examined 3 primary systems that process event-based outbreak information: Global Public Health Intelligence Network, HealthMap, and EpiSPIDER. Despite similarities among them, these systems are highly complementary because they monitor different data types, rely on varying levels of automation and human analysis, and distribute distinct information. Future development should focus on linking these systems more closely to public health practitioners in the field and establishing collaborative networks for alert verification and dissemination. Such development would further establish event-based monitoring as an invaluable public health resource that provides critical context and an alternative to traditional indicator-based outbreak reporting.
India, Bangladesh, Vietnam and mainland China also experienced new outbreaks of H5 N1 influenza in December. During the same period, four new human cases - in Egypt, Cambodia and Indonesia - were reported to the World Health Organization. A 16-year-old girl in Egypt and a 2-year-old girl in Indonesia have died.
HMPV infection incidence ranged from 2.2% to 10.5% in outpatient cohorts. Infections were asymptomatic in at least 38.8% of each of these cases. Symptoms when apparent were typical of upper respiratory tract infection.
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