Download Role of Media Scanning and Verification System as a

J. Commun. Dis. 44(1) 2012 : 9-14
Media Scanning and Verification System as a Supplemental
Tool to Disease Outbreak Detection & Reporting at
National Centre for Disease Control, Delhi
Sharma Rajeev*, Karad AB**, Dash B**, Dhariwal AC***,
Chauhan LS****, Lal S*****
(Received for publication January 2012)
Abstract
Media scanning for unusual health events can efficiently supplement
conventional communicable disease surveillance systems for early
detection and response to outbreaks. There is a need to rapidly process
and appropriately disseminate the media reports on unusual health
events for timely action. Hence to address this need in India a Media
Scanning & Verification Cell (MSVC) was established in July 2008 at the
National Centre for Disease Control, Delhi. MSVC is supervised by
Epidemiologists working in Central Surveillance Unit of IDSP. This
unique system monitors Global and National Media sources such as
National and Regional print media, news on internet, news wires and
websites, news channels and news shared by partners like Global Public
Health Intelligence Network (GPHIN), Canada, WHO and other
International and national agencies. The information is shared to the
districts affected and District Surveillance Officer (DSO) and his team is
expected to investigate and revert through the internet about the
correctness and action taken. A mean number of 4 Media Alert reports are
generated each day. A total of 1685 alerts were reported in a period
between July 2008 to December 2011. Of these 1241 (73.7%) were verified
*
Global Disease Detection Centre, INDIA, 22- Shamnath Marg, Delhi-54
**
IDSP, National Centre for Disease Control, 22- Shamnath Marg, Delhi-54
*** National Vector Borne Disease Control Programme, 22-Shamnath Marg, Delhi-110054
**** National Centre for Disease Control, 22- Shamnath Marg, Delhi-54
***** Advisor (PH), Dte. General of Health Services, Min of H&FW, Nirman Bhawan, ND
Correspondence to: Dr Rajeev Sharma, Public Health Specialist, Global Disease Detection Centre INDIA,
22-Shamnath Marg, Delhi-110054, E-mail: [email protected]
Sharma Rajeev et al
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as real events and 183 (10.9%) were considered outbreaks by local health
officials. Most events were captured through internet (57%) followed
by the print media (24%). The most common disease events identified
were food-borne and diarrhea (29.1%), dengue (10.68%), influenza &
respiratory disease (8.1%) and malaria (7.4%). The sensitivity of MSVC
to detect outbreaks was 14.8% with more than half of outbreaks detected
before they were identified by the conventional surveillance system. It
has proven to be a highly effective supplemental tool to official
surveillance system in the detection of early warning signals and hence
timely detection and management of public health threats in India.
Key words: Media Scanning and Verification Cell, Early warning
Signals, IDSP
INTRODUCTION
Integrated Disease Surveillance Project
(IDSP) was, launched in November 2004 by
the Ministry of Health & Family Welfare and
National Centre for Disease Control, Delhi
was identified as implementing agency. Its
main objective is detection of early warning
signals of impending outbreak and help to
initiate an effective response in a timely
manner.
In the age of real-time electronic media
and television, journalists became a vital
source of instant information that public
health authorities could use to detect
outbreaks.1 There is a need to rapidly process
and appropriately disseminate the media
reports on unusual health events for timely
action. To address this need in India a Media
Scanning & Verification Cell (MSVC) was
established on July 2008 under the Integrated
Disease Surveillance Project (IDSP) at the
National Centre for Disease Control (NCDC),
Delhi.
This unique system monitors Global and
National Media sources such as National and
Regional print media, news on internet, news
wires and websites, news channels and news
shared by partners like Global Public Health
Intelligence Network (GPHIN)2, Canada,
WHO and other International and national
agencies. MSVC daily scans 25 national daily,
74 internet news websites, 19 national and
regional news channels. Print, electronic
media and television reports are scanned
manually for unusual health events daily by a
team of assistants. Unusual health events are
analyzed by trained epidemiologists who
generate Media Alerts that are disseminated
electronically to relevant State and District
Health Officers and followed up by phone for
verification. Verified Media Alert reports are
distributed to responsible health authorities
and stakeholders for appropriate public
health action.
RESULTS
On an average 4 media alerts on occurrences
of unusual health events were detected and
verified daily. A total of 1685 alerts were
reported in 42 months (July 2008 to December
2011). Of these 1241 (73.7%) were verified as
real events and 183 (10.9%) were considered
outbreaks by local health officials. Most
events were from internet (57%) or print
media (24%) sources. Unusual health events
Media Scanning and Verification System as a Supplemental tool to Disease........
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Fig. 1 : State wise distribution of media alerts
from July 2008 - December 2011
Fig. 2 : Disease wise distribution of Media alerts from
24 July 2008 till 31 December 2011
were identified from 26 of 28 Indian States
and 3 of 7 Union Territories with majority
reporting from Uttar Pradesh (21.1%), Delhi
(8.6%), Karnataka (6.7%) and Andhra
Pradesh, Gujarat, West Bengal, Rajasthan,
Haryana and Orissa (5-6% each). The most
common disease events identified were foodborne and diarrhea (29.1%), dengue (10.68%),
influenza and respiratory disease (8.1%) and
malaria (7.4%). The sensitivity of MSVC to
detect outbreaks was 14.8% with more than
half of outbreaks detected before they were
identified by the conventional surveillance
system. The sensitivity of MSVC to detect
outbreaks: Number of alerts or rumors
confirmed as outbreak/Total Real Events
×100 = 14.8%.
Total Media
Real
Outbreaks
alerts
events
detected
July 2008-Dec 2011
1685
1241 (73.7%) 183 (10.9%)
Sharma Rajeev et al
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14
3 2
Internet
Print Media
24
57
Word of Mouth
Television
Others
Fig. 3 : Percentage of distribution of health alerts by source of information,
n = 1685 (100%)
DISCUSSION
MSVC has proven to be an effective tool in the
early detection and management of public
health threats. It has political impact to
compel providers of health services to
investigate further the issue.3,4,5 It can assist in
the generation of hypotheses about potential
epidemiological links between cases. It helps
in tracking further spread of disease. During
parliament sessions MSVC has been
extensively used for keeping the lawmakers
abreast with the status on the media reported
disease outbreaks.
Presently the Media Scanning and
Verification Cell is functioning at national
level at National Centre for Disease Control,
Delhi. It is required to make this activity
decentralized and generating ownership in
the States and Districts of India. Establishing
similar models of Media Scanning and
Verification Cell in different states for more
regional coverage and further reducing the
time difference between detection and control
of an outbreak is a challenge.
During early initiation phase the states
having relatively better health systems in
place and better socio-economic status have
reported more outbreaks through IDSP
routine surveillance system while states
where routine outbreak reporting is not that
well established, have reported higher
number of outbreaks through media alerts
(fig. 1). It displays importance of media
surveillance system where the formal
system is not yet strong enough. There is
high political commitment and concern
for outbreaks reported in media, which
sensitizes health authorities for rapid
response for outbreak containment.
The system is very cost effective – the cell
has potential to be replicated to, at all levels of
IDSP with minimum cost involved. Many
Media Scanning and Verification System as a Supplemental tool to Disease........
states like Karnataka have now established
state level media scanning cells which have
further strengthened their surveillance
systems and also increased the regional
coverage. As such the system has proven to
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be highly efficient and effective in timely
detection and management of many public
health threats.
In India, the MSVC serves as a cell
gathering unconfirmed media reports of
Sharma Rajeev et al
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public health significance in real time and
immediately disseminating the information
to the public health community electronically
for verification and action. It often identifies
outbreaks before the conventional reporting
system, helping initiate an earlier response
and containment. It has proven to be a highly
effective supplemental tool in the timely
detection and management of public health
threats in India.
Future directions: The Media Scanning
and Verification Cell is working in the
direction to establish a robust and efficient
National Event Based Surveillance System by
involving community, institutions and other
partners and to help the states in establishing
similar model at state head quarters and
districts and further providing them with
necessary guidelines and training for setting
up and running the cell.
ACKNOWLEDGEMENT
The authors are thankful to Dr. Kenneth
Earhart, Director, CDC India for his
continuous support and technical guidance.
Authors would like to acknowledge hard
work of Mr. Avnish Sharma, Mrs Pooja Arora,
Mr. Om Thakral and Mrs. PL Sethi (Media
Scanning assistants) and Mr Ajay Dogra.
REFERENCES
1.
A Guide to establishing event based surveillance, WHO.
2.
Global Public Health Intelligence Network,
Canada, Abla Mawudeku, Michael Blench.
3.
Surveillance Sans Frontières: Internet-Based
Emerging Infectious Disease Intelligence and
the Health Map Project. John S. Brownstein,
Clark C. Freifeld, Ben Y. Reis, Kenneth D.
Mandl.
4.
Grein TW, Kamara KB, Rodier G, Plant AJ,
Bovier P, et al. (2000) Rumors of disease in the
global village: Outbreak verification. Emerg
Infect Dis 6: 97–102.
5.
M'Ikanatha NM, Rohn DD, Robertson C, Tan
CG, Holmes JH, Kunselman AR. Use of the
Internet to enhance infectious disease
surveillance and outbreak investigation.
Biosecur Bioterror. 2006; 4: 293–300. DOI:
10.1089/bsp.2006.4.293.