Recent hepatitis A outbreaks in Hawaii and Virginia had health officials scrambling to limit their communities' exposure. The food services that introduced the virus into these communities were closed down; yet, two months after the first outbreak, the virus continued to spread.
Certainly, managing a hepatitis A outbreak includes locating its origin and shutting it down, but that doesn't mean the crisis is over. Once hepatitis A is introduced into the community, it continues to spread through human contact. Where will the contagion go? Who is most at risk? Are resources available to handle an epidemic? By making information accessible, understandable and actionable, geographic information system (GIS) technology can unlock the data that holds the answers to these questions.
Time Is of the Essence
When hepatitis breaks out, time is critical for curbing an epidemic. GIS rapidly processes health data information, quantifies it and shows it on a continually updated map. The expediency of the system enables health agencies to readily detect an outbreak, locate the source and immediately begin knocking on doors.
If a hepatitis outbreak becomes an epidemic, community health services need to move into disaster response mode. An online situational awareness map shows where and how fast disease is spreading, while a real-time map shows information as soon as it is reported.
Adding analysts’ predictive models to the situational awareness map shows health providers, hospital administrators and clinic managers the local risk level so that they can pool their resources to inoculate citizens and serve those who are infected. Community members can also open the map and see whether they live in vulnerable areas, locate medical services and get information about steps they need to take for their own safety.
Data Holds Answers
GIS manages and processes data to create maps that are easy to understand. It does much more with data than make dot and aggregate maps of disease outbreaks. GIS makes disease-control strategies more precise. Using a digital basemap as the canvas for adding layers of different types of data, a public health manager can see patterns and relationships that otherwise might not be obvious.
A public health analyst can create complex models that offer greater insight into risk indicators. By comparing case report locations with environmental influencers, detected in water supply samples and sanitation quality data, the analyst deduces cause and effect. By analyzing demographic data — such as age, income and vocation — in a geographic context, the analyst locates vulnerable communities. By correlating outbreak reports, neighborhood income levels, and morbidity and mortality data and putting these onto a map, the analyst can see patterns and relationships within diverse communities to find commonalities. GIS statistical and forecasting models predict disease spread and locate vulnerable entities such as neighborhoods and schools. The outcome helps health services officials target their investigation, vaccination and treatment activities.
By sharing data, maps and intelligence about disease, communities can see what needs to be done, find consensus for a strategic defense, and prioritize their activities and resources in ways that make the greatest impact. Data on an open platform enables the health-care community to share information. An online GIS platform is the infrastructure for the free flow of geographic data among local law enforcement, health agencies and communities. Online geospatial platforms enable stakeholders and partners to collaborate on health initiatives. Web apps make it easy for people to interact with maps and data in useful ways.
Building online GIS Web apps is not hard, and public health agencies can use GIS data to easily design Web apps, author maps and distribute information. For instance, an agency can use a template to design a GIS app for people working in the field. During a neighborhood survey, health personnel use the app on their mobile device to ask residents predefined questions and collect data on an answer form, record audio, take pictures and capture the location. The app streams the data to the GIS platform. The agency uses another template to create a crowdsourcing Web app for citizens to report their own symptoms and GPS coordinates. The user opens the app, answers some questions and clicks send. That information goes into the database as another informational layer for the situational awareness map.
Emerging Web technologies continue to improve health-care systems. Now organizations can map big data collected by agencies around the county, the nation and the world. Staff can also track health events as they unfold in near real time.
A GIS platform provides context needed for solving the world's most critical health problems. Tracking hepatitis occurrences on a global scale requires a smart mapping platform that ingests all types of data to create geography-based disease intelligence.
Este Geraghty is the chief medical officer and health solutions director at Esri.