In recent years social and news media have increasingly been used to explain patterns in disease activity and progression. Social media data, principally from the Twitter network, has been shown to correlate well with official disease case counts. This fact has been exploited to provide advance warning of outbreak detection, tracking of disease levels and the ability to predict the likelihood of individuals developing symptoms. In this paper we introduce DEFENDER, a software system that integrates data from social and news media and incorporates algorithms for outbreak detection, situational awareness, syndromic case tracking and forecasting. As part of this system we have developed a technique for creating a location network for any country or region based purely on Twitter data. We also present a disease count tracking approach which leverages counts from multiple symptoms, which was found to improve the tracking of diseases by 37 percent over a model that used only previous case data. Finally we attempt to forecast future levels of symptom activity based on observed user movement on Twitter, finding a moderate gain of 5 percent over a time series forecasting model.
One of the most interesting recent studies in this area was carried out by Li & Cardie @cite_23 . Using Twitter data they built a Markov Network able to determine when the flu levels in a US state had reached a breakout'' stage when an epidemic was imminent. Their system takes into account spatial information by building a simplified network map of the US, where each state is a node connected to its neighbouring states. It also takes into account Twitter's daily effect - the fluctuation in the number of tweets posted based on the day of the week.
@cite_23
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Background Surveys are popular methods to measure public perceptions in emergencies but can be costly and time consuming. We suggest and evaluate a complementary “infoveillance” approach using Twitter during the 2009 H1N1 pandemic. Our study aimed to: 1) monitor the use of the terms “H1N1” versus “swine flu” over time; 2) conduct a content analysis of “tweets”; and 3) validate Twitter as a real-time content, sentiment, and public attention trend-tracking tool. Methodology Principal Findings Between May 1 and December 31, 2009, we archived over 2 million Twitter posts containing keywords “swine flu,” “swineflu,” and or “H1N1.” using Infovigil, an infoveillance system. Tweets using “H1N1” increased from 8.8 to 40.5 (R2 = .788; p<.001), indicating a gradual adoption of World Health Organization-recommended terminology. 5,395 tweets were randomly selected from 9 days, 4 weeks apart and coded using a tri-axial coding scheme. To track tweet content and to test the feasibility of automated coding, we created database queries for keywords and correlated these results with manual coding. Content analysis indicated resource-related posts were most commonly shared (52.6 ). 4.5 of cases were identified as misinformation. News websites were the most popular sources (23.2 ), while government and health agencies were linked only 1.5 of the time. 7 10 automated queries correlated with manual coding. Several Twitter activity peaks coincided with major news stories. Our results correlated well with H1N1 incidence data. Conclusions This study illustrates the potential of using social media to conduct “infodemiology” studies for public health. 2009 H1N1-related tweets were primarily used to disseminate information from credible sources, but were also a source of opinions and experiences. Tweets can be used for real-time content analysis and knowledge translation research, allowing health authorities to respond to public concerns. With the proliferation of social networks and blogs, the Internet is increasingly being used to disseminate personal health information rather than just as a source of information. In this paper we exploit the wealth of user-generated data, available through the micro-blogging service Twitter, to estimate and track the incidence of health conditions in society. The method is based on two stages: we start by extracting possibly relevant tweets using a set of specially crafted regular expressions, and then classify these initial messages using machine learning methods. Furthermore, we selected relevant features to improve the results and the execution times. To test the method, we considered four health states or conditions, namely flu, depression, pregnancy and eating disorders, and two locations, Portugal and Spain. We present the results obtained and demonstrate that the detection results and the performance of the method are improved after feature selection. The results are promising, with areas under the receiver operating characteristic curve between 0.7 and 0.9, and f-measure values around 0.8 and 0.9. This fact indicates that such approach provides a feasible solution for measuring and tracking the evolution of health states within the society. A microblogging service like Twitter continues to surge in importance as a means of sharing information in social networks. In the medical domain, several works have shown the potential of detecting public health events (i.e., infectious disease outbreaks) using Twitter messages or tweets. Given its real-time nature, Twitter can enhance early outbreak warning for public health authorities in order that a rapid response can take place. Most of previous works on detecting outbreaks in Twitter simply analyze tweets matched disease names and or locations of interests. However, the effectiveness of such method is limited for two main reasons. First, disease names are highly ambiguous, i.e., referring slangs or non health-related contexts. Second, the characteristics of infectious diseases are highly dynamic in time and place, namely, strongly time-dependent and vary greatly among different regions. In this paper, we propose to analyze the temporal diversity of tweets during the known periods of real-world outbreaks in order to gain insight into a temporary focus on specific events. More precisely, our objective is to understand whether the temporal diversity of tweets can be used as indicators of outbreak events, and to which extent. We employ an efficient algorithm based on sampling to compute the diversity statistics of tweets at particular time. To this end, we conduct experiments by correlating temporal diversity with the estimated event magnitude of 14 real-world outbreak events manually created as ground truth. Our analysis shows that correlation results are diverse among different outbreaks, which can reflect the characteristics (severity and duration) of outbreaks. Social media have been proposed as a data source for influenza surveillance because they have the potential to offer real-time access to millions of short, geographically localized messages containing information regarding personal well-being. However, accuracy of social media surveillance systems declines with media attention because media attention increases “chatter” – messages that are about influenza but that do not pertain to an actual infection – masking signs of true influenza prevalence. This paper summarizes our recently developed influenza infection detection algorithm that automatically distinguishes relevant tweets from other chatter, and we describe our current influenza surveillance system which was actively deployed during the full 2012-2013 influenza season. Our objective was to analyze the performance of this system during the most recent 2012–2013 influenza season and to analyze the performance at multiple levels of geographic granularity, unlike past studies that focused on national or regional surveillance. Our system’s influenza prevalence estimates were strongly correlated with surveillance data from the Centers for Disease Control and Prevention for the United States (r = 0.93, p < 0.001) as well as surveillance data from the Department of Health and Mental Hygiene of New York City (r = 0.88, p < 0.001). Our system detected the weekly change in direction (increasing or decreasing) of influenza prevalence with 85 accuracy, a nearly twofold increase over a simpler model, demonstrating the utility of explicitly distinguishing infection tweets from other chatter.