HSOC 591

Surveillance

Rachel and Gianella

Agenda
1. Understand how the transmission of disease has changed with improvements to
transportation and the growth of spatial mobility
i.
Video: https://vimeo.com/32996870 (2:00)
ii.
Cliff, A., & Haggett, P. (2004). Time, travel and infection. British Medical
Bulletin, 69(1), 8799. (8:00) - Brief overview of paper
Total time: 10:00
2. Understand how disease is transmitted and how social networks offer a way of
detecting outbreaks sooner
i.
Activity (see appendix A) (5:00)
ii.
Christakis, N. A., & Fowler, J. H. (2010). Social Network Sensors for Early
Detection of Contagious Outbreaks. PLoS ONE, 5(9), e12948. Discuss what
we learned from the activity and relating it to ideas put forth by Christakis &
Fowler, 2010 (10:00)
Total time: 15:00
3. Understand the challenges associated with verbal autopsy tools and potential ways
of overcoming these challenges
i.
Small group discussion (4 groups of 4) (8:00)
Questions:
a. What are the strengths and weaknesses or verbal autopsy tools?
Soleman, N., Chandramohan, D., & Shibuya, K. (2006).
Verbal autopsy: current practices and challenges. Bulletin of
the World Health Organization, 84(3), 239245.

ii.

b. Can you think of alternatives to verbal autopsy tools that could be used
in resource poor settings?
c. Can you think of potential stakeholders that would be beneficial to the
creation and dissemination of a standardized surveillance tool?
Discussion of groups findings (7:00)

Total time: 15:00

4. To explore surveillance networks and digital disease detection systems that are
improving how we identify and respond to disease outbreaks
i.
My wish: Help me stop pandemics (Larry Brilliant) (TED video) http://www.ted.com/talks/larry_brilliant_wants_to_stop_pandemics (10:00)
ii.
Discussion of INDEPTH, CORDS and HealthMAP (with simulation http://www.healthmap.org/ebola/#timeline) (5:00)
iii.
Aha moments (5:00)
Total time: 20:00
Additional scholarly sources consulted:

HSOC 591

Surveillance

Rachel and Gianella

Freifeld, C. C., Mandl, K. D., Reis, B. Y., & Brownstein, J. S. (2008). HealthMap: Global
Infectious Disease Monitoring through Automated Classification and
Visualization of
Internet Media Reports. Journal of the American Medical Informatics
Association: JAMIA, 15(2), 150157.
Gresham, L. S., Smolinski, M. S., Suphanchaimat, R., Kimball, A. M., &
Wibulpolprasert, S. (2013). Creating a Global Dialogue on Infectious Disease
Surveillance: Connecting Organizations for Regional Disease Surveillance
(CORDS). Emerging Health Threats Journal, 6.

Appendix A
The Infection Game: The Shape of Change
By: Rob Quaden and Alan Ticotsky with Debra Lyneis (Published by the Creative Learning
Exchange)
How It Works
In this game the interaction that drives the spread of an epidemic is represented by the
multiplication of numbers. One student will be assigned the number zero, while the rest
will be assigned the number one. As they multiply their numbers together in pairs, the
repeated multiplication process will cause more and more products to result in zero. In
other words, the number zero simulates the infective agent spreading through the
population.
Infection Game Rules
1. You will each receive a sheet to track the results of the game.
2. You will each be given a secret number which will be already filled in on your record sheet.
3. Secrecy is very important to this game.
4. You will play the game for several rounds. In the first round, find any other student, and quietly
tell each other your numbers. Then, on your own, secretly multiply your two numbers together
and record the product on the next line of your sheet. This will be your new number for the next
round.
5. Example: If you have a 2 and the other student has a 3, you will both get 2 X 3 = 6 for your
new number on the next line.
6. Second round: Find any other student, exchange numbers, secretly multiply them together, and
record the new product for the next round.
7. Continue to do this until we end the game.
Gather data for debriefing:
Ask students who had their FIRST entry of zero in the beginning to raise their hands. (This
should be only one student.) Record this information on the first column of the Teachers
Class Record Sheet
Ask for hands to count how many students had their FIRST entry of zero in the second round.
Repeat this for all subsequent rounds and record the information until there are no new
infections with zero. Do not discuss or reveal the results to students yet.
It is essential to record only the number of new students infected each round in the first
column.
You will also need the total number of infected students as the game progressed.

HSOC 591

Surveillance

Rachel and Gianella

Record this in the second column of the Teachers Class Record Sheet, by keeping a running
tally and adding the number of new students each round, as below.

A behavior over time graph is a line graph sketch showing how the number of infections changed
over time during the game. The general pattern is an S-shaped growth

Initially, very few people had the infection, so it spread very slowly. As more and more people
were infected and they interacted with others, the disease spread at an increasing rate. When most
people already had the illness, there were fewer healthy people to infect, so the disease spread
more slowly.
The game is a simplified version of reality. This simulation shows a disease from which there is
no recovery. The simulation also implies that contact with a carrier will always result in getting
the disease.
It is also interesting to explore the rate of the spread of the infection. This pattern is called a
bell-shaped curve.

Initially, the infection started off slowly, but then grew at an increasing rate as more and more
people transmitted the infection. When fewer contacts resulted in new infections, the number of
new infections slowed down until it reached a peak. The total number of infections continues to
increase after the peak, just at a slower rate until everyone got infected.