Abstract
Background: Hand foot Mouth Disease (HFMD) is a worldwide Enteroviral infection; severe outbreaks have occurred recently in the US and Asia. Google technology has been shown to predict influenza epidemics and is a potential resource to track epidemics in developed countries where the use of Web-based searches is prevalent.Methods: Google Trends and Google Correlate were used to enumerate Web based search queries related to HFMD in three Asian regions and were compared to known seasonal variations and standard surveillance data to investigate for strong correlation. We also test whether a mathematical model, constructed using Google Correlate, would have been able to predict, in retrospect, an outbreak of HFMD in Singapore.Results: HFMD-related search queries strongly correlated to known HFMD seasonal variation and standard surveillance data. Our mathematical model of Singaporean HFMD did predict the magnitude and chronology of the summer 2012 outbreak.Conclusions: Given the correlation of Google technology with known HFMD seasonal patterns and surveillance data in select Asian regions, this technology shows enormous potential for HFMD surveillance. Further prospective studies are needed to validate the utility of Google technology in HFMD surveillance.
Highlights
Hand, Foot, and Mouth Disease (HFMD) is a worldwide illness caused by Enteroviral infection
Concerns for emerging infectious diseases and bioterrorism heightens the need for real-time surveillance of infectious outbreaks to allow for the rapid institution of public control measures to reduce the frequency and mortality from epidemic illnesses, including HFMD [3]
This ability is highlighted by the fact that Google Flu Trends® (GFT) can predict influenza outbreaks one week faster than conventional reporting methods from the Centers for Disease Control and Prevention (CDC) [4]
Summary
Foot, and Mouth Disease (HFMD) is a worldwide illness caused by Enteroviral infection. Patients commonly present with fever, malaise, and pharyngitis days before onset of a characteristic vesicular eruption on the palms and soles, and posterior pharyngeal erosions. The typical patient recovers with only symptomatic treatment, but recently there have been outbreaks associated with severe disease, such as aseptic meningitis, encephalitis, and even death [2]. Several of these severe outbreaks have been associated with Enterovirus 71 infection in East and Southeast Asia. In the United States, Coxsackie virus A6 was associated with severe HFMD presentations during a large outbreak in the winter of 2011-2012 [2]. Given the lack of specific treatment and vaccination, endemic regions rely on surveillance and public control measures to decrease the frequency of case severity in at-risk populations [3]
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