Layout 1 ISDS Annual Conference Proceedings 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution- Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ISDS 2012 Conference Abstracts MoH+: A Global, Integrated, and Automated View of Official Outbreak Reporting Chi Bahk*1,2, David Scales1, Sumiko Mekaru1,3, John S. Brownstein1,4,5 and Clark Freifeld1,6 1Children’s Hospital Informatics Program, Division of Emergency Medicine, Children’s Hospital Boston, Boston, MA, USA; 2Dept of Global Health and Population, Harvard School of Public Health, Boston, MA, USA; 3Dept of Epidemiology, Boston University School of Public Health, Boston, MA, USA; 4Dept of Pediatrics, Harvard Medical School, Boston, MA, USA; 5Dept of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; 6Dept of Biomedical Engineering, Boston University, Boston, MA, USA Objective To introduce MoH+, HealthMap’s (HM) real-time feed of official government sources, and demonstrate its utility in comparing the timeliness of outbreak reporting between official and unofficial sources. Introduction Previous studies have documented significant lags in official re- porting of outbreaks compared to unofficial reporting (1,2). MoH+ provides an additional tool to analyze this issue, with the unique ad- vantage of actively gathering a wide range of streamlined official communication, including formal publications, online press releases, and social media updates. Methods Outbreaks reported by official sources were identified through MoH+ (healthmap.org/mohplus), which collects surveillance data published globally by ministries of health (MoH), other related min- istries, government portals, government-affiliated organizations, and international governing bodies (Fig. 1). Reporting of these outbreaks was also identified in unofficial sources using various HM feeds in- cluding Google News, ProMED, and participatory surveillance feeds. Of the 109 outbreaks identified since May 2012, 65 were excluded as they started before data collection, 7 were excluded as they were not reported by unofficial sources, and 1 was excluded as it was a non-natural outbreak. For the remaining 36 outbreaks, the median difference in first date of report between official and unofficial sources was analyzed using a Wilcoxon sign rank test. Results Outbreak reporting in official sources lagged by a statistically sig- nificant median of 2 days (p=0.003). Among unofficial sources, on- line news most often (75%) was the fastest to report an outbreak, followed by ProMED (22%) and participatory surveillance (3%). Among official sources, national government affiliated institutes were most often (41%) the fastest, and repeatedly providing prompt out- break reports were the US Centers for Disease Control and Preven- tion (CDC), Public Health Agency of Canada, Finnish Food Safety Authority, Health Protection Scotland, UK Health Protection Agency, and French Institute of Public Health Surveillance (FIPHS). Follow- ing such institutes were the European CDC (ECDC) with 22% of first reports of outbreaks; MoH’s (17%); and WHO (10%). There were 4 instances in which official sources reported before unofficial sources—3 by the ECDC and 1 by FIPHS. Conclusions Compared to the Chan study reporting a 16 day lag between first public communication and WHO Outbreak News (1) and the Mondor study reporting a 10 day lag between non-government and govern- ment sources (2), the present study shows a much condensed lag of 2 days between unofficial and official sources. Because the two ear- lier studies cover a much broader historical time frame, one expla- nation for the reduced lag time is increased adoption of online communication by official government agencies. However, despite such improvements in communication, the lag persists, pointing to the importance of using informal sources for outbreak surveillance. The present study was limited by small sample size, as the study is in its early stages. We will continue to gather data and all numbers will be updated in time for the presentation to reflect the larger data- base. Future directions of this study include characterization of offi- cial and unofficial reporting by region, language, disease, and source. Fig. 1. Interactive visualization of HealthMap MoH+, at healthmap.org/mohplus Keywords disease surveillance; outbreak reporting; timeliness; MOH; official sources References 1. Chan et al. Global capacity for emerging infectious disease detection. PNAS 2010. 2. Mondor et al. Timeliness of Nongovernmental versus Governmental Global Outbreak Communications. EID 2012. *Chi Bahk E-mail: cbahk@hsph.harvard.edu Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e62, 2013