The year-long rise of ISIS, and its leaders’ appeals for supporters to carry out attacks around the world, has authorities on high alert.

Sourced through Scoop.it from: www.nbcnews.com

Visiting New York City yesterday, it was clear that the southern tip of Manhattan is now the center of homeland security surveillance.

New York City should be the center of surveillance for any spatial epidemiology program.

The very first disease map we have on paper was produced in the late 1790s by Dr. Valentine Seaman of the medical school in New York.

ValentineSeamanMaps1797-1805

He was trying to determine if yellow fever was of local origin or imported by ships (our famous Benjamin Rush blamed it on imported coffee beans that went sour).

IMG_4769

A number of past yellow fever outbreaks made their way into this country via these slips and piers.   More would follow, for example malaria, cholera, diphtheria, typhoid, and most recently west nile and measles (Palisades Shopping Plaza, 2013).

IMG_4820

The rates at which people move in and out of this location are unimaginable.   The other day, at about 2:30 in the afternoon, in just fifteen minutes I saw more than a hundred ferries and tourist boats, helicopters, subways, air, land and water taxis, city and tourist buses, and private tourism vehicles.

IMG_4797

Three hours later, as I took leave from this area, I could see they were dropping off more than a thousand locals and tourists per quarter hour, right around dinnertime.

This meant that the routes leading from South Street Seaport to the 911 Memorial Museum were filled with thrice as many people than typically seen at this time of the day.  You couldn’t help but follow them.

IMG_4873

The travel routes were well defined by roadblocks.  These well-defined routes to the Memorial were secured by nearly a dozen different types of public service, military, guard, national park, and homeland security units.   Need I say, surveillance cameras were everywhere, and as this new story indicates–they were even way overhead in the form or aerial and satellite surveillance.  The subway I was heading to was in this general direction.  All I had to do was follow the masses, then take leave once I reached the tunnels.

When I got close to the entrance to the subway station, enough people were heading underground to fill the stairways.  I decided to hold off a half hour, and so headed to where everyone else was flocking, the 911 Memorial.  You could see hints of this setting two blocks away.  There was a new rib-like display in place, mimicking the skeleton of a fish or fallen building, I thought.

IMG_4872

Now, imagine having to trace the source and predict the path of a biological outbreak that originated here in upcoming days.  That is what a Biosecurity Unit can do using GIS.

See on Scoop.itMedical GIS Guide

California lawmakers voted on Thursday to substantially limit vaccine exemptions for school children in the most populous U.S. state, an initiative prompted by last year’s measles outbreak at Disneyland that sickened more than 100 people.

Sourced through Scoop.it from: www.yahoo.com

History repeats itself, especially in medicine.  

 

It is exactly 100 years since there was a significant outbreak of small pox in Niagara Falls, NY, a town that had just incorporated several years earlier.  

 

We have now we have gone full cycle on the reasons why Niagara Falls had such a memorable small pox outbreak–at least to some medical historians.  

 

The issue hand:  mothers decided not to vaccinate their children due to the anti-vaccination movement going on.  Animal Rights activists were its primary instigators.  Due to public pressure, New York allowed parents to decide on their own if theirs kids were to be vaccinated for a number of infectious diseases.  They called this ability to opt out–"compulsory."

 

Just a few years into this movement, 1914/5, a number of states had developed strong anti-vaccination movements, and large percentages of children began to attend school completely unvaccinated (85% to 100%).  In some towns, with strong religious leaders, in politics as well as the law, outbreaks ensued as a result of a lone infected person attending the same school  and coming down with the infection.  

 

A significant small pox outbreaks ensued in Niagara Falls due to this.

 

It is now 100 years later, and the Measles outbreaks of 2014 have just passed.  This outbreak started in California for much the same reason.  Once it took off, it quickly made its way back east to the same part of western NY where small pox made a brief stay.  

 

Ironically, both of these times we put Canada at risk, due to the same human behaviors in the U.S. and and the same economic geography and physical geography related reasons.  

 

So I wonder what Canada has to say about all of this!

See on Scoop.itEpisurveillance

portrait_3Dlandscapev3-octagon

The research question for this review is:  How many “unique people” visit this site?

By unique, I mean unique names.  Individuals may return several days per week, and each day gets counted as an individual person, and each page they go to as a unique visit.  But at the end of the week, one person who visited several times per day, daily, will be counted as at least seven individuals.  So I worked on a way to evaluate the numbers of unique people who come to this page/site.  For this review, I focused on the main page.

To accomplish this, I reviewed the numbers of visits, developed an equation for calculating numbers of visitors for entire 5.5 years, based on the last three years, and came up with estimates/guesstimates on the numbers of unique visitors.

In general, the average number of pages visited per visitor is between 1.5 and 1.75.  The value 1.5 means that approximately 33% see just one page and 66% see two pages. (1:1 is 50% see one page, 50% see two pages.)

HomePageVisitsPerQuarterPerYear

.

This first set of graphs depict values per period, illustrated as quarterly and yearly.  These are not cumulative data.  Over time, the numbers of followers continued to increase.  Again, this is the number who visited just my main blog page, no special pages on the topics I review.  Typically, a person first visits a special topics page, then looks for the main page to see who the author is.

For the first quarter in 2015, which I call “Spring”, I had 77,474 visits. (Jan-Feb-March is actually Winter, but I called the end of the year “Winter” for this review.)

A cumulative of this period is as follows:

HomePageVisitsPerQuarterPerYear_65%

This is a conservative estimate, based on the 1.5 value noted earlier.  It takes into account the influx of new members each month, and then estimate how many of them return over the remaining periods, per month and quarter.

The conservative estimate of number of people impacted by this site in just under 90,000 people.

It is estimated that about half of these visitors are doing work or research in medical GIS.  The other half are visiting for information about medical history and/or medical botany, and/or due to links from other places such as LinkedIn, ScoopIt!, Tumblr, and a few other sites that re-post much of my work.  (I recently learned get on the average 1300 to 1500 re-posts per new blog/home page posting, per special search engines, and about 15 reposts of my work by other ScoopIt! sites.).

The less conservative estimate for individual impacted, by my pages only (not the LinkedIn and others), increases this number to 100,000 or more.

HomePageVisitsPerQuarteronly_75%

So, I need to add–many  thanks to all you out there revisiting this site.

ESRI still has links to the historically important historical medical geography maps and articles I have posted, so I appreciate this support from ESRI as well.

I am in the process of translating the text (handwritten script, in Old German, using Old German medical and geographic terminology) and determining how to reproduce the famous disease map of Friedrich Schnurrer, ca. 1827 (figure below).  It is the first map of diseases, globally, based on his review of the literature for the time.  His work focuses on the famous epidemics and diseases documented by earlier writer.  Schnurrer was an expert in Chinese culture, and perhaps produced these maps due to the cholera impacts on China before it turned into a pandemic.

Schnurrer_map1-world

**********************************************

A bizarre invasive worm with its mouth in the middle of its belly has been found in the United States for the first time, according to new research. The New Guinea flatworm (Platydemus manokwari) is only a couple of millimeters thick but grows to be up to 2.5 inches (65 millimeters) long. As an invasive species, it’s a threat to native snails — so much so that the Invasive Species Specialist Group of the International Union for Conservation of Nature (IUCN) lists it among the 100 worst invasive species in the world.

Sourced through Scoop.it from: news.yahoo.com

What insights does this provide to disease ecologists?

 

The ability of small invertebrates to make it pass the security checks also means that other hitchhikers like then and the hitchhikers residing on these hitchhikers could make it into the U.S.  

 

We traditionally maintain a high alert for obvious pathogens, like the mycobacterium species responsible for bovine tuberculosis or the ticks that can make their way in with farm animals.  

 

The New Guinea flatworm is now causing U.S. ecologists to be prepared for yet another disturbance in the food web and cycles.  The flatworm itself is not a health concern.   Since the 1970s, the invasive "jumping worm" from China has been a pain to U.S. fishermen; it doesn’t stay on the hook that well due to weak musculature and lack of tough skin.  

 

But these small organisms serve as ecological test species for those mapping the unique pedochemical, hydrologic, and climatically impacted  behaviors of these organisms as they make their way into this country.  Modeling can be done with the pre-vertebrates, to establish baselines for how to map the same environmental features once an pathogen-carrying host makes it past the security checks.  

 

The impacts of a mistake can be quite devastating.  Not just due to diseases, but also due to the potential these organisms have upon food and livestock security.   So the best of us who read news about a possible foreign agent coming into this country, also have public health in mind.  

 

Perhaps it’s time to review those older studies of diseases we’ve managed to avoid the past 50 to 75 years.  Re-emerging diseases are not just those that arise as examples produced by human pathogens.   We can get away with ignoring ecology when we study primarily human-based diseases; but when anthropozoonotic diseases become the issue, we have to convert to a more natural ecological means to perform our Medical GIS. 

See on Scoop.itGlobal∑os® (GlobalEOS)

The number of Ebola cases has risen in Guinea and Sierra Leone for the second consecutive week, the World Health Organization said Wednesday. In Guinea, 16 new cases were found in the week ending June 7, with 15 more found in neighbouring Sierra Leone. In the previous week, 13 new cases had been found in Guinea, a clear increase on the nine reported a week before that.

Sourced through Scoop.it from: news.yahoo.com

. . . Third Base . . . . Forgive me for being a political satirist here, but I would like to say (and post) the following for this news :

“Let the games begin! We will start out the season with WHO vs. MERS, and then follow it up with games involving the Ebola team. Then WHAT’s Second?. Counter-Defense Crews (the anagram here) will make their way into the games, once they win out in the American BA (BS Artists’) series. ABsA and NBsA will then go face to face for the greatest game of all—the World Series. But only those customers caught distracted by watching the games are the real losers here–forgetting their safety when it comes to wild throws and foul-balls. But isn’t that really what this “game” is all about? Errors by in-field mistakes?

(What we don’t know is when is ‘I DON’T KNOW’ up to bat? That’s the big question here!)”

See on Scoop.itGlobal∑os® (GlobalEOS)

For those in need of a refresher:  Abbott and Costello’s “Who’s on First?” :

These four maps demonstrate the significant spatial differences in distributions of four disease patterns.  The four mapped diseases are Diphtherie (Diphtheria), Unterliebstyphus (Typhus),  Lungenwindsucht (Tuberculosis or Consumption), and Sumpffieber or Wechselfieber (Malaria).   Diphtheria is dependent primarily upon people.  Typhus is due to a combination of transportation, population density and people.  Tuberculosis distribution is defined by a combination of topography, climate and pedological (soil) features in relation to people.  Malaria is an example of the classic host-vector zoonotic disease migration problem that plagues the world for nearly two centuries by the time this was published.

The influences of Prussian (German) cartographers and medical topographers/medical climatologists dominated the medical and disease geography profession between 1800 and 1850.  When the first influential disease geographer became famous, Alexander Keith Johnston, the map he produced (http://brianaltonenmph.com/gis/historical-disease-maps/alexander-keith-johnstons-famous-map-a-detailed-review-1856/  ) was up against three very reputable maps produced by three German medical cartographers.   

 

The most famous map that was published about the time of Johnston’s map was produced by Adolph Muhry (1856) (image with review is at http://brianaltonenmph.com/gis/historical-disease-maps/adolph-muhrys-global-disease-map/&nbsp ;).  Its emphasis on climate, global wind flow patterns, travel routes, and latitude-longitude global features made it a tough map to follow to physicians in the more Anglican communities.  The predecessor to this map, produced in 1848 by Heinrich Berghaus (‘Planiglob . . . der vornehmsten Krankheiten’, image with review is at http://brianaltonenmph.com/gis/historical-disease-maps/heinrich-berghauss-physikalischer-atlas-1848/&nbsp ;) served the German readership with the needed background to interpreting and understanding Muhry’s map. 

 

British mapmakers had less a sense of authority in this profession globally at the time.  Supplementing the German leadership in this field was the purely geographic taxonomy for diseases developed by another Prussian/Germanic cartographer and specialist in this field in 1847 –- Dr. Carl Friedrich Canstatt and his book Handbuch der medicinischen Klinik (http://brianaltonenmph.com/gis/historical-medical-geography/dr-carl-friedrich-canstatts-handbuch-der-mediziniche/  ), in which the classification of diseases was perfected based upon a combination of environmental and human population features, including topography, climate, population patterns, wildlife and plants, natural disaster events, solar and even barometric influences.

 

Prior to the perfection of the climate-topography philosophy of disease in the 1840s was the work of German cartographer and sociologist Freidrich Schnurrer (coarse image with review is at http://brianaltonenmph.com/gis/historical-disease-maps/friedrich-schnurrers-charte-uber-die-geographische-ausbreitung-der-krankheiten-1827/ ; my complete translation and review of this map is now in process).  

 

Like many broadly read and trained professors, he had the knowledge background needed to map out the underlying climatic, environments, temperamental, evolutionary (pre- or Social Darwinian), cultural, anthropic, toxicologic, geologic, climatic and biological nature of the large numbers of diseases documented by explorers and missionaries around the world. Schnurrer also managed to review the famed plague epidemics and a variety of race-ethnicity related histories of diseases, and placed his observations on his map, detailing a part of medical history that has barely covered since and before this work was accomplished.

 

In light of these findings, from my work on these four most important maps in the history of medical geography, it now makes sense why this 1880 map on four Prussian diseases in the Germanic part of Europe remains one of my top visitor sites.

 

I review extensively the evolution of disease map philosophy and history at http://brianaltonenmph.com/gis/applying-new-methods-with-gis/space-time-behavior-in-medical-geography/ 

See on Scoop.itMedical GIS Guide

A UN-sponsored report on Monday denounced the World Health Organization’s slow response to the Ebola outbreak and said the agency still did not have the capacity to tackle a similar crisis. “It is still unclear to the panel why early warnings approximately from May through to July 2014 did not result in an effective and adequate response,” an interim report by a six-member expert team said. WHO only declared a global public health emergency on August 8 — almost five months after the outbreak had taken hold in west Africa. The panel, set up on March 9, is led by Barbara Stocking, who formerly headed Oxfam.

Source: news.yahoo.com

So what have we learned from the last 13 months?

 

It was April 10th, 2014 when I posted my first review and warning about Ebola’s migration habits or patterns, and the need for Medical GIS to be available outside the WHO and CDC settings.  It is important to remember that WHO and CDC are organization, pretty much agencies behaving like businesses, that have other agendas to consider.  The primary agenda is world stability, politically, financially and, oh yeah, healthwise.

 

Two more months passed before either agency paid much attention to the facts about ebola.  Unfortunately, even the total facts about spatial habits of diseases like ebola. was a knowledge base both WHO and CDC lacked enough experience with to foresee the reasons for the upcoming cascading of this outbreak.  

 

Historical epidemics demonstrate these patterns.  They have their ebbs and flows just like the plagues and contagion before.  For medical historians, it is nice that history repeats itself; this concept however is most because people repeat themselves, including their bad habits and poor learning curve following recent and new outbreaks.

 

So what have we learned?  The news tells it all:

 

LESSON 1.  May 12:  As Ebola disappears, no useful data seen from vaccine trials -WHO.   http://finance.yahoo.com/news/ebola-disappears-no-useful-data-122852064.html 

 

We allocated money in the wrong directions.  Pharma companies effectively convince investors and health officials that they had the cure.  Internal benefits linked to these actions helped fuel these tests of the new medications.  The patenting of a bioengineered plant phenotype that produces an antiviral drug was one result; the proof that we (NIH and CDC) need to patent the deadliest ebola of all, because we need to have control of this bioweaponry – – against future outbreaks that is.

 

Instead, this money should have been completely allocated to just two things–surveillance and cessation/prevention activities to prevent the further spread of Ebola.

 

LESSON 2.  Adam Justice.  May 12.  Ebola: Liberia celebrates as WHO declares the nation clear.   https://uk.news.yahoo.com/ebola-liberia-celebrates-declares-nation-clear-085546124.html 

 

FOX News.  May 11.  Liberia declared Ebola-free, but outbreak continues over border 

http://www.foxnews.com/health/2015/05/11/liberia-declared-ebola-free-but-outbreak-continues-over-border/ 

 

When it comes to the global outbreak and rapid rise in numbers, nothing is final.   While Liberia celebrates, the disease remains active just across the border.  In fact, we saw this happen between at least 3 countries in Africa.  While you appease one side with money and tactics, the carriers remain at large.  This is due to ignoring the first warnings, lacking an effective intervention plan for when the outbreak ensues, lacking trained professionals with expert experience in the plague known as ebola, and inadequate education and experience as an organization–no proper foresight.    We always forget our mistakes deliberately–we can’t accept them and handle them–and we certainly won’t admit them–so the line in this articles taht states:  "Now comes the challenge. The challenge of working with our two neighbouring countries. To make sure they reach the same level of progress that we have reached" means you still have a lot of convincing of others to accomplish–this epidemic is not over.

 

The Solution:  Eliminate current plans and procedures, replace inadequate staff, invest more in the GIS/HIT needed for surveillance and reporting outside the two major agencies, and regional/state/county agencies with attached agendas.  Each business (insurance or tertiary care giver) has a responsibility for trusting only itself when it comes to smart corporate decision making.  Big Business suffers the most, when expenses needs to be covered for an outbreak their auditors and regulators failed to prevent.  Its like a government charging the taxpayers for not fixing up the roads.

 

LESSON 3.  Doctor Who Survived Ebola Nearly Lost His Vision.  http://news.yahoo.com/doctor-survived-ebola-nearly-lost-vision-145513068.html   

 

Too much favoritism and elitism are found in medical profession behaviors.   Crozier and others failed to abide by their own public health and safety rules.  And there is no way this will even NOT HAPPEN.  People are into "the self"–the self’s desire for some fast food picked up by a drive through (where the card or paper money spreads the disease, like it did with cholera), the self’s desire to get home or to a relative’s place no matter what–no matter how many hundreds to thousands of people you potentially expose directly and indirectly.  We punished the newscaster who did not abide by her requirements; we failed to treat the others accordingly.  Nature showed Crozier that he made a terrible professional decision related, unethical mistake.

 

SOLUTION:  be more responsible in catching and/or quarantining these types.

 

LESSON 4.  May 12.  Experts denounce WHO’s slow Ebola response.   http://news.yahoo.com/experts-denounce-whos-slow-ebola-response-101853741.html 

 

Ebola: Expert panel urges ‘unified entity’ within WHO for emergency response 

http://www.newkerala.com/news/2015/fullnews-56871.html

 

It is not over until it’s over–and perhaps may never be over.  This in fact should say, "A third new group of experts who reviewed the outbreak of Ebola felt WHO and CDC could have performed better."    The "Unified Entity" some nations are talking about is idealistic, not realist.

 

SOLUTION: See LESSON 2.

 

LESSON 5.  May 12.  Experts denounce WHO’s slow Ebola response (Update).  http://medicalxpress.com/news/2015-05-experts-denounce-ebola-response.html 

 

What happens to WHO influences and/or also happens to CDC.  Recall, there was a 180 turn around in CDCs claims in July 2014.  For just one day, WHO’s statements were in disagreement with CDC’s statements, claiming that there was a new outbreak that required immediate reaction.

 

SOLUTION: 90% of all surveillance per ICD/disease type should be done outside WHO and CDC.  Multiple agencies interacting with each other make it less likely for governmental decisions to endanger local, national or global public health.   90% of all public health activities, for an outbreak like ebola, or measles, or cholera, should be performed by local interest groups first using GIS, then the national and international groups.  And those local groups should encompass more than just your regional, county or state health departments.

 

See on Scoop.itMedical GIS Guide

Follow

Get every new post delivered to your Inbox.

Join 4,625 other followers