Grippenet: a participatory system to monitor and fight the Flu.

A participatory system to monitor and fight the Flu

The Flu is a major public health issue, resulting in increased medical care consumption, absenteeism and mortality, to name a few. Along with several partners, researchers from the Swiss Federal Institute of Technology in Zurich (ETHZ) and the University of Geneva (UNIGE) developed and deployed Grippenet.ch, the Swiss component of a European initiative for participatory influenza minitoring called Influenzanet. Through this system, data on Flu is contributed directly by citizen participants, contrary to Sentinella, the epidemiological surveillance system active in Switzerland since 1986, where reports of Flu are reported by health practitioners. Results show that Grippenet.ch could prove faster, more flexible, and a useful supplemental tool for early detection and monitoring of infectious outbreaks.

Grippenet.ch is also pioneering the extension of traditional participatory monitoring to a state-of-the-art digital health tool: The Swiss researchers and their collaborators have released a mobile App, which allows participants to contribute measurements made by their mobile phone sensors. This data will be used in research that could allow scientists to better understand the transmission of the virus and to leverage information technologies and human behavioral responses to help contain epidemics.
A participatory information platform

"The principle is very simple. After an anonymous and free registration on grippenet.ch, participants receive a short survey on a weekly basis, enquiring about whether they suffered from potentially Flu-related symptoms" explains Aude Richard, Coordinator for the French speaking Grippenet platform at the Institute of Global Health at the Faculty of Medicine of UNIGE. Throughout the winter of 2016-2017, 342 Swiss residents informed researchers about the presence or absence of Flu-like symptoms in themselves and in those living with them.

Grippenet.ch is also an educational and information platform. Contributors can view a map of Switzerland to see the Flu levels reported by the community in different cantons, including their own, as well as other statistics on Flu incidence. They can also access more information about influenza and preventive measures. "The more aware and informed people are, the better they can protect themselves," says Dirk Helbing, Professor of Computational Social Science at the ETH Zurich. "I am thinking, for example, about measures such as vaccination, avoiding intense contact with crowds, and better hand hygiene.”.

An innovative digital tool to predict and contain the Flu

The Grippenet.ch team just launched a new Android App, initiating a research study with the aim to develop cutting-edge Machine Learning models to predict Flu exposure through sensor data. Flu transmission is driven by human mobility and contact patterns, which can be inferred using measurements made through mobile phone sensors. Furthermore, this is done in a privacy preserving fashion by aggregating and anonymizing the data that is shared with researchers. “If enough people contribute their measurements, we might be able to build a system that learns to make accurate predictions of who is at high risk of being sick, using regularities in the data. This requires user trust and the utmost respect for their privacy”, explains Olivia Woolley, who runs the Grippenet.ch team at ETH Zurich. “Our ultimate goal is to create a tool that gives people accurate information about their exposure to the Flu so that they have the power to take smart actions to protect themselves and avoid spreading the Flu to others.” The App and study are developped in collaboration with the the Computational Epidemiology Laboratory (ISI, Turin), and the center for Embeded Intelligence (DFKI, Germany) and partially funded by the European Communities H2020 Program, namely the project called CIMPLEX: Bringing CItizens, Models and Data together in Participatory, Interactive SociaL EXploratories (http://www.cimplex-project.eu).

A complement to the Sentinella system

Each year in Switzerland, the Flu causes anywhere from 112'000 to 275'000 medical consultations, as well as an excess of mortality among the elderly and additional 97 million francs costs to the health care system. Absenteeism-related costs amount to an additional 200 million francs. All these reasons and more motivated the start of the Grippenet project in December 2016, allowing the monitoring of influenza epidemics though the direct action of Swiss citizens and residents. Based on the European Influenzanet platform that started in 2003 in the Netherlands and Belgium, Grippenet.ch was implemented and launched in Switzerland by the Professorship of Computational Social Sciences (ETHZ), the Institute of Global Health of the Faculty of Medicine at UNIGE, the Digital Epidemiology Laboratory (EPFL, Lausanne) and the National Reference Center for Influenza (HUG, Geneva).

In Switzerland, the Sentinella epidemiological surveillance system has been monitoring Flu outbreaks since 1986. Based on weekly reports by doctors, it provides a continuous observation of influenza viruses circulating in the country. The Sentinella platform works in the monitoring of many acute communicable diseases and is used for research in general medicine. Since its start, 150 to 250 GPs participate voluntarily in the Sentinella system each year.

If Sentinella is a well-established and effective system, then why was grippenet.ch developed? "Unlike the Sentinella network that relies on medical practitioners for the declaration of cases of Flu, grippenet.ch gets its data directly from the population, explains Antoine Flahault, Director of the Institute of Global Health at the Faculty of Medicine of UNIGE. This provides us with a monitoring system that could potentially be faster and more flexible than Sentinella, and allows for direct international comparisons of Flu epidemics, since the data is directly comparable with other European countries. In addition, not everyone who gets the Flu sees a doctor, which is why Grippenet.ch is complementary to Sentinella. "The comparison of the two systems gives us important insights for the planning and prioritization of the public health epidemic response, allowing us, for example, to estimate the percentage of people who do not consult a doctor in case of Flu-like symptoms", adds Antoine Flahault.