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Todd, Stacy; Diggle, P. J.; White, P. J.; Fearne, A.; Read, J. M. (2014)
Publisher: BMJ Publishing Group
Journal: BMJ Open
Languages: English
Types: Article
Subjects: Influenza, 1692, wc_515, Research, wa_105, wa_20_5, Outbreak, 1706, Syndromic Surveillance, 1506, Public Health, qw_160, 1724

Classified by OpenAIRE into

mesheuropmc: food and beverages, technology, industry, and agriculture, health care economics and organizations
Objective \ud \ud To assess whether retail sales of non-prescription products can be used for syndromic surveillance and whether it can detect influenza activity at different spatial scales. A secondary objective was to assess whether changes in purchasing behaviour were related to public health advice or levels of media or public interest.\ud \ud Setting \ud \ud The UK.\ud \ud Participants \ud \ud National and regional influenza case estimates and retail sales from a major British supermarket.\ud \ud Outcome measures \ud \ud Weekly, seasonally adjusted sales of over-the-counter symptom remedies and non-pharmaceutical products; recommended as part of the advice offered by public health agencies; were compared with weekly influenza case estimates. Comparisons were made at national and regional spatial resolutions. We also compared sales to national measures of contemporaneous media output and public interest (Internet search volume) related to the pandemic.\ud \ud Results \ud \ud At a national scale there was no significant correlation between retail sales of symptom remedies and cases for the whole pandemic period in 2009. At the regional scale, a minority of regions showed statistically significant positive correlations between cases and sales of adult ‘cold and flu’ remedies and cough remedies (3.2%, 5/156, 3.8%, 6/156), but a greater number of regions showed a significant positive correlation between cases and symptomatic remedies for children (35.6%, 55/156). Significant positive correlations between cases and sales of thermometers and antiviral hand gels/wash were seen at both spatial scales (Cor 0.477 (95% CI 0.171 to 0.699); 0.711 (95% CI 0.495 to 0.844)). We found no significant association between retail sales and media reporting or Internet search volume.\ud \ud Conclusions \ud \ud This study provides evidence that the British public responded appropriately to health messaging about hygiene. Non-prescription retail sales at a national level are not useful for the detection of cases. However, at finer spatial scales, in particular age-groups, retail sales may help augment existing surveillance and merit further study.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. World Health Organisation. International health regulations. 2nd edn. World Health Organisation, 2005.
    • 2. Ortiz JR SV, Uez OC, Oliva O, et al. Strategy to enhance influenza surveillance worldwide. Emerg Infect Dis [serial on the Internet] 2009. http://wwwnc.cdc.gov/eid/article/15/8/08-1422.htm
    • 3. Triple SP. Assessment of syndromic surveillance in Europe. Lancet 2011;378:1833-4.
    • 4. Briand S, Mounts A, Chamberland M. Challenges of global surveillance during an influenza pandemic. Public Health 2011;125:247-56.
    • 5. Lipsitch M, Hayden FG, Cowling BJ, et al. How to maintain surveillance for novel influenza A H1N1 when there are too many cases to count. Lancet 2009;374:1209-11.
    • 6. Severi E, Heinsbroek E, Watson C, et al. Infectious disease surveillance for the London 2012 Olympic and Paralympic Games. Euro Surveill 2012;17:20232.
    • 7. Dailey L, Watkins RE, Plant AJ. Timeliness of data sources used for influenza surveillance. J Am Med Inform Assoc 2007;14:626-31.
    • 8. Wagner MM, Tsui FC, Espino J, et al. National retail data monitor for public health surveillance. MMWR Morb Mortal Wkly Rep 2004;53 (Suppl):40-2.
    • 9. Welliver RC, Cherry JD, Boyer KM, et al. Sales of nonprescription cold remedies: a unique method of influenza surveillance. Pediatr Res 1979;13:1015-17.
    • 10. Davies GR, Finch RG. Sales of over-the-counter remedies as an early warning system for winter bed crises. Clin Microbiol Infect 2003;9:858-63.
    • 11. Das D, Metzger K, Heffernan R, et al. Monitoring over-the-counter medication sales for early detection of disease outbreaksNew York City. MMWR Morb Mortal Wkly Rep 2005;54(Suppl):41-6.
    • 12. Ohkusa Y, Shigematsu M, Taniguchi K, et al. Experimental surveillance using data on sales of over-the-counter medicationsJapan, November 2003-April 2004. MMWR Morb Mortal Wkly Rep 2005;54(Suppl):47-52.
    • 13. Socan M, Erculj V, Lajovic J. Early detection of influenza like illness through medication sales. Cent Eur J Public Health 2012;20:156-62.
    • 14. Goldenberg A, Shmueli G, Caruana RA, et al. Early statistical detection of anthrax outbreaks by tracking over-the-counter medication sales. Proc Natl Acad Sci USA 2002;99:5237-40.
    • 15. Burkom HS, Elbert Y, Feldman A, et al. Role of data aggregation in biosurveillance detection strategies with applications from ESSENCE. MMWR Morb Mortal Wkly Rep 2004;53(Suppl):67-73.
    • 16. Proctor ME, Blair KA, Davis JP. Surveillance data for waterborne illness detection: an assessment following a massive waterborne outbreak of Cryptosporidium infection. Epidemiol Infect 1998;120:43-54.
    • 17. Kirian ML, Weintraub JM. Prediction of gastrointestinal disease with over-the-counter diarrheal remedy sales records in the San Francisco Bay Area. BMC Med Inform Decis Mak 2010;10:39.
    • 18. Health Protection Agency. Epidemiological report of pandemic (H1N1) 2009 in UK, 2010. http://www.hpa.org.uk/Publications/ InfectiousDiseases/Influenza/ 1010EpidemiologicalreportofpandemicH1N12009inUK/
    • 19. NHS Scotland; NHS Wales; Department of Health SSaPS. Important information about swine flu-leaflet. Last Update 4 Apr 2014. http:// www.nhs.uk/news/2009/04April/Documents/Swine%20Flu% 20Leaflet_Web%20Version.pdf
    • 20. Rutter P, Mytton O, Ellis B, et al. Access to the NHS by telephone and Internet during an influenza pandemic: an observational study. BMJ Open 2014;4:e004174.
    • 21. Public Health England. Influenza Surveillance in the United Kingdom. Last Update. http://www.hpa.org.uk/web/ HPAweb&HPAwebStandard/HPAweb_C/1195733821514
    • 22. Brooks-Pollock E, Tilston N, Edmunds WJ, et al. Using an online survey of healthcare-seeking behaviour to estimate the magnitude and severity of the 2009 H1N1v influenza epidemic in England. BMC Infect Dis 2011;11:68.
    • 23. HarcourtT SE, Smith GE, Elliot AJ, et al. Use of a large general practice syndromic surveillance system to monitor the progress of the influenza A(H1N1) pandemic 2009 in the UK. Epidemiol Infect 2012;140:100-5.
    • 24. LexisNexis. Nexis | Home. Last Update 16 January 2014. http://www.nexis.co.uk/
    • 25. Meltwater. Meltwater-Online Media Monitoring-Public Relations Software-Social Marketing Software. Last Update 16 January 2014. http://www.meltwater.com/
    • 26. Google. Google Trends. Last Update 16 January 2014. http://www.google.com/trends/
    • 27. Riberio J, Diggle P. geoR: a package for geostatistical analysis. R-NEWS 2001;1(2):15-18.
    • 28. Vergu E, Grais RF, Sarter H, et al. Medication sales and syndromic surveillance, France. Emerg Infect Dis 2006;12:416-21.
    • 29. Wallstrom GL, Hogan WR. Unsupervised clustering of over-the-counter healthcare products into product categories. J Biomed Inform 2007;40:642-8.
    • 30. Miller E, Hoschler K, Hardelid P, et al. Incidence of 2009 pandemic influenza A H1N1 infection in England: a cross-sectional serological study. Lancet 2010;375:1100-8.
    • 31. Dawood FS, Iuliano AD, Reed C, et al. Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study. Lancet Infect Dis 2012;12:687-95.
    • 32. Presanis AM, Pebody RG, Paterson BJ, et al. Changes in severity of 2009 pandemic A/H1N1 influenza in England: a Bayesian evidence synthesis. BMJ 2011;343:d5408.
    • 33. Vernacchio L, Kelly JP, Kaufman DW, et al. Cough and cold medication use by US Children, 1999-2006: results from the Slone survey. Pediatrics 2008;122:e323-9.
    • 34. Rubin GJ, Amlôt R, Page L, et al. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. BMJ 2009;339:b2651.
    • 35. SteelFisher GK, Blendon RJ, Ward JRM, et al. Public response to the 2009 influenza A H1N1 pandemic: a polling study in five countries. Lancet Infect Dis 2012;12:845-50.
    • 36. Fleischman DS, Webster GD, Judah G, et al. Sensor recorded changes in rates of hand washing with soap in response to the media reports of the H1N1 pandemic in Britain. BMJ Open 2011;1:e000127. Published Online First: Epub Date. doi: 10.1136/ bmjopen-2011-000127
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