a Health Economics and Modeling Unit, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
b Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, United States of America.
c Epidemic Intelligence Service assigned to Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Correspondence to Isaac Chun-Hai Fung (e-mail:CFung@georgiasouthern.edu).
To cite this article:
Fung ICH, Wong K. Efficient use of social media during the avian influenza A(H7N9) emergency response. Western Pacific Surveillance and Response Journal, 2013, 4(4):
1–3. doi:10.5365/wpsar.2013.4.3.005
During the 2013 outbreak of human infections of avian influenza A(H7N9), the Centers for Disease Control and Prevention (CDC) used official data released by the World Health Organization (WHO) and the Chinese government to keep United States public health officials informed of updates of the outbreak.1 The Chinese central government released official avian influenza A(H7N9) data via its web sites (e.g. National Health and Family Planning Commission2), their official news agency (Xinhua News Agency) and their official newspapers (e.g. People’s Daily, Beijing). In addition, official avian influenza A(H7N9) information was released by Chinese provincial and municipal governments such as Shanghai Municipal Bureau of Health,3 Jiangsu Department of Health4 and Zhejiang Department of Health.5 Prior studies have discussed the role of social media in the early detection of disease outbreaks6–9 and the facilitation of community-level discussion.10 In this perspective, we focus on the use of social media by public health agencies to disseminate and obtain official outbreak information during a public health emergency response.
Weibo (literally, microblog) is a category of Chinese microblogging sites that are similar to Twitter. Both Twitter and weibo are social media that allow users to post a 140-character long message online. Weibo has become popular in China since August 2009 when Twitter became unavailable to users in mainland China. As of December 2012, 309 million people were reported to be weibo users in China as compared to the global 500 million registered Twitter users as of July 2012. There are several different providers of weibo, including Sina Weibo, Tencent (QQ) Weibo, Sohu Weibo, Baidu Weibo, ifeng Weibo, NetEase Weibo and others. Most weibo users live in China; a random sample of users of Sina Weibo found that 1.6% of users were from countries other than China.11
Social media platforms provide a new channel through which public health agencies release official information, either by posting new outbreak information directly or by guiding people to official web sites. The 2013 H7N9 outbreak was the first time that WHO used Twitter for initial release of official outbreak information.12 Likewise, the Chinese central government, some of its provincial and municipal governments and the Chinese official news agency released some official outbreak information via weibo nearly simultaneously with their web site press releases (the exact time of information release is known for weibo but often not for web sites; Table 1). An official list of Chinese provincial and municipal health authorities’ weibo accounts can be found at the web site of the National Health and Family Planning Commission.13 Social media, like Twitter and weibo, are used by WHO and the Chinese authorities to direct attention of online communities towards their official web site press releases (Table 1). Weibo users can also post text longer than 140 characters as an image attached to their weibo post, which is known as a long weibo. The Chinese government used this function to post press releases on weibo. An example of a long weibo post containing a whole press release by the Shanghai Municipal Government14 can be found in Table 1.
* The precise release time for the official press releases was not available as the webpages did not carry a stamp of their release time. Nonetheless, based on our experience, the online press releases and the social media posts were released by WHO and the Chinese authorities nearly simultaneously.
Social media platforms can help CDC epidemiologists obtain official information more efficiently because information from multiple sources can be obtained from a central access point. During the avian influenza A(H7N9) outbreak, a team at CDC followed the social media accounts of multiple official sources so that new outbreak information from WHO and the Chinese health authorities would automatically come to the team’s attention. When new case data were released by WHO or the Chinese government at its national, provincial or municipal level via Twitter and/or weibo, the event was re-tweeted by social media users; thus even a message originating on a Chinese-language web site of a provincial health department would be rapidly noticed worldwide and quickly rise to the team’s attention. While these social media posts might include information that was already available elsewhere, they did alert epidemiologists to the release of new information through official sources, allowing the team to gather additional information from official web sites if available (Table 1) and obviating the need for constant monitoring of multiple news sources and web sites, such as individual web sites of the many local Chinese health departments.
The use of Chinese social media, like weibo, coupled with the necessary Chinese language and cultural knowledge, enabled CDC epidemiologists to gather the Chinese official data so that it could be translated, contextualized and interpreted in an efficient manner during the A(H7N9) emergency response. To ensure timely and complete understanding of an outbreak situation, it may be helpful for epidemiologists to track social media, including Twitter and weibo, in addition to traditional methods of communication.7 Our experiences in the 2013 avian influenza A(H7N9) outbreak could be relevant to other outbreaks in other countries and to public health agencies of other nations.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
None declared.
None.
We want to thank the team members: Fiona Havers, Su Su, Kira Christian and the Global Disease Detection Operations Center, Center for Global Health. We thank Fiona Havers, Wenkai Li, Martin I Meltzer, Scott Santibanez and Michael Washington for their comments on earlier versions of this manuscript.
