Tuesday, December 04, 2012

Looking For Zebras


Google Search Screenshot


# 6761



Every day a small, dedicated group of volunteers around the world begin their day with a pot of coffee, an internet connection, and the goal of finding hints of `a zebra’ – an unusual or exotic disease outbreak – from hundreds of news sources around the globe.


You see the results of their work often in this blog, or on Crof's H5N1, and in the daily listings of `flu forums’ like FluTrackers and the Flu Wiki.  


Sure, Crof and I hunt for, find, and translate many of our own articles, but its a big internet and and even bigger world. So we often rely on the dozens of newshounds who spend countless hours scouring the internet, looking for tiny morsels of potentially important information. 


This is difficult, exacting, sometimes mind-numbing work.  Particularly when dealing with languages like Arabic or Chinese.



As you can see, just finding the articles that need to be translated is a major undertaking.


Once a likely article is found, newshounds use a variety of translation methods (including the linguistic prowess of native speakers) to turn Bahasan, or Arabic, Spanish, French, or Chinese into some semblance of English. Often, when we must rely on machine translations, we use more than one translation system, to try to get the most readable result.


Even then, it takes experience and knowledge of idioms and local customs to properly interpret these stories - skills that many of these newshounds have developed over these many months (and sometimes years) of volunteer work.


All the more remarkable, these newshounds are uncompensated for their time and effort.  They do it because they believe it is important.


You’ll see that Crof and I try to credit these volunteer newshounds whenever we use the fruits of their labor because recognition is pretty much the only reward (other than personal satisfaction) they get. 


An incomplete list of some of the more prolific newshounds would include:

Gert van der Hoek, Ronan Kelly, Giuseppe Michieli, Tetano, Shiloh, Diane Morin, Pathfinder, Missouri Watcher, Treyfish, Alert, Tonka, Laidback Al, Carol@SC, Sharon Sanders, Alaska Denise, Hawkeye, Arkanoid Legent, Catbird,  Commonground, Shannon, Mingus, mixin & AlohaOR.


There are many others, including some that work on other forums than FluTrackers and the Flu Wiki.  So my apologies to those who I failed to mention.


Last April, when a mysterious pneumonia swept a hospital in Jordan the newshounds at FluTrackers began a thread on the outbreak, and over the next 7 days made 90 posts, including scores of Arabic news article translations.


We now know that this incident was the first known outbreak of the novel coronavirus now garnering considerable attention in the Middle East. 


Most of the time, outbreaks like this turn out to be something far less exotic, like seasonal influenza, Dengue or Chikungunya.  But the truth is, most disease outbreaks – regardless of their cause – start out looking pretty much the same; a cluster of flu-like-illnesses or pneumonias.


So newshounds take all of these outbreaks seriously, accepting that most will turn out to be something other than zebras, but documenting them anyway.


Because, like the cluster of unexplained pneumonias last April, sometimes they make sense only in retrospect. 


Today we’ve a good example of an `odd’ news report posted by Gert van der Hoek on FluTrackers that may – or may not – become a bigger story in the days to come.


The thread is Brazil: unknown respiratory disease, and it contains a machine translated account of five patients being transferred to a larger hospital due to an unknown pneumonia.  According to the news report, another 14 people have similar symptoms.


Here is an excerpt from the news report:


Respiratory syndrome patients are transferred from Bethlehem to Curuçá

From the newsroom  Para News Agency

The State Department of Public Health (Sespa) decided to transfer to Bethlehem five patients with clinical gentler, who were admitted to the Hospital Municipal Curuçá with symptoms of acute respiratory syndrome because as yet undefined.

The aim is to ensure better care of the sick, whose cases are still being investigated by the Epidemiological Monitoring of Sespa in conjunction with the 3rd Regional Center for Health in Castlebay, the Municipal Health Curuçá, Central Laboratory of the State (Lacen), Centre Skill Scientific Renato Chaves (CPC) and Instituto Evandro Chagas.

Patients transferred to the capital will be admitted to the Unit Diagnosis of Meningitis (UDM), the University Hospital João de Barros Barreto, under monitoring of infectious disease. In addition to these five people, 14 more showed symptoms of the disease since the beginning of the outbreak in Curuçá Municipal Hospital, where a 17-year-old died in the ICU of the Holy House, on the evening of Saturday, 01.

(Continue . . . )


Armed with this information, I did a quick search myself, and found several other news reports regarding this `outbreak’, which may be viral, bacterial, or possibly even the result of chemical or radioactive exposure.


A report, dated yesterday from the Diario do Para, states:


Sai result today on infection in hospital

Monday, 03/12/2012, 1:47 a.m.

The State Department of Health (SESPA) has no information about what the real focus of the contamination in Unit Joint Health Dr. Henrique Alves de Christo, located in the municipality of Curuçá, northeastern state. The complaint made by the hospital staff said that about 10 employees were contaminated by alleged leakage of a chemical used to make dental x-ray. Some employees are hospitalized in Curuçá and others were taken to Bethlehem for treatment.


Since last week the SESPA became aware of the case and is investigating the complaint on two lines of research. One is that the symptoms reported by employees can be caused by bacteria or a respiratory virus.


Laboratory technicians Central State (Lacen) and Epidemiological Surveillance investigating the case. The result of tests performed by teams due out today (Monday).

(Continue . . . )



Is this a `Zebra’?


We won’t know that until more information comes in. Most turn out to be less than earthshaking in their impact.  But every once in awhile . . .


The point is, these stories – whether they turn out to be something of global importance or not – are being monitored, organized, and posted every day by the newshounds of Flublogia – making a historical record available for anyone who wants to look.



I couldn’t do a lot of what I do in this blog without their capable assistance, and for that, they get my profound thanks and admiration.




The term `Zebra’ comes from the famous adage, retold to almost every beginning medical student, is that if you are in Central Park, and you hear hoof beats coming up behind you . . . think horses . . not zebras.


Simply put, doctors should always seek to rule out the most likely diagnoses first, not some obscure and exotic disease.


The caveat being that every once in awhile you run into a zebra.


Joe said...

Sounds like they don't expect final results for a week, but with the Sxs displayed it's sounding like an organism over a chemical exposure (sorry for the long link): http://translate.google.com/translate?langpair=auto|en&u=http%3A%2F%2Fwww.diariodopara.com.br%2FN-163687-SAI%2BHOJE%2BRESULTADO%2BSOBRE%2BINFECCAO%2BEM%2BHOSPITAL.htmlhttp://translate.google.com/translate?langpair=auto|en&u=http%3A%2F%2Fwww.diariodopara.com.br%2FN-163687-SAI%2BHOJE%2BRESULTADO%2BSOBRE%2BINFECCAO%2BEM%2BHOSPITAL.html

Commonground said...

You're welcome, Mike. I rely on your blog for all the news of the day, and I appreciate your dedication also.


Carol @SC said...

Hi Michael!
Here it is Jan. 22, 2013 and I just read this. It shows how focused I am everyday on the Fluwiki News Diary. We at Fluwiki think of you as a friend and we love you visiting us so keeping coming over to browse around. I am always very honored to be mentioned by you. Thank you for recognizing what we do and why we do it.
Carol @SC