Social Media Helps Sound Alert for Foodborne Strep Throat Outbreak

Use of social media helped alert health authorities about an foodborne outbreak strep throat. (Image: CDC/ Dr Heinz F. Eichenwald)

Use of social media helped alert public health authorities about a foodborne outbreak of strep throat. (Image: CDC/ Dr Heinz F. Eichenwald)

Although many people worry about the negative effects of social media on teenagers, one Minnesota parent used a child’s Facebook posts to alert public health officials about a large foodborne outbreak of strep throat.

Strep throat, or Group A Streptococcus (GAS) pharyngitis, generally spreads from person to person by respiratory droplets, but transmission from contaminated food does occur. Among 63 people who ate at a high school dance team’s banquet, 18 developed symptoms of strep throat within 3 days. Multiple posts soon appeared on the group’s Facebook page. Mounting reports of ill team members and relatives prompted a concerned parent to notify the state health department. The full report is published online in Clinical Infectious Diseases.

Investigators interviewed approximately 100 people by telephone, including those who attended the banquet, household contacts of attendees, and those who did not attend but ate the leftovers. Using pulse field gel electrophoresis, they compared the DNA fingerprints of the strep isolates collected from those who developed GAS infection and from samples of leftover food.

The most likely source of the outbreak was pasta served at the banquet, reported Sarah Kemble, MD, and a team of investigators from the Minnesota Department of Health. Bacteria from the throats of those who became ill after attending the banquet matched bacteria identified in the pasta. One person who did not attend the banquet but ate some leftover pasta brought home by family members developed a laboratory-confirmed GAS infection that matched the same DNA fingerprint pattern, helping confirm the route of transmission. No one else in the household had symptoms of strep throat, and throat swabs on all the other household members were negative for GAS.

The researchers said they suspect that someone who carried strep bacteria in the throat unknowingly contaminated the food during preparation. “The food probably was not kept hot or cold enough to stop bacterial growth,” said Kemble in a statement. Both the parent who prepared the pasta and a child in the same household reported having strep throat 3 weeks before the banquet.

Rapid, real-time communication within a large group using online social media played a critical role in bringing this outbreak to the attention of public health authorities. Previous work has demonstrated the utility of search engines and social media to accurately track influenza activity. Google.org, which launched Google Flu Trends in 2008, subsequently developed Google Dengue Trends to help track outbreaks of illness caused by the mosquito-borne dengue virus and provide users and public health officials with timely estimates of dengue activity in their region. The organization said that it has found a close relationship between the number of people searching for dengue-related topics and how many people actually have dengue symptoms.

In coming years, social media will likely play an increasing role in disease surveillance and outbreak investigations. The US Department of Homeland Security, for example, has funded a $3 million pilot program to link and analyze data from social media networks to help the Office of Health Affairs “better inform and protect the public in the event of a national health emergency such as an infectious disease outbreak or a biological attack.” Recognition of the potential of social media to aid in epidemiologic investigations could be a major boon to public health, especially in the current era of shrinking budgets.

Think Before You Tweet, E-mail, or Post to Online Groups, Advise Physicians

Physicians should thoughtfully manage their online reputations by careful and ethical use of digital technology. Image: Brian Jackson/iStockphoto.com

Physicians should thoughtfully manage their online reputations by careful and ethical use of digital technology. Image: Brian Jackson/iStockphoto.com

Physicians should pause before hitting “send” on an e-mail, tweet, or other digital communication to ensure that the communication will uphold their professional obligations to patients and not mar the reputation of the profession, urges a new joint position paper released by the American College of Physicians (ACP) and the Federation of State Medical Boards (FSMB).

Questionable physician behavior online is not uncommon, suggested a 2012 study that found 92% of state medical boards had received reports of online violations of medical professionalism. The most commonly reported violations were inappropriate communication with patients (such as sexual misconduct), inappropriate medical practices such as prescribing of medications outside the physician-patient relationship, and misrepresentation of the physician’s credentials. A previous study had documented online misbehavior by medical students. But Humayun J. Chaudhry, DO, MS, SM, FSMB president and chief executive officer and one of the study’s coauthors, noted that it was a surprise to see so many licensed physicians getting into trouble online.

“The feeling was that licensed physicians would be more careful,” he explained during a press briefing held at the ACP’s annual meeting in April. “We were surprised the numbers don’t bear that out.”

A follow-up study by the same group of researchers found that reports of certain types of online infractions were very likely to trigger an investigation of a physician.

To help physicians use social media and other digital communication tools in ways that are more beneficial and less likely to cause harm, the ACP and FSMB produced the current position paper. The paper emphasizes the importance of following the same ethical standards for maintaining the physician-patient relationship, confidentiality, patient privacy, and respect for individuals online or offline. It also recommended that physicians:

  • Create separate personal and professional accounts for social media and other interactions online.
  • Use e-mail only to communicate with patients with whom they have an established physician-patient relationship and only with proper patient consent.
  • Manage their online reputation by periodically searching for their name and creating a profile page of information that will likely be the first item to come up in such a search.
  • Be aware that online comments can have lasting effects on a career.

“A comment you have not thought through can take on a life of its own,” Chaudhry said. “Be careful what you post.”

Physicians Cautioned About Online Behaviors

Physicians who unwisely use social media to post false information about their credentials or treatments, engage in unprofessional interactions with patients, or post information about patients may find themselves under investigation by state medical boards, a new survey has found. Image: Lisa Eastman /iStockphoto.com.

Physicians who unwisely use social media to post false information about their credentials or treatments, engage in unprofessional interactions with patients, or post information about patients may find themselves under investigation by state medical boards, a new survey has found. Image: Lisa Eastman /iStockphoto.com.

Physicians are likely to find themselves in hot water for ill-considered online behaviors, such as posting information that misrepresents their credentials or their treatments, violating patient privacy by posting patient photographs online, or sending inappropriate messages to patients, according to a survey of state medical boards. But the survey, published today in the Annals of Internal Medicine, also found there is less consensus among medical boards about whether other types of unprofessional online behavior would result in their investigating a physician. Continue reading

Proposed Rules Would Boost Human Research Protections

Proposed rules would boost protection for individuals who participate in human research studies. (Image: NIH)

Proposed changes to US oversight of human research would extend existing protections to studies not receiving federal funding and offer individuals more control over how their tissues are used in research, according to Department of Health and Human Services (DHHS) officials who unveiled the proposal during a press briefing today.

The proposal aims to update the “Common Rule” of medical ethics regarding participants in human research, which was last established in 1991. “These regulations were developed at a simpler time,” said DHHS Assistant Secretary for Health Howard K. Koh, MD, MPH, during the briefing. He explained that in the past 20 years, huge changes occurring in research have rendered the regulations out of date. Larger, more complex multicenter studies have become more common as have studies funded by private entities. Additionally, advances in genomics, expanded use of the Internet in research, and more study of behavioral issues have raised new concerns. Continue reading