Feeling Under the Weather:

Tracking the Diffusion of Infectious Diseases Through Weather Patterns

Jake Simon
Geography 20U
Human Geography

Increased traveling among of people, expansion of international trade,
urbanization and environmental changes are all examples of the how rapidly-changing
the world is. Add to that the rapid movement of old contagious diseases and the
emergence of new ones to examine how a global infectious diseases surveillance system
is a major concern for all. Since diseases can be spread rapidly, they are also able to
spread by many different means. Tracking diseases have been around for a long time, but
since there are many factors to where and why diseases travel, it has been very difficult to
pinpoint main causes of diffusion.
There has been an advancement of new technologies that focus on how weather
systems can be used to help track and predict routes for infectious diseases. This paper
aims to showcase the new technologies as well as taking a closer look at certain diseases
that are affected by weather patterns. The ability to precisely track the diffusion of
infectious diseases through weather patterns and thus forecast the possible routes, will
play a major role in future spread of diseases. There currently exists research in the field
of developing this technology and the success of future disease prevention is dependent
on the ability to develop accurate and useful software. Meteorology and disease tracking
can combine to help forecast possible disease routes with the ultimate mission to save
lives. Taking a closer look into the new technologies will conclude that the development
of disease tracking holds the key to a healthier future, free of infectious diseases.
Infectious diseases travel through many diffusion means such as direct contact,
indirect contact, insect bites and food contamination. There is realistically nowhere on the
globe that a pathogen can really remain isolated [1]. The easiest way to catch most
infectious diseases is to come in contact with a person/animal that is infected which could
be spread from person to person, animal to person or mother to unborn child. Another
form of diffusion is indirect contact, which is mainly caused by lingering germs. Insects
can be carriers and pass a disease from host to host by biting. Food contamination is
another mean of diffusion that causes germs to infect the body after the digestion of
contaminated food. Most of these means have been known for a long time and limiting
contact with germs, uncooked or unwashed foods and insects can significantly decreases
someones chances of becoming infected. Research has found that diseases can also
diffuse through a much simpler way. Since many diseases are variable depending on
different temperatures and pressures, diseases can be easily spread through the
movements of weather systems.
Although some software is new regarding infectious disease tracking through
weather patterns, the use of climatological data to predict outbreaks of infectious diseases
dates back to the time of Aristotle (384-322 BC) [2]. This is when the first knowledge of
the intimate interaction between climate and health was first even considered. As the
ability to forecast weather and climate has significantly improved since then, in 1923, Dr.
Gil and other researchers in India developed the first early warming system (EWS) for
malaria based on rainfall [2]. Dr. Rodgers then conducted similar research in the 1920s
that linked climate data with other epidemic information. He established a connection
between climatic variables and the incidence of diseases. These variables included
rainfall, temperature, humidity and winds. Even though this research has been done since
the 1920s, significant advancements in climate data availability has led to the increase in
demand for new operational disease early warning systems.
Health scientists want to be able to give updates saying that there is a 10 percent
chance of showers today, but a 70 percent chance of flu next month [3]. These Health
scientists and researchers are trying to move towards a forecast system that can
accurately track and predict the spread of deadly diseases through meteorological data
[1]. Health officials believe that these types of software could be used to fine-tune
vaccination campaigns for prevention efforts for common and uncommon diseases [3].
The software that is being developed has both a disease prevention/tracking component
as well as a meteorological/climate data component. The disease prevention component is
similar to most other disease tracking software that looks at hospital/clinic reports,
outbreak potentials and land conditions. The World Health Organization is a leading
agency that coordinates global response to any major diseases. The WHO is in charge of
maintaining a website [9] to give accurate and up-to-date descriptions of active disease
outbreaks worldwide. The climate component of the new software incorporates over 100s
of years of metrological data that can be analyzed to show average rainfall, average wind
speed and direction as well as average high and low humidity and temperatures. Relating
current disease locations with the deviation from average of these climate variables could
give a good understanding and reason to why there was a diseases outbreak and can even
be used to determine where the disease may spread to next.
As described by the World Health Organization
(see Figure 1), a framework for developing climate-
based early warning systems for infectious diseases has
to be able to evaluate epidemic potential and to identify
geographical location of epidemic [2]. The software
must also have early warning detection components to
monitor the disease risk factors. Having a control
response is mandatory to ensure prompt and effective
reaction to disease outbreaks. Post-epidemic
assessments for early warning systems are necessary to
see if they were effectively used to their full potential
and if there were any plans that needed to be modified.
This type of framework is what all early warning
systems need to consider, but specifically for climate based early warning systems, the
early warning detection component must display accurate climate data to be able to
precisely predict the diffusion/outbreak.
An example of popular software in the world of infectious disease tracking is
IBM (International Business Machines)s new Weather Map software. The software
was developed with the help of John Hopkins University and the University of California,
San Francisco [8]. The Weather Map software can create an epidemiological model for
how an infectious disease is likely to geographically spread over time based on certain
parameters [7]. With customizable models that have different variables including
climate records, airport locations, road maps, travel patterns, migratory routes and much
more, this software is unlike any other disease prediction software in the market. The
software is called Spatio-Temporal Epidemiological Modeler (STEM), and is so unique
Figure 1. Saving lives with climate data. [8].
because the main goal is for people to work together to build models to respond to
emerging epidemics and ultimately save as many lives as possible [7]. IBM believes that
to be able to track infectious diseases by weather patterns; international collaboration is
essential to developing these models. The STEM Software gives the opportunity to plan
and predict health crisis scenarios on a global scale and models the spread of diseases
much like modeling a storm or hurricane. The STEM Software is not the only software
that aims to track infectious diseases through weather patterns, but is one of the most
recent and highly developed software.
There are many examples of different diseases that can be tracked through
weather patterns and each diseases uses different applications to track the progress of
diffusion. As previously mentioned, the STEM system is a new way to track and predict
the diseases but recent developments in weather tracking technology has helped satellites
become a much more sophisticated computer data processing application. Other software
applies some of the latest models of computing technology and mathematical skill and in
the last decade, theres been a noticeable improvement in weather-focused disease
modeling [3]. Satellite imagery plays a crucial role in the effectiveness to respond to
disease predictions. These satellite imagery systems have been developed by
organizations such as US National Aeronautics and Space Administration (NASA)s
Earth Observing System [1], which are not always perfect. These complex satellite and
STEM applications could have some incomplete information, which would ultimately
result in false alarms or missed outbreaks. Although not always correct, these data
sources combine population statistics and disease path algorithms to build a realistic
model of the transportation of infectious diseases. Similar software incorporates visual
radar and LiDAR (light detecting and ranging radar) to really hone predictions of some
diseases down to a tree line [1]. These software rely heavily on ground based
measurements and observations and also allow researchers to look at what is happening
at a satellite imagery level. With the use of these applications and technologies, there are
a variety of potential diseases that have been able to be tracked using climatological data
and variables, which will now be discussed.


Dengue Fever [5], [8], [10]
Dengue Fever has only recently been linked to variations in rainfall and has since gained
a lot of attention for the potential to track and prevent the spread of this fever. In recent
years, Dengue Fever has spread to over 100 countries, including the United States [8]. As
previously mentioned, using the STEM Software, researchers are building models on top
of models and integrating them with location-specific climate data to model mosquito
movements that relate to dengue fever. Similarly, Columbia Universitys International
Research Institute for Climate and Society (IRI) has been given over $900,000 by
Google.org to map the emerging dengue fever worldwide.
Google.org is an organization that develops technologies to help address global
challenges and supports innovative partners through grants and investments [10] [11].
As seen in the following map, one of their recent projects looks at historical data for
dengue activity in certain areas. Then, using other climate and weather prediction models,
depending on if the current estimate is higher or lower than the baseline, Google Dengue
Trends reports general dengue activity as Minimal, Low, Moderate, High or Intense.


Using this software, people are able to see the dengue activity in their region of the
world. As seen from the Google predictions, there is no data and no predictions for all of
Africa, and due to this lack in data, more research is being conducted in this area.
Currently, the IRI is focusing much of their efforts in Eastern Africa, but specifically in
Ethiopia, where almost two thirds of the population lives in epidemic-prone regions.

Malaria [4], [5], [6], [8]
Malaria is responsible for nearly 1 to 3 million deaths in sub-Saharan Africa each year,
with most of them being children. These death rates due to malaria could be increased
due to meteorological factors such as changes in temperature and precipitation. New
technology has realized that previous methods have not been accurately measuring how
temperature is likely to affect both the intensity and distribution of the malaria outbreaks.
New advancements in technology have realized that more climatological variables such
[10]
as low humidity, low water levels, and climate change play a much larger role in
determining where the disease will spread to next. Tom Burkot, of the CDC says,
I think when people think about climate change, they only think about the old
term of the climate heating up, and really its the rainfall patterns which I think
are more important for malaria transmission. More rain is generally better for
malaria because you get more breeding sites being created [6].
Using cooler conditions with the tracking software described earlier will result in
underestimating parasite development while warmer conditions do the opposite.
Scientists and researchers of IRI (described earlier) use predictions about rainfall patterns
for the upcoming season and track where outbreaks frequently occur to determine where
the worst epidemics of malaria may be in a given year. At these locations, drugs and
vaccines are administered and anti-mosquito bed nets and sprays are distributed. Such
efforts by the IRI have already helped significantly reduce malaria outbreaks in countries
such as Botswana, Columbia and Senegal.

Avian Flu [1], [4], [7]
Remote data and software that has been described has already been used to help map the
avian flu in Asia. By looking at weather changes and vulnerability of the habitat of the
domestic duck, the flu can be easily tracked. The common place for the duck to live is in
the Southeast Asian rice paddies. Both the duck and migratory birds are carriers of the flu
and by tracking their migrations; the flu can be tracked as well. Their migrations are
effected by temperature changes and by gathering land use data and temperature
information from satellites, researchers are able to track the spread of the flu by
determining where the birds will travel and bring the disease to. A map of potential hot
spots of virus transmission can then be made after the analysis of the bird migration
patterns and poultry production information, which are both affected by different weather
conditions. As previously mentioned, the STEM System application has been used by the
Global Pandemic Initiative to create an epidemiological model to see how bird flu is
likely to geographically spread over time based on important parameters like population,
airport locations and bird migratory routes not just in one country or continent, but
around the world.

Influenza [1], [3], [4], [11], [12]
Many respiratory infections are well known as highly climate dependent or seasonal [4]
and Influenza is one of those infections. The pandemic spread of the H1N1 swine flu and
continued spread of the H5N1 Avian Flu has sparked attention to develop better flu
tracking technologies. The National Academy of Sciences [3] has published findings that
after the implementation of the STEM and Satellite software, they were able to say that
flu cases in New York City could be forecasted seven weeks before the peak of the flu
season. They did this by designing a more advanced model to incorporate weather data,
flu data and humidity readings from past years (2003-2009) to reveal that flu travels
fastest when air is dry but then turns colder. Similar to the Dengue Trends that
Google.org has been predicting, Google.org has uses Google Search data to estimate
influenza search activity for a number of countries, in real time. They compare the search
data to official historic influenza data to determine if areas have a higher or lower risk
due to the temperature, humidity and wind effects.

As seen from above, highlighting the United States shows that based on average
historical data of Google searches, the current flu activity is low, whereas Mexico and
Russia have areas of moderate flu activity. The Google.org data can even go more in
depth, per country and even city to compare past data models and climate variables.
Figure 2 shows a more zoomed in version of the United States, breaking up the flu
activity outlook by each state. Figure 3 even goes more in depth to show the past (under
the axis for years 2012-2013) and current flu (2013-2014) activity in the city of
Philadelphia.


Even though influenza is mostly a wintertime diseases in temperate climates (due to
changes in temperature), Google is able to determine through climate data that are both
winter and summer peaks for influenza outbreaks in subtropical and tropical regions. Due
to different climate regions, peaks occur at different times for each country. By using
Googles Public Data Explorer [12] and Tobler's first law of geography, Everything is
[11]
Figure 2. Figure 3.
related to everything else, but near things are more related than distant things, we can
see how countries with similar climates have similar influenza outbreak patterns. We see,
in Figure 4 that when we try to compare the spikes in flu related searches in the United
States and Australia, the increased search times were not in sync.


When we compare the same type of data (increase in flu related Google Searches),
between the United State and Canada (Figure 5) and Australia with New Zealand (Figure
6), we see a strong correlation among the peaks of increased flu related searches. This is
mainly due to the climate data that affects the increased flu outbreaks and shows how
dependent the outbreaks are on climate variability.


Figure 4. Google Public Data Explorer.
Flu Search Activity (standard deviation
from baseline. Web. Australia and
United States.
Figure 5. Google Public Data Explorer. Flu
Search Activity (standard deviation from
baseline. Web. Canada & United States.
Figure 6. Google Public Data Explorer. Flu
Search Activity (standard deviation from
baseline. Web. New Zealand & Australia.
Rift Valley Fever [2], [3]
Based on climatological conditions and variables, some early warning systems (EWS) for
Rift Valley Fever have been developed in select locations worldwide. Rift Valley Fever is
a virus that spreads from animal to humans and can potentially cause blindness or death.
These EWS are used to alert ministries of health about the potential for increased risks of
outbreak and ultimately help improve the preparedness of each country. The Risk
Maps/ EWS for Rift Valley Fever (RVF) use satellite imagery and combine data on
rainfall, measured sea-surface temperatures and cloud density to help track and predict
the virus. Since certain areas around the globe are more prone to RVF, coverage and
tracking of this fever is patchy. Due to advancement of software and knowledge about
this virus, improved research in some cases has given two to six weeks advance warning
on the diffusion of this virus. Although two to six weeks do not seem like a long time, it
is an enough time to spread awareness and eventually save countless amount of lives that
could have otherwise been infected.

Waterborne Diseases [4]
Water and climate are intimately related to each other and thus, precipitation and extreme
natural events have been associated with the increase in some waterborne diseases
outbreaks. Flooding is by far the most frequent natural weather phenomenon, which
affects over 70 million people worldwide each year. Common disease outbreaks that are
associated with floods include cholera, typhoid, hepatitis/jaundice, leptospirosis and
tetanus. Due to floods and sea-level rise, there has been a noticeable increase in these
diseases diffusions in specific areas of the world (that are most affected). It is interesting
to think about what the next couple of decades could mean for sea-level rise due to
climate change. A rise in sea-level on a national or international level, combined with
increased severe weather events, is likely to make flooding events and diseases that are
associated with flooding much more common and thus, much more harmful.

Cholera [1], [3], [4]
Satellite imaging has been used to help warn outbreaks of cholera. Due to climate change,
the outbreaks of cholera are predicted to worsen and become much more commonplace.
The satellites relay information regarding water surface temperatures, which is a key
component in this waterborne disease. Receiving information about small changes in
average temperatures in Africa was big enough warning sign to predict that cholera was
coming and would double within four months. Using and analyzing the weather data
collected, one study found that giving prevention instructions such as filtering water
through a Sari cloth could reduce the amount of cholera-related deaths by over 50% in
some areas! Developing a viable forecast system to be able to give early predictions on
the spread of cholera significantly helps to decrease the amount of people eventually
infected. Also, being able to know when an outbreak of cholera may happen allows
public health workers to stress basic hygiene and sanitation that can further decrease the
probability of getting infected. Due to the rapid development and advancement of the
satellite systems, there is strong conscience that satellite imaging provides significant
promise for the prediction of cholera and could eventually give notice of weeks or even
months in advance of an epidemic. Specifically, considerable work has gone into
predicting outbreaks of cholera in both Bangladesh and South America. This is because
recent increases in outbreaks have forces the development of prediction software to
ensure potential tremendous outbreaks are known well in advance.

West Nile Virus [3]
West Nile Virus is very difficult to forecast based on weather predictions. This is an
ongoing virus that has resulted in over 240 deaths in the past year [2012]. The virus can
be specifically tracked because milder winters, earlier spring and very hot summers are
all conditions that increase potential for the virus. These conditions help the mosquito
population breed faster, thus spreading the virus earlier, which in turn, infects the most
amounts of citizens. Due to temperature differences, the spread of the virus in past years
has not been uniform. In the past few years, areas such as Texas and other central,
southern states that have similar weather patterns were hit harder with the virus. Areas
with similar ecological conditions and similar weather patters share the same possibility
of diffusion since temperature and climate data significantly affect the spread of the virus.

Hantavirus Pulmonary Syndrome [1], [3], [4]
Hantavirus is a pulmonary disease that is spread by rodents and after much research, has
been linked to changes in precipitation. There was an outbreak of HPS in the
southwestern part of the United States in 1993 and was linked to the abnormally high
rainfall. It was determined through climate records that there was an association of the
outbreak due to high El Nino precipitation that year. These increased precipitation
amounts resulted in increased vegetation, which made the rodent population significantly
increase during that year. After that incident, researchers were able to study patterns of
plant growth, to determine which plans attract the most rodents in order to predict further
outbreaks. Pinpointing these areas before an outbreaks potentially starts buys precious
time to spread awareness to public health officials, thus, saving more lives.

Other [1], [2]
Each of the previous diseases that have been mentioned was tracked using the help of
weather patterns. There are an extensive amount of diseases that could also use
climatological variables to track their spread and eventually be prevented using weather
pattern software and analysis. Other diseases that rely on temperature, pressure, humidity,
sea-level/water rise and other weather variables include Limes Disease, Meningococcal
Meningitis, African Trypanosomiasis, Yellow Fever, Japanese Encephalitis, St. Louis
Encephalitis, Leishmaniasis, Ross River Virus and Murray Valley Encephalitis.
As evident in the amount of diseases that can be tracked and thus predicted using
weather patterns, there is certainly a high demand for this type of disease tracking
technology, thus career options are endless. As new technology is emerging for tracking
diseases through weather patterns, so are potential jobs and careers in the GIS field.
Careers as possible projection analysis can help to improve software and predict as many
diseases as possible and would significantly advance the field of diseases tracking.
As seen by the previous examples, infectious disease events can be closely related
to environmental and global change, in specific, climatic variables can really help to
accurately track and predict the diffusion of different diseases. New and different
software as well as satellite imagery can be critical in effectively predicting these
diseases. It is clearly evident from all the applications described throughout this paper,
that a strong global satellite program as well as a strong global infectious diseases
surveillance system are essential for future diseases prediction [4]. The ultimate reason
for predicting infectious disease diffusion is to be able to save lives of those who may
become infected. This mission is even more so of an issue in the third world, where
climate records are not nearly as good as they are in other places. Predicting weather
patterns, as well as diseases will never be 100 percent accurate, but Director of the IRI
believes that mapping hotspots can help reduce the spread of these killer diseases and
save countless lives [5]. Ultimately, predictive modeling such as diseases tracking using
weather patterns will lead to an improved understanding and eventually prevent future
epidemics of pandemic diseases. As presented in this paper, within several decades, there
have been significant resources toward eradicating, vaccinating, treating and predicting
potential disease outbreaks. Imagine what another several decades could mean for this
developing technology and the countless lives this technology will be able to save in the
future.






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