Data alerts community when sickness lurks
What if you could check the “forecast” for respiratory illness as easily as you can check the weather? Would it influence your decision-making?
Would you feel better knowing what bug is going around?
Many people would say yes, and that’s why Public Health Madison & Dane County launched its interactive Respiratory Illness Dashboard last fall. The easy-to-use data tool offers a quick snapshot of the current levels and trends of respiratory illnesses in the area, including influenza, COVID-19, human metapneumovirus, parainfluenza, rhinovirus, enterovirus, and respiratory syncytial virus (RSV). It also offers a prediction of whether cases of flu or COVID-19 are about to spike.
The data come from a variety of sources, including UW School of Medicine and Public Health research projects that measure respiratory illness in the community, as well as ongoing wastewater surveillance within the Wisconsin State Laboratory of Hygiene (an auxiliary unit of the school). These hyper-local data sources helped the county-level dashboard tool garner a Model Practice Award, in recognition of exemplary and replicable outcomes in response to a public health need, from the National Association of County and City Health Officials this month.
“In the U.S., we too rarely take advantage of opportunities to combine and analyze data for some purpose that will improve public health,” said Dr. Jonathan Temte, associate dean for public health and community engagement who also serves as the medical director for the county’s public health department. “It can be expensive and time-consuming. But these were natural, organic partnerships and public health staff has done a tremendous job of analyzing and visualizing the data in a way that is easy to access for virtually everyone.”
Inspired by the success of the COVID-19 Dashboard (launched in 2020 and drawing most of its early data from PCR testing), the Respiratory Illness Dashboard began taking shape in late 2022, according to Katarina Grande, who leads the epidemiology and data science team for Public Health Madison & Dane County.
“The COVID-19 Dashboard was the health department’s most-viewed web page of all time,” said Grande. “It showed us that people are hungry for this kind of data. We were at a moment in the pandemic where the data sources for the virus were changing, and we decided to pivot from focusing on just COVID-19 and broaden to a respiratory illness focus.”
Grande and her team held conversations with groups that are often disproportionately affected by respiratory illness—library directors, childcare centers, long-term care facility leaders and older adults—and discovered that people wanted to know the “forecast.” Not just “what is circulating now?” but also “what outbreak might be lurking in the near future?”
That’s where the UW data sources proved invaluable.
Linking student absenteeism to community illness
Temte and his research team have been studying child absenteeism in the Oregon public schools as a predictor of respiratory illness in the community since 2014. The project, known as ORCHARDS (ORegon CHild Absenteeism Due to Respiratory Disease Study), collects absenteeism data through Infinite Campus, an electronic student information system, and confirms its viral causes through follow-up home visits and tests. The team’s most important finding, said Temte, was that when absenteeism due to illness spikes in schools, a corresponding spike in community influenza cases follows roughly 10 days later.
Grande’s team wasn’t aware of Temte’s long-running ORCHARDS project until the subject of the new respiratory illness dashboard came up.
“We said, wait a second! We have a local team that has made a connection between absenteeism in schools being predictive of flu spreading in the community? That is exactly the piece of data we need to build out the predictive component of our dashboard.”
Temte envisions the dashboard being used by schools, teachers, clinicians, urgent care providers and others who are hit hard by respiratory infections.
“Another useful purpose could be planning within long-term care facilities,” he added. “If you know that flu is in the area, turning on a preventive approach, like early detection, could more than pay for itself.”
Tracking viruses in the air
David and Shelby O’Connor, professors of pathology in the UW School of Medicine and Public Health’s Department of Pathology and Laboratory Medicine, contributed data to the dashboard through local air sampling. In 2021, the O’Connors began talking with Public Health Madison & Dane County about placing air samplers in schools (starting with the Oregon district, through ORCHARDS). At that time, they were looking for airborne SARS-CoV-2, the virus that causes COVID-19, as a novel approach to tracking it. Experience had taught them that strong community partners were essential to success.
“We didn’t want to be these rogue virologists showing up in school cafeterias,” recalled Dave O’Connor, who earned a doctorate in medical microbiology and immunology from UW—Madison. “We wanted to work with public health on a responsible way to collect the data.”
The Respiratory Illness Dashboard is the first in the country to include data from air samplers. Currently, 16 air samplers are set up in 15 schools. The AerosolSense instruments are about the size of a microwave and feature small plastic cartridges equipped with tiny foam sponges. The samplers run continuously for a couple of days and then the cartridge is removed, the sponge is squeezed out (along with the viruses it has collected) and researchers begin analyzing the results—which are not limited to COVID-19. The data are shared with the public health department and inform the First Alert portion of the dashboard.
“The idea that we can take a big swing at problems like this, that might have benefits beyond the university’s borders, is enabled by the Wisconsin Idea,” said Dave O’Connor.
Monitoring COVID-19 in wastewater
A third School of Medicine and Public Health contribution to the dashboard comes from the Wisconsin State Laboratory of Hygiene. Laboratory personnel sample wastewater throughout Wisconsin to assess the level of COVID-19 in the population as part of the Wisconsin Wastewater Monitoring Program, which also includes contributions from the Wisconsin Department of Health Services and the University of Wisconsin-Milwaukee. The collaborative partners were early pioneers in developing and applying wastewater-based surveillance during the COVID-19 pandemic. In 2023, the Centers for Disease Control and Prevention (CDC) named the Wisconsin Wastewater Monitoring Program a National Center of Excellence.
“I think that Madison and Dane County are unique,” said Grande. “Making data actionable is deeply imbedded in my team’s values, and we are so lucky to have the UW here to collaborate with us.”
Explore more ways UW School of Medicine and Public Health researchers are advancing public health through data sharing:
- The City of Milwaukee’s 2023 water equity plan is guided by the Area Deprivation Index from our Center for Health Disparities’ Neighborhood Atlas.
- The 988 Suicide & Crisis Lifeline Data Dashboard offers a snapshot of suicide risk in our state, thanks to a collaboration between the school’s Population Health Institute and the Wisconsin Department of Health Services.