TRACKING OF DISEASES FROM OUTER SPACE

ABSTRACT….Early identification of an infectious disease outbreak is an

important first step towards implementing effective disease interventions and
reducing resulting mortality and morbidity in human populations. In the majority
of cases, however, epidemics are generally well under way before authorities are
notified and able to control the epidemic or mitigate its effects. Both geographical
and seasonal distributions of many infectious diseases are linked to climate,
therefore the possibility of using seasonal climate forecasts as predictive indicators
in disease early warning systems (EWS) has long been a focus of interest. During
the 1990s, however, a number of factors led to increased activity in this field:
significant advances in data availability, epidemiological modeling and
information technology, and the implementation of successful EWS outside the
health sector. In addition, convincing evidence that anthropogenic influences are
causing the world’s climate to change has provided an added incentive to improve
understanding of climate-disease interactions. Projections indicate an approximate
average global warming of 2-5 ºC within the twenty-first century (IPCC 2001),
accompanied by an increase in the frequency of extreme and anomalous weather
events such as heat-waves, floods and droughts It has been widely speculated that
these projected changes may have significant impacts on the timing and severity of
infectious disease outbreaks.
.Index terms: GIS, EWS, epidemiology, Meningitis
.
1. INTRODUCTION

Last year more than a million people died of malaria, mostly in Sub-
saharan Africa. Outbreaks of Dengue Fever, hantavirus, West Nile Fever, Rift
Valley Fever, and even Plague still occasionally strike villages, towns, and whole
regions. To the dozens or hundreds who suffer painful deaths, and to their loved
ones, these diseases must seem to spring upon them from nowhere.

Yet these diseases are not without rhyme or reason. When an outbreak
occurs, often it is because environmental conditions such as rainfall, temperatures,
and vegetation set the stage for a population surge in disease-carrying pests.
Mosquitoes or mice or ticks thrive, and the diseases they carry spread rapidly.
 Mosquitoes and other pests are often to blame for the sudden outbreak of
an infectious disease. So why not watch these environmental factors and warn
when conditions are ripe for an outbreak? Scientists have been tantalized by this
possibility ever since the idea was first expressed by the Russian epidemiologist E.
N. Pavlovsky in the 1960s. Now technology and scientific know-how are catching
up with the idea, and a region-wide early warning system for disease outbreaks
appears to be within reach, Meningitis.

2. HISTORY

Ronald Welch of NASA's Global Hydrology and Climate Center in

Huntsville, Alabama, is one of the scientists working to develop such an early
warning system. "I have been to malarious areas in both Guatemala and India," he
says. "Usually I am struck by the poverty in these areas, at a level rarely seen in
the United States. The people are warm and friendly, and they are appreciative,
knowing that we are there to help. It feels very good to know that you are
contributing to the relief of sickness and preventing death, especially the children."

The approach employed by Welch and others combines data from high-
tech environmental satellites with old-fashioned, "khaki shorts and dusty boots"
fieldwork. Scientists actually seek out and visit places with disease outbreaks.
Then they scrutinize satellite images to learn how disease-friendly conditions look
from space. The satellites can then watch for those conditions over an entire
region, country, or even continent as they silently slide across the sky once a day,
every day.

In India, for example, where Welch is doing research, health officials are
talking about setting up a satellite-based malaria early warning system for the
whole country. In coordination with mathematician Jia Li of the University of
Alabama at Huntsville and India's Malaria Research Center, Welch is hoping to do
a pilot study in Mewat, a predominantly rural area of India south of New Delhi.
The area is home to more than 700,000 people living in 491 villages and 5 towns,
yet is only about two-thirds the size of Rhode Island.

In the Mewat region of India livestock is an important part of the

predominantly rural, subsistence economy. The presence of livestock facilitates
the spread of malaria and other mosquito-borne diseases, because the insects
prefer to feed on the animals' blood.

"We expect to be able to give warnings of high disease risk for a given
village or area up to a month in advance," Welch says. "These red flags will let
health officials focus their vaccination programs, mosquito spraying, and other
disease-fighting efforts in the areas that need them most, perhaps preventing an
outbreak before it happens

3. PREDICTING OUT BREAKS FROM OUTER SPACE

“Epidemiology has run out of steam on a lot of fronts,” says Dr. Fish
bluntly. “but now we have new tools, both micro and macro.” On the micro end
are molecular probes, which make it possible to study minute fragments of DNA
for clues to the identity of pathogens (microorganisms or substances capable of
producing disease). At the other end of the spectrum is remote sensing technology:
satellites that photograph the surface of the earth from several hundred miles up.
When that data is analyzed, and corroborated by old-fashioned legwork in the
field, the result is an extraordinarily detailed portrait of a piece of the planet--and a
powerful new tool for combating the spread of infectious disease worldwide
.
3.1. HOW CAN SATELLITES TRACK TINY MICRO ORGANISMS?
Eyes In the Sky
Satellites are our "eyes in the sky." Pictures of Earth from space have
radically altered our perception of our planet, and greatly improved our ability to
observe
the effects of environmental changes. Satellites
can’t--but they can create detailed maps of the
vegetation patterns, which characterize
different habitats. All infectious agents, and the
organisms that transmit them, are biological
entities which are restricted to particular
habitats,
whether marshes or riverbeds, dense forests or
open fields. This concept is hardly new to
ecologists and environmental scientists, but it has only recently begun to be
applied to the study of human disease--thanks to satellite images which can
identify specific environments, over large areas, anywhere on earth.
The idea behind this new field of study, which is called landscape epidemiology,
is that by pinpointing the areas where pathogen-friendly conditions occur,
scientists can predict where the risk of outbreaks is highest. Residents of those
areas can then be vaccinated and educated about preventive measures, and people
in low-risk areas can avoid getting unnecessary vaccines.

3.2 HOW DOES REMOTE SENSING WORK?

Many of the local and regional features that define ecosystems can be
recorded by instruments on aircraft and satellites. (This is called remote sensing or
RS). Specialized computer software (called geographic information system, or
GIS) can model the occurrence of these features in space and time, creating a
database that illuminates aspects of disease behavior over this same space and time
Satellite sensors record electromagnetic radiation (energy transmitted
through space in the form of waves) as a continuous stream of digital data. Remote
sensors consist of several detectors that record specific wavelengths of the
radiation. When analyzed, this data can reveal detailed information about land
features. The data is transmitted to ground reception stations and made available
through various commercial and government programs. Different vegetation
reflect or absorb light in unique ways, and show up as different digital values on
the satellite images; image processing software translate these values to a range of
colors used for analysis.

4.USING REAL TIM E GIS TO PREVENT DISEASE OUTBREAK

In the past year, India has seen many epidemic outbreaks, Bird Flu,
Chikungunya and Dengue. These diseases have been hard to contain and it has
been spreading from state to state. Today, technology exists that can provide
officials and the public timely and relevant information to help understand the
nature of the epidemic and control it.
Epidemics are very spatial phenomena. They originate in a location and
spread to other locations depending on the carrier of the decease and
environmental conditions. Getting a perspective on spatial distribution of the
outbreak combined with environmental conditions and socio-economic parameters
can help find patterns and prevent it from spreading further.
We studied about this very-cool mapping application called EpiScanGIS which
monitors Meningitis disease in Germany and helps detect outbreaks in timely
manner. This system maps all register cases of the disease as and when they
happen. This is displayed on a dynamic and rich interface along with other data
layers. This is where the power of GIS is evident. One can see the spatial pattern
of the occurrences and learn that cases are concentrated in population centers.
Turning on the layer for 'annual income' shows that there's isn't much correlation
with the places of high occurrence with income, But the population density data
identifies that disease is spreading fast in areas of high population density. It has a
time slider through which one can see how the disease has been spreading over
time. This is very helpful in detecting the pattern and predicting ( and hopefully
preventing) next outbreak.
There is also a built-in alert system, which automatically identifies cluster
of disease occurrences . Based on an algorithm, if the system determines it to be a
potential outbreak, it sends out alerts to local health officials.
4.1.IMPACT OF RESEARCH
The researchers hope to create confidence in the predictive power of GIS
and the reproducibility of the methods we develop towards other regions and even
other diseases. In doing so, we hope for a broader usage of GIS allowing for the
following three broad impacts:
a) Cost effective risk assessment
Manual surveys are cumbersome and time consuming. By using the GIS
technique, this expensive manual process can be avoided by updating data through
Remote Sensing images and mapping the resultant distribution of malaria vectors
(Anopheles mosquitoes) instantly.
b) Cost effective policy design
This technique can delineate the areas favorable for any species of flora
and fauna, which is very useful for targeting precision manual surveys. It also
allows control measures to be quickly applied towards areas with major outbreaks
and more importantly prevent outbreaks a priori by implementing prevention
measures in high-risk areas. Prevention, as stated earlier, is more cost effective
than control.
c) Reproducibility
The GIS tool can be used easily duplicated in other parts of the country or world.
For any disease, once the vector distribution is known, species-specific control
measures can be f formulated in cost-effective manner.
5. APPLICATIONS
5.1.CHOLERA
Since 1817 there have been seven mysterious global epidemics of cholera, a
potentially devastating intestinal illness caused by the bacterium Vibrio cholera.
The disease has long been linked to unsanitary water, but it was only recently
learned that V. cholera is a natural part of the food chain that feeds on
photoplankton. Warm water can stimulate photoplankton “blooms,” which can be
tracked by satellite images. Rita R. Colwell of the University of Maryland
Biotechnology Institute has been working with CHAART to explain and predict
the timing of cholera outbreaks. For example, coinciding with a historic warming
of Pacific waters, in 1991 cholera struck South America for the first time in a
hundred years.
Visceral leishmaniasis, a serious tropical disease typically transmitted by sand
flies in jungle habitats, has recently, and alarmingly, moved into urban centers.
Researchers are using satellite photographs of Brazilian cities to pinpoint the areas
with the highest infection rates so that prevention measures can be put into effect.
A “green corridor” of vegetation tends to link high-risk urban areas to the jungle,
leading researchers to suspect that foxes may be the vectors. This study “wouldn’t
have happened without the satellite images,” says James Maguire of the Harvard
School of Public Health
5.2. MENINGITIS

Duststorms are being mapped

for the ESA led epidemic
project. Image credit: ESA
 All those eyes in the sky are coming in handy for purposes scientists
never imagined. Now researchers from ESA are using Envisat data to track places
on Earth where disease epidemics could get started. The team was able to link the
outbreak of diseases in Africa with dryness and drought. So far they've been able
to track regions which are dry, which contribute to the spread of meningitis. Aid
workers can then target these regions to give vaccinations and provide early
warnings.
The amount of data acquired by satellites is increasing at an exponential rate, and
researchers are learning about the value of this data in fighting epidemic outbreaks
as a result of the ESA's Epidemio project. The ESA-funded Epidemio project was
developed in January 2004 to illustrate the benefits of remote-sensing data for
studying, monitoring and predicting epidemic outbreaks.
By using data which focuses on a region's landscape – rainfall, vegetation, water
bodies, elevation, dust mapping and temperature – researchers are able to pinpoint
climatic conditions which are favourable for harbouring various epidemic hosts,
indicating where people are at greatest risk.
Combining ESA Envisat satellite data, under the Epidemio project, on water
bodies, forest cover and digital elevation models (DEMs) with field results,
Moussavou and his team were able to link the epidemic with dryness and drought.
Moussavou said determining these factors will allow officials to tell the villagers
in the area that current conditions for transmission are high, and that they need to
take extra precautions. "Because there are no medicines to prevent or cure Ebola,
predictions and prevention are necessary."
Dry conditions are also favourable for the spread of meningitis, an inflammation
of the brain and spinal cord lining. Epidemics nearly always start in the early part
of the dry season when it is hot and dusty. For this reason, ESA has been
providing dust maps for high-risk areas to aid in implementing early warning
systems.
As the project draws to completion, epidemiologists and data users gathered in
Frascati, Italy, at the 'Earth Observation in Epidemiology Workshop', on 8-10
March 2006, to report on how Earth observation (EO) has benefited the field of
epidemiology.
Christelle Barbey of Silogic, in France, is currently involved in an Epidemio
project to provide wind blown dust maps for Africa. Although her final results are
still coming in, she was able to detect 100 percent of known dust events, using
MeteoSat data, and determine that dust maps do correspond to a user need to
contribute to meningitis prevention.
The Epidemio project - funded by the Data User Element of the ESA Earth
Observation Envelope Programme - concludes its two-year mission in April 2006,
but the groundwork it has laid will aid users in the continuance of their research
and allow new projects to be undertaken
5.3. MALARIA
Perfect predictions will likely never be possible. Like weather, the phenomenon of
human disease is too complicated. But these encouraging results suggest that
reasonably accurate risk estimates can be achieved by combining old-fashioned
fieldwork with the newest in satellite technologies.
"All of the necessary pieces of the puzzle are there," Welch says, offering the hope
that soon disease outbreaks that seem to come "from out of nowhere" will catch
people off guard much less often.
In India, for example, where Welch is doing research, health officials are talking
about setting up a satellite-based malaria early warning system for the whole
country. In coordination with mathematician Jia Li of the University of Alabama
at Huntsville and India's Malaria Research Center, Welch is hoping to do a pilot
study in Mewat, a predominantly rural area of India south of New Delhi. The area
is home to more than 700,000 people living in 491 villages and 5 towns, yet is
only about two-thirds the size of Rhode Island.
"We expect to be able to give warnings of high disease risk for a given village or
area up to a month in advance," Welch says. "These 'red flags' will let health
officials focus their vaccination programs, mosquito spraying, and other disease-
fighting efforts in the areas that need them most, perhaps preventing an outbreak
before it happens."
Documenting some of these factors, such as soil type and local bucket-leaving
habits, requires initial groundwork by researchers in the field, Welch notes.
This information is plugged into a computerized mapping system called a
Geographical Information Systems database (GIS). Fieldwork is also required to
characterize how the local species of mosquito behaves. Does it bite people
indoors or outdoors or both? Other factors, like the locations of cattle pastures and
human dwellings, are inputted into the GIS map based on ultra-high resolution
satellite images from commercial satellites like Ikonos and QuickBird, which can
spot objects on the ground as small as 80 cm across. Then region-wide variables
like temperature, rainfall, vegetation types, and soil moisture are derived from
medium-resolution satellite data, such as from Landsat 7 or the MODIS sensor on
NASA's Terra satellite. (MODIS stands for MODerate-resolution Imaging
Spectrometer.
Scientists feed all of this information into a computer simulation that runs
on top of a digital map of the landscape. Sophisticated mathematical algorithms
chew on all these factors and spit out an estimate of outbreak risk.
This pair of NOAA/AVHRR satellite images shows Kenya and surrounding areas
on December 1996 (A) and December 1997 (B). The greening reflects an increase
in rainfall, which created conditions for an outbreak of Rift Valley Fever in
December 1997. The basic soundness
of this approach for estimating disease
risk has been borne out by previous
studies. A group from the University
of Nevada and the Desert Research
Institute were able to "predict"
historical rates of deer-mouse infection by the Sin Nombre virus with up to 80%
accuracy, based only on vegetation type and density, elevation and slope of the
land, and hydrologic features, all derived from satellite data and GIS maps.
A joint NASA Ames / University of California at Davis study achieved a
90% success rate in identifying which rice fields in central California would breed
large numbers of mosquitoes and which would breed fewer, based on Landsat
data. Another Ames project predicted 79% of the high-mosquito villages in the
Chiapas region of Mexico based on landscape features seen in satellite images.
CONCLUSION
The key to success of such a system is accurate and timely data. We do not have a
central agency in India that records and monitors all the cases of a particular
disease. Also the distributed and unorganized nature of medical services makes it
hard to get this kind of data from a single source. The solution is to involve the
community of doctors, hospitals, health officials and even citizens. An application
similar to EpiSanGIS could allow this community to submit data on disease
occurrences in their area. The advent of Web 2.0 has shown that such
collaborative models for data collections work so much better than traditional
centralized methods. Also given that people have enough incentive in stoppi, a
people-powered GIS would be a very effective tool in preventing epidemics and
saving lives.
The interrelationship between infectious agents and their environments is
enormously complex, and researchers are just beginning to apply this new
technology to epidemiology. “You have to understand that there is not really much
hard data yet” “This science is really still in its pre-infancy.” Also, obtaining and
interpreting the data is only the first step. The challenge lies in acting on the
information in a way that will decrease the incidence of disease. Far-sighted
epidemiologists believe that remote sensing technology will enable them to do just
that: by targeting potential.
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Jay, R Jain - gisdevelopment.net
2) Remote Sensing and Geographic Information Systems (GIS) For Developing Countries, M.
Mohamed and R. Plante, Maryland , USA
3) GIS for Health and the Environment, Sharma V.P Tropical Medicine & International Health,
Volume 2, Number 5, May 1997, pp. 508-510(3)
4) http://orissagov.nic.in/health/nthlthprog.htm
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environmental health sciences ,Kistemann T.1; Dangendorf F.1; Schweikart J.2International
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TRACKING OF DISEAES FROM OUTER SPACE