Company warned officials
of flu 18 days before alert was issued

By Les Blumenthal        | McClatchy Newspapers

<http://www.mcclatchydc.com/251/story/67283.html>Company warned 
officials of flu 18 days before alert was issued | McClatchy

WASHINGTON - A Washington state biosurveillance firm raised the first 
warning about a possible outbreak of swine flu in Mexico more than 
two weeks before the World Health Organization offered its initial 
alert about a public health emergency of international concern.

Both federal and international health officials had access to the 
warning from Veratect Corp. Later e-mails calling attention to the 
company's subsequent report that the disease was possibly spreading 
in Mexico were sent to 10 officials of the Centers for Disease 
Control and Prevention, said Robert Hart, the company's chief 
executive.

Hart said he wasn't sure why health officials didn't act sooner.

"They have a lot of other responsibilities," Hart said on Thursday. 
"But every day makes a difference."

CDC officials in Atlanta said they were aware of Veratect's claims 
and hadn't been working with the company.

"We have nothing to add about their claims," said CDC spokesman 
Llelwyn Grant, adding that the CDC and other public health agencies 
had plans in place to deal with a flu pandemic and responded rapidly 
once they became aware of the Mexican outbreak.

Veratect, based in Kirkland, Wash., uses a technique known as "data 
mining" to automatically search tens of thousands of Web sites daily 
for early signs of looming medical problems or civil unrest anywhere 
in the world. Anything of interest is turned over to a team of 35 
analysts to determine its significance and to post on the company's 
Web site. The company markets access to its Web site to government 
agencies, businesses and others and has tried unsuccessfully to sell 
its service to the CDC, the World Health Organization and the 
Department of Homeland Security.

Rep. Norm Dicks, D-Wash., who talked with the CDC, the Department of 
Homeland Security and other agencies as late as January about 
Veratect, said the federal government had made a mistake in not 
purchasing the company's program, especially in light of the flu 
outbreak.

"I am very upset about this," Dicks said. "Not to have it is totally 
ridiculous. This is a perfect example of why they needed this and now 
we are paying a price."

Earlier this year, Hart said, Veratect gave free access to its Web 
site to the CDC and the WHO on a trial basis.

On April 6, 18 days before the WHO issued its alert, Veratect 
reported on its Web site a strange outbreak of respiratory disease in 
La Gloria, Mexico, noting that local residents thought the outbreak 
was linked to contamination from pig breeding farms nearby.

Hart said the information was available to the CDC and many state and 
local health authorities. The company's server showed an 
epidemiologist at the Pan American Health Organization, which is part 
of the World Health Organization, looked at the message about the La 
Gloria outbreak twice, on April 10 and 11, Hart said.

Ten days after the warning was first issued, on April 16, Veratect 
reported the disease was possibly spreading in Mexico with an 
"unspecified number of atypical pneumonia cases" detected at a 
hospital in Oaxaca. Because of the heightened concern, an automated 
e-mail was sent to 10 people at the CDC to notify them the report was 
available.

With the outbreak apparently spreading, Hart said the company's chief 
scientist, James Wilson, called people he knew at the CDC's Emergency 
Operations Center on April 20 to alert them to what was happening in 
Mexico. At that point, the CDC was focused on possible swine flu 
events in Texas and California, and a physician at the emergency 
operations center indicated the CDC was not aware of the spreading 
outbreak in Mexico, Hart said.

"We thought this deserved immediate attention and they started 
looking at it," Hart said.

Four days later, the World Health Organization made its announcement.

Veratect's warnings came as President Barack Obama prepared for his 
trip to Mexico, arriving in Mexico City on April 16. The White House 
said Thursday that an Energy Department staffer who was part of the 
advance team for Obama's visit is suspected of having contracted 
swine flu in Mexico and transmitting it to his family in Maryland. 
White House spokesman Robert Gibbs said the man, who wasn't 
identified, never got within six feet of the president.

Hart said his company's system operated as it was supposed to.

"We don't make predictions," he said. "We give the earliest wisp of 
smoke before the fire."

Hart said he wasn't critical of the CDC or other health 
organizations, adding that what was needed was an effective global 
health monitoring system that Veratect should be a part of.

"Hindsight is great and it's hard to say whether (the delay) altered 
anything," he said. "The only way to stop anything like this is to 
break the cycle."

Others, however, cautioned that the use of data mining to track a 
possible disease outbreak was untested and said a number of questions 
about its effectiveness remained unanswered.

"This approach is not yet vetted," said Dr. Marguerite Neill, an 
infectious disease specialist at Brown University and a spokeswoman 
for the Infectious Disease Society of America. "It is an interesting 
idea, but we haven't used it before."

Neill said the problem with using information picked up through data 
mining was determining whether it was just an indication of a routine 
disease outbreak or something much more serious.

"It needs to be put in a clinical or epidemiological context," she 
said. "I'm not sure Veratect can do that."

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