Measles and Pertussis outbreaks in England and Wales: a time-series analysis

Shepherd, Thomas; Mallen, Christian

Abstract

Background
Vaccine coverage for common infectious diseases such as Measles and Pertussis (also known as whooping cough) have been declining in England and Wales since 2014. Consequently, significant increases in Measles and Pertussis cases are observed in the community.

Aim
To explore whether Google Trends offers a predictive utility as a health surveillance tool for Meases and Pertussis in England and Wales.

Design and Setting
Google search data related to Measles and Pertussis, including common associated symptoms, were downloaded for 52 weeks from 07/01/2023 – 07/01/2024. Measles and Pertussis case data were retrieved from the weekly Notification of Infectious Disease (NOID) reports.

Methods
The associations between searching and case data were explored using a time-series analyses, including cross-correlations, Prais-Winsten regression and joinpoint analysis.

Results
Significant cross-correlations were found for Measles cases and “measles” searching (r=.41) at a lag of -1 week. For Pertussis cases, searching for “whooping cough” (r=.31), “cough” (r=.39), “100 day cough” (r.41) and “vomiting” (r=.42) were significantly correlated at a lag of -3 to -2 weeks. In multivariable regression, “measles” remained significantly associated with Measles cases (β=.24, SE=.33, p=.02) as did “whooping cough” (β=.71, SE=.27, p=.01) and “cough” (β=1.99, SE=.54, p=.001) for pertussis.

Conclusion
Increases in Measles and Pertussis cases follow increases in online searches for both diseases and selected respective symptoms. Further work is required to explore how GT can be used in conjunction with other health surveillance systems to monitor or even predict disease outbreaks, to better target public health interventions.

Plain Language Summary
In England and Wales, declining vaccine coverage for Measles and Pertussis since 2014 has led to a resurgence of these diseases. This study explores the potential of Google Trends (GT) as a predictive health surveillance tool for monitoring Measles and Pertussis (Whooping cough) outbreaks. Google search data related to these diseases and their associated symptoms were analysed with disease cases data. Significant correlations were found between online search trends and disease cases, with Measles cases correlating with searches for "measles" and Pertussis cases with terms like "whooping cough" and "cough." These correlations suggest that increases in online searches precede rises in numbers of new diagnoses of measles and Pertussis, indicating GT could be useful in predicting outbreaks. Integrating GT with traditional surveillance systems could enhance early detection and response to disease outbreaks, enabling more targeted public health interventions. Further research is needed to explore the full potential and limitations of GT in disease surveillance and prediction.

Citation

Shepherd, T., & Mallen, C. (2024). Measles and Pertussis outbreaks in England and Wales: a time-series analysis. NIHR Open Research, 4, 56. https://doi.org/10.3310/nihropenres.13607.1

• Journal Article Type: Article
• Acceptance Date: Oct 7, 2024
• Online Publication Date: Oct 7, 2024
• Publication Date: Oct 7, 2024
• Deposit Date: Oct 8, 2024
• Journal: NIHR Open Research
• Print ISSN: 2633-4402
• Publisher: Taylor and Francis
• Peer Reviewed: Not Peer Reviewed
• Volume: 4
• Pages: 56
• DOI: https://doi.org/10.3310/nihropenres.13607.1
• Keywords: Measles, Pertussis, Whooping cough, epidemiology, health surveillance, vaccination
• Public URL: https://keele-repository.worktribe.com/output/949312
• Publisher URL: https://openresearch.nihr.ac.uk/articles/4-56/v1
• Additional Information: Referee status: Awaiting Peer Review; Grant Information: This project is funded by the National Institute for Health and Care Research (NIHR) under (Grant Reference Number NIHR 203020). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.; Copyright: This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.