AI, Spike in Respiratory Illnesses, & Vaccine-Preventable Disease Outbreaks

Three Things Thursday -- the good, the bad, and the ugly of January 2024

Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. This week I am paying attention to the use of AI in medicine, the increases in respiratory illnesses following the holidays, and outbreaks of measles & pertussis in the early weeks of 2024.

Hoping this post helps to educate and empower you
to be healthy and create healthy communities.

AI Identifies Social Determinants of Health in Medical Records

Yesterday a new study — Large Language Models to Identify Social Determinants of Health in Electronic Health Records — was published in npj Digital Medicine. The research team using large language models/AI (think: chatGPT) was able to identify 93.8% of cancer patients with adverse social determinants of health. ICD-10 codes, which are medical diagnosis codes, captured only 2%.

In short (and why I am so excited about this study and its findings), large language modules, like chatGPT, did better at mining patient records and finding their social needs than healthcare providers.

The social determinants of health —

“Include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Addressing social determinants of health is important for improving health and reducing longstanding disparities in health and health care.”

Screening for the social determinants of health in medical records is challenging. It can be hard for a physician to see that a patient has mobility issues or trouble getting to the pharmacy to pick up a prescription. Issues such as loneliness, not eating enough, or not being able to safely move around their home are hard to identify in medical records. However, each of these social determinants of health is key to a patient’s health and recovery. Identifying these social issues and addressing them is how we create healthy communities to create healthy individuals.

One of the study authors told STATNews —

“As a physician trying to understand a patient’s needs, you’re trying to do a needle in a haystack type search for clinical information. Patients oftentimes have thousands of notes.” ~ Danielle Bitterman

Before AI, like chatGPT, can be used in a clinical setting, we need to ensure that it can accurately and equitably extract data about the social determinants of health from medical records. More research and testing is needed. But this is an exciting start and use of AI in medicine…

Big Increases in Respiratory Diseases

It’s been 10 days since the holidays wrapped up and there is A LOT of sickness out there. According to the CDC —

“Seasonal influenza activity is elevated and continues to increase in most parts of the country.”

One out of every 14 doctor visits in the US last week were for influenza-like illnesses. During the last week, seven children died of influenza (a total of 27 to date).

In addition to influenza, COVID-19 is also on the rise. Wastewater levels of the SARS-CoV-2 virus — one of the earliest indicators of community spread of disease — are VERY HIGH. Thanks, to the JN.1 subvariant, which has become the most popular of them all in 2024.

COVID-19 hospitalizations have increased by more than 20% in the past week.

There is also a lot of RSV around (still). Some of the models are showing that the number of cases has peaked; others are showing we may have a week or two left in the high season. Only time will tell…

In the midst of respiratory disease season —

It is NOT too late to get vaccinated. Go get your COVID and flu vaccines TODAY. And if you are eligible, get your RSV vaccine.

Additionally, be sure to —

Wash our hands

Lay low (and avoid crowded places)

Wear a mask (Be sure to wear a mask in healthcare settings)

Commit to staying home when we are sick.

Measles & Pertussis Outbreaks in Pennsylvania

For a few months now, I’ve been writing about the decline in routine vaccination rates. And I am VERY concerned about vaccine-preventable diseases becoming epidemic.

Unfortunately, those fears became a reality this week…

The Philadelphia Department of Health has issued a warning to the public about a measles outbreak and potential public exposure to the virus. To date, eight individuals have been diagnosed with measles. Of those diagnosed, more than 60% are hospitalized; measles causes serious respiratory symptoms, brain swelling (encephalitis), and a high fever. The first case, diagnosed at Children’s Hospital of Philadelphia in early December, was an infant who was exposed to the disease during international travel. In the days following the first diagnosis, another child was diagnosed in a daycare facility in the city (yes, the kid was at daycare with measles).

The city has notified the public of several possible places and times of possible exposure to the virus. Measles is highly contagious; in fact, it is the most contagious disease on the planet. It is spread through the air from person to person. It can also be spread through droplets (think snot and sneezes).

According to vaccine surveillance data, 93% of children in Philadelphia (by age 6) are fully vaccinated against measles. This sounds like a lot; however, 95% of the population needs to be vaccinated for there to be herd immunity. More cases of measles in Philadelphia and throughout the surrounding communities are possible in the coming days and weeks.

In addition to the measles outbreak, both the Pennsylvania and New York Departments of Health are reporting outbreaks of pertussis.

Pertussis is a bacteria that causes a contagious upper-respiratory disease. It is also known as whooping cough.

Pertussis is vaccine-preventable.

The moral of the story… get vaccinated.

Those childhood vaccines that we are all supposed to get —

Are so important.
They save lives.
They prevent hospitalizations.
They keep you healthy.
They prevent the spread of diseases like measles & pertussis.

Get vaccinated.

Questions or comments about this week’s three things? or want to know more about childhood vaccines? or the spread of respiratory diseases in 2024? Please leave a comment.

And because health is not something you can do on your own & I need your help in making my dream for 2024 a reality — please share this post (and all the others with your friends and family).