Dashboard-Based Worldwide Infectious Disease Surveillance for Allied Forces

Gerd Großmanna, Alexander Zieglera

a Bundeswehr Medical Academy – Division MI2, Munich, Germany

Background

Force Health Protection (FHP) is a critical, albeit often overlooked, priority for achieving success on the battlefield. It is the responsibility of military commanders to ensure that their forces are medically ready and protected from health and safety threats. These threats include infectious diseases that may not only impair an individual’s health but also endanger mission successt when larger force populations are affected. Epidemiological surveillance represents an essential component of infectious disease prevention, encompassing the ongoing systematic collection, analysis, and interpretation of disease data. Within this framework it is of particular importance to disseminate findings in a timely and comprehensive manner to conduct adequate countermeasures. In the context of the SARS-CoV-2 pandemic, digital dashboards have demonstrated their efficacy as Command and Control (C2) assets (see Figure 1), facilitating information gathering and processing as well as decision-making cycle [3][4]. Subsequently, the Bundeswehr Medical Service has been engaged in the development of dashboards focusing on a range of infectious disease topics, including Mpox, African swine fever, avian influenza, and wastewater-based surveillance [1][2].

Fig. 1: During the COVID-19 pandemic, digital dashboards such as this overview on COVID-19 cases in the Bundeswehr have shown to be efficient tools for surveillance and management of threats to the health of military forces.

Here we present a novel dashboard, the FHP Explorer, which provides a range of features relevant to FHP, including worldwide infectious disease surveillance for allied forces.

Implementation

The FHP Explorer is based on a previous dashboard that had been developed in response to the crisis in the Eastern Mediterranean and Red Sea following the attacks by Hamas on Israel on October 7th, 2023. Proprietary software, namely ArcGIS (ESRI Inc., Redlands, CA, USA), is used to aggregate data on infectious diseases obtained from open and commercial sources. These include, but are not limited to, ProMED, BlueDot, WHO, EIOS, EPIWATCH, WOAH, ECDC, or the CDC. Each selected health event is briefly summarized in English and geolocated. During this task, information on infectious diseases is subjected to a screening and evaluation process to ascertain its relevance in a military context prior to incorporation into the source file of the dashboard. The file is updated and uploaded on a weekly basis. The data are then automatically displayed in the dashboard via a script developed to combine data derived from multiple independent source files. The FHP Explorer is divided into several sections, including a headline, tabs, filters, a legend, an interactive map, a statistics tool, and an event list (see Figure 2).

Fig. 2: Layout of the novel FHP Explorer showing the main functions of this internet-based dashboard with the main elements: (1) Headline with dashboard name, security classification, and date of last update. (2) Tabs with access to maps on infectious or animal diseases, food and water security, etc. (3) Contributor list. (4) Filters permit detailed event selection. (5) Map with interactive events as well as layer and basemap selection options. (6) Event window with detailed information on selected event. (7) List showing events in chronological order. (8) Legend with information on map options. (9) Statisctics tool provides analytical options for events.

Over the past year, an average of 10–20 disease-related events have been added per day. To reduce the amount of information displayed on the interactive map, individual events are removed following a period of two weeks. However, using the provided filter settings, past events can still be displayed if desired. The filters permit the selection of events based on a number of criteria, including date, status (e. g. new event or update from previous event), country of occurrence, category (e.g. infectious or animal disease), event type (e. g. A/H5N1 or dengue), and contributor. Moreover, the background map can be modified according to the user’s needs. To enhance visibility, events are color-coded based on their category.

Conclusion

The principal objective of the FHP Explorer is to furnish the commander and his or her staff – in particular, LMED, J2, J3/ J5, J4, J9, and CBRN elements – with current information on infectious disease outbreaks around the globe, animal disease outbreaks, as well as environmental and industrial hazards of operational relevance. The data displayed on the dashboard are classified as NATO UNCLASSIFIED (NU) – RELEASABLE TO INTERNET, thereby facilitating data sharing and communication between allied forces. In addition, the individual geographic information system (GIS) layers can be exported for integration into other ArcGIS environments, as well as other GIS software. The geolocation of information on infectious diseases and other events related to FHP enables the identification of patterns of occurrence and the delineation of hotspots, thereby facilitating epidemiological surveillance, the implementation of targeted FHP countermeasures, and ultimately C2. Furthermore, the FHP Explorer is available via the Internet, allowing approved users to access this tool from a variety of electronic devices, even in the field.

References

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  2. Frangoulidis D, Markt R, Barth, D et al.: Abwasserbasierte Infektionsepidemiologie – manchmal muss man für Innovationen auch im Trüben fischen. WMM 2024; 68(6): 283-289. mehr lesen
  3. Rabiei R, Bastani P, Ahmadi H et al.: Developing public health surveillance dashboards: a scoping review on the design principles. BMC Public Health 2024; 24: 392. mehr lesen
  4. Roßmann K, Andres B, Frangoulidis D et al.: Drei Jahre InfektInfo COVID-19. Arbeitsmedizin Sozialmedizin Umweltmedizin 2023; 58(4): 243-249. mehr lesen

For the Authors

Lieutenant Colonel Priv.-Doz. Dr. Alexander Ziegler

Bundeswehr Medical Academy, Divison MI2

Dachauer Straße 128, D-80637 Munich

E-Mail: alexander4ziegler@bundeswehr.org

Presented as a poster at the 55th Annual Congress of the Deutsche Gesellschaft für Wehrmedizin und Wehrpharmazie from November 14th to 16th 2024 in Augsburg, Germany.