Click http://google.org/flutrends for the real-time app. We've found that certain search terms are good indicators of flu activity. Google Flu Trends uses aggregated Google search data to estimate flu activity in your state up to two weeks faster than traditional systems. - Mitchell Tsai

See "Google search engine flags flu activity in U.S." [Reuters - 11/11/08] http://reuters.com/article... http://friendfeed.com/e... - Mitchell Tsai

Studies indicate that between 35 and 40 percent of all visits to the Internet are begun by people looking for health information. When people are sick, they tend to look up their symptoms. - Mitchell Tsai

Google Flu Trends uses search terms that people put into the Web-based search engine to figure out where influenza is heating up, and notify the U.S. Centers for Disease Control and Prevention in real time. Google is keeping the search terms it uses private, but influenza-like illnesses include symptoms such as fever, muscle aches and cough. Sneezing usually occurs with other viruses such as rhinoviruses. - Mitchell Tsai

"One thing we found last year when we validated this model is it tended to predict surveillance data," Finelli said. - Mitchell Tsai

"The data are really, really timely. They were able to tell us on a day-to-day basis the relative direction of flu activity for a given area. They were about a week ahead of us. They could be used ... as early warning signal for flu activity." - Mitchell Tsai

Influenza kills an estimated 36,000 people a year in the United States and 250,000-500,000 globally. - Mitchell Tsai

Experts are keen to track flu activity in case of a pandemic -- a global epidemic of a new and deadly strain of flu that could kill millions within a few months. - Mitchell Tsai

i hear the Google Flu is not as bad as it sounds, though... ;) - edythe

but seriously, mitchell, this is awesome. - edythe

Polly: I love this idea of using Google (and/or social networks)'s knowledge of what people are interested in to benefit society (and not just whether we're going to be terrorists). I'd love to see similar efforts in monitoring (1) what cancer patients are looking at for cures/treatments (2) what kids & adults are interested in (3) popular exciting travel spots - Mitchell Tsai

How can we move "news" to the next generation past (a) Digg/Reedit (b) Google News (c) Disqus/Google Reader/FriendFeed (d) Flickr/picture-sharing (e) Wikipedia. The "Google Flu monitoring" seems to be the 1st jump in bringing data-mining of social networks to new usefulness. What if we had a service which took "50 pages in Wikipedia most active" combined with some "educational benefit" metric to inform us about newly active topics? - Mitchell Tsai

Twitter/Summize combo kicks-butt for monitoring real-time events (1) earthquakes (2) elections... but it's still a huge swamp of info. Could services like "Google Flu Trends" pull out 100 interesting topics from all the Twitter traffic? (kind of big-brother for a good purpose) - Mitchell Tsai

i made a flu room! http://friendfeed.com/rooms... - Brian Ries

Thanks Brian. Nice flu articles. Many nations' leaders spend money REAL fast when faced with possible pandemics. They're not stupid... - Mitchell Tsai

Gregory, the profit margin on vaccines is actually quite low, which is why the pharmaceutical companies aren't inclined to produce tons of it. The influenza virus changes its genetic make-up every year, forcing the vaccine makers to anticipate what strain will be predominant, and sometimes the vaccine makers guess wrong. - Victor Ganata

http://reason.com/news... "In the past three decades, the number of vaccine manufacturers in America has plummeted, as the industry has been flooded with lawsuits." He added. "Today, there is only one manufacturer in the United States that can produce influenza vaccine." Since 1967 the number of American vaccine manufacturers has dropped from 26 to just 4 today. The problem is that vaccines are low–profit margin products sold for a few bucks per dose, yet potentially they expose manufacturers to hundreds of millions of dollars in liability. - Mitchell Tsai

...another example of how medical & legal reform are so closely intertwined... - Mitchell Tsai

Tough world of profits http://goliath.ecnext.com/coms2... (Good) Net product sales for the year ended December 31, 2005, increased 12 percent, or $155 million, compared to the year ended December 31, 2004, primarily due to $96 million in sales of FLUVIRIN vaccine in 2005, compared to $2 million in sales of FLUVIRIN vaccine in 2004, which related to late sales from the 2003-2004 influenza season. - Mitchell Tsai

(Bad) As previously reported, in the year ended December 31, 2004, the entire FLUVIRIN vaccine product inventory was written off, resulting in a $91 million charge to cost of sales. No sales of BEGRIVAC influenza virus vaccine in 2005 due to a product sterility issue - Mitchell Tsai

http://jhsph.edu/publich... It’s important to point out that the current vaccine crisis is an extreme example of what’s wrong with the vaccine supply system in the United States. Many people are quick to criticize industry, but making flu vaccine is really difficult. - Mitchell Tsai

Companies do not receive the virus strains for the vaccine until March. They are expected, on a very tight timeline, to get an egg supply, grow the vaccine and have it ready to ship by September or October. They charge anywhere from $8 to $22 a dose, which is not a large profit margin. - Mitchell Tsai

http://weeklystandard.com/Content... http://qando.net/details... Why is it that 100 percent of our flu vaccines are now made by two companies in Europe? Chiron was scheduled to supply 46 million of the 100 million doses to be administered in the United States this year. The other 54 million will come from Aventis Pasteur, a French company with headquarters in Strasbourg. ---- Trial lawyers drove the American manufacturers out of the business. - Mitchell Tsai

Today there are only four that make any type of vaccine and none making flu vaccine. Wyeth was the last to fall, dropping flu shots after 2002. For recently emerging illnesses such as Lyme disease, there is no commercial vaccine, even though one has been approved by the Food and Drug Administration. - Mitchell Tsai

All this is the result of a legal concept called "liability without fault" that emerged from the hothouse atmosphere of the law schools in the 1960s and became the law of the land. Under the old "negligence" regime, you had to prove a product manufacturer had done something wrong in order to hold it liable for damages. - Mitchell Tsai

Under liability without fault, on the other hand, the manufacturer can be held responsible for harm from its products, whether blameworthy or not. Add to that the jackpot awards that come from pain-and-suffering and punitive damages, and you have a legal climate that no manufacturer wants to risk. - Mitchell Tsai

In theory, prices might have been jacked up enough to make vaccine production profitable even with the lawsuit risk, but federal intervention made vaccines a low-margin business. Before 1993, manufacturers sold vaccines to doctors, doctors prescribed them to patients, and there was some markup. Then Congress adopted the Vaccine for Children Act, which made the government a monopsony buyer. The feds now purchase over half of all vaccines at a low fixed price and distribute them to doctors. This has essentially finished off the private market. - Mitchell Tsai

As recently as 1980, 18 American companies made eight different vaccines for various childhood diseases. Today, four companies--GlaxoSmithKline, Aventis, Merck, and Wyeth--make 12 vaccines. Of the 12, seven are made by only one company and only one is made by more than two. "There are constant shortages," says Dr. Paul Offit, head of the Vaccine Education Center at Children's Hospital of Philadelphia. "With only one supplier for so many vaccines, the whole system is fragile. When even the smallest thing goes wrong, children miss their vaccinations." - Mitchell Tsai

The intersection between mass vaccinations and the tort system was bound to be messy. When you vaccinate enough people, someone, somewhere, is going to have a bad reaction. You could give a glass of milk to 100 million people and a few would inevitably get violently sick from it. - Mitchell Tsai

The first instance of this came in 1955 with polio vaccinations. Cutter Laboratories, the California company that now distributes Cutter's Insect Repellent, made an early batch of vaccines, some of which had live viruses in them. Almost all the children in Idaho were administered the vaccine and several dozen contracted polio. - Mitchell Tsai

The jury found Cutter's actions were not negligent--the orders had been rushed, standards had not been clear, and safety precautions were still rudimentary at the time. But, using the new doctrine of liability without fault, the jury held Cutter accountable anyway and awarded $147,300. "That decision made Ralph Nader possible," Belli later claimed. - Mitchell Tsai

"It was a turning point," says Dr. Offit, whose book The Cutter Incident will be published next year. "Because of the Cutter decision, vaccines became one of the first medical products to be eliminated by lawsuits." - Mitchell Tsai

Yale Law Journal published an article arguing that insurance against adverse reactions was the solution. Unfortunately, this thesis failed to anticipate how high damage awards would go. - Mitchell Tsai

WHEN AN UNUSUAL EPIDEMIC occurred in 1976, the federal government decided to vaccinate the whole country against the new "swine flu." To the astonishment of Congress, the insurance companies refused to participate. The Congressional Budget Office predicted that with 45 million Americans inoculated, there would be 4,500 injury claims and 90 damage awards, totaling $2 million. Congress decided to provide the insurance. - Mitchell Tsai

As Peter Huber recounts in his book Liability, the CBO's first estimate proved uncannily accurate. A total of 4,169 damage claims were filed. However, not 90 but more than 700 suits were successful and the total bill to Congress came to over $100 million, 50 times what the CBO had predicted. The insurance companies knew their business well. - Mitchell Tsai

Adding to the problem are the predictable panics about vaccines that spread among parents and are abetted by trial lawyers. In 1974, a British researcher published a paper claiming that the vaccine for pertussis (whooping cough) had caused seizures in 36 children, leading to 22 cases of epilepsy or mental retardation. - Mitchell Tsai

Subsequent studies proved the claim to be false, but in the meantime Japan canceled inoculations, resulting in 113 preventable whooping cough deaths. In the United States, 800 pertussis vaccine lawsuits asking $21 million in damages were filed over the next decade. The cost of a vaccination went from 21 cents to $11. - Mitchell Tsai

Every American drug company dropped pertussis vaccine except Lederle Laboratories. In 1980, Lederle lost a liability suit for the paralysis of a three-month-old infant--even though there was almost no evidence implicating the vaccine. Lederle's damages were $1.1 million, more than half its gross revenues from sale of the vaccine for that entire year. - Mitchell Tsai

In 1998, the FDA approved a vaccine for Lyme disease, which strikes 15,000 people a year. GlaxoSmithKline manufactured it for three years but quit when rumors began circulating that the vaccine caused arthritis. - Mitchell Tsai

Each year in February, the Centers for Disease Control meets with the vaccine-makers--all two of them--and decides which strain of the virus to anticipate for next year. Then they both make the same vaccine. Last year the committee bet on the Panama strain, but a rogue "Fujian" strain suddenly emerged as a surprise invader. A mini-epidemic resulted and 93 children died, only two of them properly vaccinated. - Mitchell Tsai

Whether doctors are quitting the profession because of an out-of-control tort system, whether malpractice premiums are the cause of health care increases--such hardy perennials of the litigation debate are still a subject of lively controversy. But with vaccines there is no argument. Trial lawyers have all but ruined the market. Yet they are still unwilling to take responsibility. - Mitchell Tsai

What is frustrating about all this is that vaccination is such an easy intervention, and so many lives have been saved with near-universal vaccination against childhood diseases. When you do the cold-hard calculus comparing the number of adverse events versus the number of deaths prevented, it definitely seems worth it. Unfortunately, the mathematics of the legal and economic end of things don't agree. - Victor Ganata

Thanks Mitchell.. mind if I write this up for GoogleTutor? - Phil G

Victor: (A) It seems "right" that people might be compensated for dying due to a vaccine. (B) However, when a drug company's entire profit margin can be wiped out by 2 lawsuits, how can you do business? (C) We might look to the Japanese legal system which sets maximum damages. Or just ask people to "suck up". If you die due to vaccine (and it's not the manufacturers fault), that's the risk you take for the possible protection. - Mitchell Tsai

Phil: Feel free to write this for Google Tutor (what's that?). Journalistic disclaimer: I haven't triple-checked my sources... :-) - Mitchell Tsai

Similar question: If we go to a surgeon for a 95% effective surgery, do we sue the doctor for the 5% deaths? ---- Another industry with a different answer (Employee injuries): In worker's comp, people decided that employers will pay for everything, to save the legal fees from deciding everything in court. Thus, a homeowner would be liable for a mailman slipping on their icy driveway. - Mitchell Tsai

Mitchell: http://www.googletutor.com - A site related to all things Google. - Phil G

In terms of malpractice, pain and suffering caps seem to be preventing physicians from fleeing the state of California. Is it a different kind of tort law that pharmaceutical companies are subject to, or would such a thing apply? - Victor Ganata

Currently, the answer is that, yes, the surgeon can get sued for those deaths, even if he/she did everything right. The answer clearly lies in limiting the damages awarded. - Victor Ganata

The case for the tort system causing physician discontent is pretty minimal, at least if you're practicing in a state that has pain and suffering caps. There are a lot of other reasons why docs are throwing in the towel. - Victor Ganata

Enjoying the ice swimming.:) - Igor Poltavskiy