Swab your nostril for science and help track the spread of flu

With an app and a cotton swab, Minnesotans can help track the spread of flu around the state. A new pilot project from the Department of Health is pairing with health app Flu Near You. 

Minnesota is one of only two places in the U.S. doing this pilot project, said Karen Martin, who works on influenza surveillance for the department.  The other is in Indiana

"Right now, it's in an exploratory stage. We're seeing if, logistically, the project will work," she said. "It’s certainly taking advantage of the fact that most people have smart phones and most people are connected to the internet. This wouldn’t have been as successful 15 years ago."

The program asks people to send in samples to the department for testing, to see what kinds of illnesses are where. 

Participatory surveillance

It's called participatory surveillance in the public health community. Other states have formed similar partnerships with Flu Near You and have used Flu Near You data to supplement data they already collect.

Currently, the state tracks flu-like symptoms in school, long-term care facilities, hospitals and clinics. 

But this pilot project hopes to piggyback off the app model. 

"It’s a group of people who are sick that we normally don’t get information about," Martin said. "We’re seeing how this will work, if it can help us supplement our other surveillance."

It helps researchers see a more accurate picture of where flu is spreading. There are plenty of people who just stay home if they have a cold or flu-like symptoms, because they know there's not much doctors can do to help low-risk people with the virus. 

So now, after you sign up for the Flu Near You app, you can sign up for the Department of Health program. It's one more step in the tracking process. The department sends you instructions and supplies on how to collect your own sample to send into the department. It will then be tested to see if it's a flu virus and what type. 

"I think it has a lot of potential. Number one, it costs relatively little money," Martin said. "We are relying on people to report things. ... The more people that participate the better the data is." 

The app has been around for a while and uses a simple question and answer interface to track flu-like symptoms via user input. 

Once a week, the app pings you, asking if you or anyone in your family is experiencing flu-like symptoms. Answer yes or no and you're taken to a map which shows instances of flu symptoms — right near you. 

In theory, people could the app to avoid places with lots of flu activity. But flu is so common that, it's unlikely you'll find a spot in the state that isn't affected, Martin said. And the app isn't in wide use in the St. Cloud area yet. 

Missing population

The pilot project or Flu Near You can't replace the surveillance programs the department already conducts. But it will give an idea on a part of the population that's missed by those programs.

If you think of all flu impact as a pyramid, at the top is the most rare outcome, people that get so sick they die. In the middle are the ones who get sick enough to go the hospital or to a clinic. But on the bottom, by far the largest group, are the people who get sick, but aren't sick enough to see their doctor. 

"We really have very little information on how big that group is, who that group is," Martin said. 'It's sort of tapping into a big part of the burden of disease. It can help us understand the entire burden of .. influenza."

By default, it will also help the department track other types of respiratory illnesses. 

"It will give us an indication of circulation patterns and the timing of other viruses," Martin siad. 

And they need your help. 

"We know we have a lot of people in Minnesota who are interested in public health, willing to help," Martin said."It really is a participatory exercise. The more people participate the better the data is going to be." 

Data handling

Now, this isn't a mail-order flu-testing service. You won't find out what your own result is.

"It's not a substitute for any kind of health care," she said. "But it can give us an understanding," Martin said, of the actual flu's spread. 

All identifying information is taken off of the sample, like all data in the department, keeping private information private. 

Because of the way samples are collected and testing protocols that won't be followed, such as refrigerating the specimen, it's not suitable for verifying flu on the individual level. 

"By law, we can't give those results out, based on how they're collected," she said. "We also don’t want to pretend or make it seem like we are some kind of health care. We don’t want to be in the business of giving people diagnoses."

This data also doesn't show up on Flu Near You's publicly available map. But if the pilot projects are successful, that could be something the app adds. 

If enough people participate, the department does plan to send summary data back to participants, so they can see what kind of impact they made. 

"I think there’s more of an interest as people know a little bit more about influenza season, about the virus and how it circulates," Martin said. "There’s more ... public awareness about it and this will feed into the normal curiosity people have about it, the desire to be informed about what’s going on."

For more information 

For more information about the flu in Minnesota, visit health.state.mn.us/divs/idepc/diseases/flu/index.html.

For the video on how to collect samples for the minnesota Department of health, visit health.state.mn.us/divs/idepc/diseases/flu/videos/fny.html.

For more information about Flu Near You, visit flunearyou.org. For the Flu Near You app for iPhone, visit itunes.apple.com/us/app/flu-near-you/id570301361?mt=8.