EXCLUSIVE: Foodborne illness in the age of Twitter

by Erica Shaffer
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FoodBorne Chicago is a project of the Smart Chicago Collaborative and the Chicago Department of Public Health.

KANSAS CITY, Mo. – Consumers brought down by a foodborne illness sometimes turn to social media platforms to air their grievances. It turns out their local health departments might be listening.

Jenine Harris, Ph.D., an assistant professor at Washington Univ. in St. Louis, conducts research on ways public health departments use social media. She found that Twitter could be a valuable tool for public health departments to better identify cases of foodborne illness and encourage those affected to file a report. Among the programs currently implemented at the state level, Harris said FoodBorne Chicago was one of the most innovative programs she’d seen.

The Chicago Department of Public Health launched FoodBorne Chicago in an effort catch incidents of foodborne illness that otherwise would have gone unreported. Brian Richardson, director of Public Affairs for the Chicago Dept. of Health, said the agency was looking for ways to get people to report foodborne illnesses they’d contracted after dining at a foodservice establishment.

He said the majority of reports come through the city’s 311 non-emergency phone line. There also is an online reporting mechanism available to the public. But in Chicago, Richardson said, 311 is ubiquitous, so that’s where a lot of people file their complaints. These calls will often trigger inspections by the food inspection team.

“A lot of people don’t know about 311, especially maybe a tourist who’s in town, or residents who just don’t use it,” Richardson said. “We’ve replied to 374 tweets — which is less than we do for 311 — which is about 1,700 a year. But it’s still important because the people who are on Twitter are not the same people who are calling 311. So, we wanted to find a way we could reach out to people and capture those concerns or issues that we otherwise may not have got.”

Click image to see how the FoodBorne Chicago program works.

 
The department chose Twitter as the ideal platform to capture reports that could fall through the cracks. The department worked with the Smart Chicago Collaborative to develop a plan and the open-source code needed to create a “supervised learning algorithm” to track Twitter messages.

“They started with just tweets that were in the Chicago area, they had a boundary set up in the algorithm; and then the tweets had to include the words ‘food poisoning’,” Harris said. “But as they went along, every time a tweet was reviewed by a human and found to indicate food poisoning in the Chicago area, they basically told the algorithm so that it could get better over time. But we started out with just the bounding box around ‘Chicago’ and ‘food poisoning’.”

In 10 months, FoodBorne Chicago staff members responded to 270 Twitter messages and provided the senders with links to the FoodBorne Chicago complaint form. A total of 193 complaints of possible foodborne illnesses were submitted through the program, which resulted in unannounced inspections at 133 restaurants in the city. Twenty-one restaurants failed inspection and were closed, while 33 passed with conditions indicating critical or serious violations. Among inspected restaurants identified through complaints not filed through FoodBorne Chicago, 25.8 percent failed and 14.2 percent passed with conditions.

Additionally, 19 of the 193 complaints described seeking medical treatment for the illness.

“We’re going to get more accurate over time,” Harris said. “Not everyone uses the term ‘food poisoning’. As we go and as the algorithm gets better, it’s going to catch more and more [complaints].”

But most users of FoodBorne Chicago stick with “food poisoning” to identify their problem, which helps keep the algorithm simple, said Raed Mansour, executive assistant to the Commissioner of the Chicago Department of Public Health, Dr. Bechara Choucair.

“I think when you start using other words, the algorithm gets more complex and you can’t discern between ‘flu’ or ‘food poisoning’,” Mansour said. “If we started using words like ‘vomit’ or ‘diarrhea’ you start bringing in other types of illnesses and noise.”

The Chicago Department of Public Health will look at ways to apply social media, such as Twitter, to other department programs.

 
Twitter has the advantage of real time. So if someone posts a tweet one night, someone from the department can respond in the same night or the next day. This is sometimes faster than an individual going to a doctor’s office or calling 311, Richardson said.

An added benefit for public health agencies is that FoodBorne Chicago is an open-source framework, which will enable other health departments adopt the application free of charge, Harris said. Richardson said the cost of developing the FoodBorne Chicago program was “minimal between staff time and a few nominal costs for the server, the URL and things like that.”

“Thankfully, the Smart Chicago Collaborative is full of so many smart, talented, dedicated professionals who are willing to volunteer their time, we were able to do most of this work at zero cost to the city,” he added.
Anyone interested in the program can go to GitHub where it’s been stored and use the open-source software and adapt it to their cities, Harris explained. Public health agencies in Boston and New York currently are working on adapting the program.

“We’re happy to work with anyone who wants to create this for their own city, or county or state,” Richardson said.

Mansour said response to the FoodBorne Chicago program has been positive, and there are tweets to prove it.

“They re-tweet to thank us, and they state that they didn’t know this was available,” he said. “It’s a good service.”

Harris said it’s too early to fully understand how social media will be useful for public health agencies. She said that while big cities have adopted Twitter and other social media platforms in unique and innovative ways, medium-size cities and smaller towns haven’t done as much with the platforms available.

“Overall, I just don’t think we know how we can use it more effectively,” Harris said. “We saw in some earlier studies that not that many people are following their local health department on Twitter, so learning how we can use it to reach people and how we can get more followers is the ongoing challenge for health departments.”

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