By Maryn McKenna
By the time WCSJ2011 opened in late June, organizers felt entitled to breathe a sigh of relief. The biennial international conference had come together despite a last-minute relocation from conflict-ridden Cairo, Egypt, to Doha, Qatar, and the attendees had arrived mostly without incident.
We (I was a speaker and panel organizer) plunged into four days of field trips, panels, debates, dinners in the souq, and late-night searches through Doha’s bizarre Shanghai-Disney skyscrapers for the few bars that serve alcohol to foreigners. All seemed well.
Until about the third day. Suddenly, there were more seats available in the meeting rooms and more chatter under the conference’s Twitter hashtag, #wcsj2011 — and a good portion of the chatter was now adorned with a second hashtag, #dohabug. Some portion of the attendees had been confined to their hotel rooms — or worse, sent in search of medical care — by what appeared to be a fast-striking foodborne illness.
The complaints increased in number as the attendees went home, and some of their descriptions were dire: flattened for a week, requiring IV fluids, hospitalized. Almost everyone had a hypothesis: It was the fish. It was the scrambled eggs. It was something at the Ezdan Hotel, the deluxe yet mysteriously scruffy property where most of us stayed.
I escaped the bug, but as someone who writes about disease detection, I thought the situation presented a rare opportunity: an outbreak that was recognized early, in a well-defined group that had both established communication channels and personal and professional reasons to want to know what happened. I am not an epidemiologist, so I asked a Twitter friend, @EpiRen (in real life, Rene Najera, MPH, who is a professional epi) to help organize a survey to analyze what went on.
I reconstructed menus for the various meals (most of them buffets) with the help of the conference staff. Rene wrote a multi-page survey and converted it into a GoogleDocs form. I circulated news of the survey in the second week of July via email and Twitter, using the same hashtags, #wcsj2011 and #dohabug. Rene analyzed the 179 replies, 63 of which came from people who were sick.
To save the WFSJ from any appearance of liability, we published the results on my Tumblr, The Further Adventures of Germ Girl, on Aug. 9. We were not able to definitively solve the outbreak — that would have required extra steps such as refrigerator searches and culture data — but we were able to define the epidemic curve, pin the exposure to a meal on June 27 or 28, and generate a solid hypothesis. Based on test results received independently by four respondents, we believe that #dohabug was Salmonella.
The graphed results and Rene’s narrative explaining them are at: http://germgirl.tumblr.com/post/8704840137/wcsj-illnesssurvey-results-here-are-the-results.
Maryn McKenna is a freelance journalist and author who specializes in public health, health policy, and medicine.
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