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FluPhone: Understanding Behavioural Responses to Infectious Disease Outbreaks

Background

How people behave, interact and travel during an epidemic could limit or exacerbate their risk of infection. In the SARS epidemic of 2003, there is evidence to suggest that people changed the amount of time spent outside and their hygiene practises in response to the perceived risk of infection. A recent study suggests that public transport usage may decline in the event of an influenza pandemic and that people may stay at home rather than go into work and risk infection. If such precautionary behaviour were to be adopted by a large number of individuals the economic implications may be profound. The cost to the UK economy through such precautionary actions may be greater than the cost incurred through actual illness, and there is little evidence that some of the actions that people may take will actually lower their risk of infection. To ensure that plans to cope with major epidemics and public information messages are appropriate, there is, therefore, an urgent need to anticipate how people are likely to change their behaviour in the event of an outbreak.

The FluPhone Project (ESRC: RES-355-25-0019) aims to bring together epidemiologists, psychologists, economists and computer scientists from seven academic institutions and governmental agencies, with the goal of developing novel and innovative methods with which to measure, understand and predict how individuals change their social behaviour in response to infectious disease. Individuals may change their behaviour for several reasons: through being ill themselves, having to care for others who are ill, or through changing their normal habits in the belief it will prevent or minimise their risk of infection.

The FluPhone project is funded by the Economic and Social Research Council and the Medical Research Council, and is being conducted by researchers at the University of Cambridge, the University of Liverpool and the London School of Hygiene and Tropical Medicine.

FluPhone Study

Could you be a super-spreader?

We are conducting an experiment using mobile phones to find out how often people come into contact with each other. All necessary information for the participants can be found in FluPhone study web page https://www.fluphone.org.  This information will help scientists and medical researchers understand how close-contact infections, such as swine ‘flu, spread between different people. This study aims at collecting the information on social encounters based in Cambridge, UK. It will use mobile phones to anonymously record how often people encounter each other, and will use this information to understand more about how fast infections, like swine flu, can spread amongst different people in Cambridge. The study is voluntary and asks consenting participants to download a free application to their mobile phone. This software, specially developed by the Computing Laboratory at Cambridge University, will record (anonymously) how often participants are in close proximity to each other, and relay the findings directly and securely to the research team.

All data provided by participants or collected by their mobile phones will only be used for the purposes of this research, will be stored securely and will not be made available to anyone outside of the research team, in accordance with the Data Protection Act. This study has been approved by the Cambridge Psychological Research Ethics Committee of the University of Cambridge.

The phone software will also permit the researchers to conduct real-time simulated epidemics of ‘virtual’ diseases, which only jump between participants’ phones when they encounter each other – these virtual diseases will not harm participants’ phones.

Participants will be able to log-on to the study website https://www.fluphone.org and see an estimate of how many people they have encountered recently and compare their social activity to other participants. Volunteers will also be able to track the progress of the virtual diseases around Cambridge and see which their phone encounters.

Participants will be asked to register to the FluPhone Study, however, if you want to try the FluPhone application without registration, please contact us.

FluPhone study schedule:

  • Pilot study in the Computer Laboratory (members of CL plus their families and friends) - April 21 - May 15, 2010.
  • Study in the University of Cambridge - May 10 - June 30, 2010.

For the study in the university, we will advertise FluPhone Study via the following channels. Targeting participants include university members, their families, colleagues, friends, and people who work or live in Cambridge.

  • Secretary of department - distribution for the members in the department
  • Secretary of publicity in college - distribution for the members on the college
  • Bulletin boards (e.g. CUSU bulletin, Graduate Union)
  • Cambridge University based societies (e.g. CUCATS)
  • Facebook and Twitter (e.g. Cambridge graduate students, Alumni)

Participants must be over 12 years old (under 16s require parental/carer consent), have the use of a compatible mobile phone, and permission from the owner and bill-payer of the phone to participate.

FluPhone Software Overview

The FluPhone is simple client-server software consisting of a mobile phone application in the phone and a receiver as a PHP script in the web server. The mobile phone application is written in Java (J2ME), which collects proximity devices data by Bluetooth, GPS coordination data, and self-reporting flu symptom. The collected data is sent via GPRS/3G to the server. Also the user can upload the data via web interface.

1. FluPhone application

The FluPhone application requires J2ME MIDP 2.0, and CDCL 1.1 with JSR-82. To get location data, the phone has to have a GPS module. If writing to a file is supported, the application will be able to dump the database files, which could be uploaded via FluPhone web. Running application is fairly intuitive: report the symptoms if any, allow the application to send data.

How the application looks like can be found at https://www.fluphone.org/help.php.

2. FluPhone GPRS/3G receiver

The GPRS/3G receiver is implemented as a PhP script that takes each packet from the phones running the sender version of the application and writes it to a file. There is also daemon job archiving the data in MS-SQL database.

Communication between the mobile application and the server is based on https. The SSL certificate issued by GlobalSign is used for the FluPhone web server.

Current limitations

  • List of tested mobile phones.
  • Collection of location data using GPS is disabled.
  • Only a basic statistics (i.e. the number of encounters past two days) is provided to the users in the mobile phone side of the application. More results to be added when the user logs in over the FluPhone web.
  • SMS based communication is disabled.
  • 'Virtual Disease' implementation is disabled.
  • 'Forgot password' function is not implemented.
  • Future support: Android and iPhone

FluPhone Software Specification

Documenting the internal specification of FluPhone:

Draft version (based on 2010/06/24): FluPhone Internal Specification. Some functions have been changed since March. However, the basic system design should be current.

Virtual Disease - J2ME version (based on 2010/08/19): User Manual and Technical Manual.

Source Code

The source code is maintained in the SVN repository. After the end of the development phase, we plan to disclose the code in an open source repository.

If you want to access to the source code of the fluphone, please contact us.

 

Contact: FluPhone Project Team email: flu-phone@cl.cam.ac.uk or eiko.yoneki@cl.cam.ac.uk