Whether we are talking about coronavirus or Ebola virus – the danger with such pathogens is that they can spread unnoticed from one person to another. If chains of infection are not quickly interrupted, the number of those infected can soar exponentially. Apps are a useful tool when it comes to tracking – and ideally breaking – the chains of infection.
It was the doctor and epidemiologist Gérard Krause from the Helmholtz Centre for Infection Research (HZI) in Braunschweig, together with a colleague, who had the idea in the autumn of 2014 to develop a mobile information system for disease tracking. At the time, the Ebola epidemic was just reaching its peak in Nigeria. “The Ebola outbreak reminded us in a very tragic way that we needed something to detect outbreaks as early as possible. But at the same time we needed a tool to respond to these outbreaks as efficiently as possible”, says Gérard Krause.
After all, what the world has been going through with coronavirus since the beginning of the year is something that the countries of West Africa already experienced with Ebola in 2014: it was the most serious outbreak of the disease that had ever been recorded. Originally, just one person in Guinea had become infected via an animal in December 2013. But this was enough to spark an epidemic. The highly contagious virus, which first shows flu-like symptoms and then triggers a life-threatening fever, spread from Guinea to neighbouring countries.
Interlinked in real time
Gérard Krause joined forces with colleagues from the Robert Koch Institute in Berlin, the Bernhard Nocht Institute for Tropical Medicine in Hamburg and the Hasso Plattner Institute at the University of Potsdam to turn his idea for an app into reality. The app is called SORMAS, an acronym for Surveillance, Outbreak Response Management and Analysis System. SORMAS interlinks doctors, laboratories, hospitals, local health authorities and epidemiologists in real time. Those infected are registered, chains of infection are reconstructed and suspected cases are monitored. Consequently, all participants have an overview of the current infection situation at all times, which allows them to initiate protective measures in good time.
One app for multiple diseases
The open-source app is now being used to monitor 400 regions in Nigeria and Ghana with a total population of around 85 million people. And because it is modular in design, the app can easily be expanded. The SORMAS team was thus able to adapt the IT tool so that it can be used not only for Ebola but also for 19 other widespread infectious diseases. These include measles, smallpox, dengue fever, malaria, cholera and bird flu. In Nigeria, the app is helping to overcome situations where several diseases have flared up at the same time. “During the last monkey pox outbreak we had several simultaneous outbreaks. We had Lassa fever in the south, meningitis in the north, and measles in the northeast”, reports Chikwe Ihekweazu, CEO of the Nigeria Centre for Disease Control. “SORMAS gives me the ability to understand what is happening, to plan the response and change the response in order to adapt to the situation.” The app should soon be available all over Nigeria, with the whole of West Africa to follow in the next phase.
Covid-19 module for Germany and the world
Unlike Ebola, the corona infection normally produces only mild symptoms. Consequently, many of those who have it go undetected but are still capable of passing on the infection. To keep this number of unregistered cases low, it is important to identify as far as possible everyone who was in contact with those infected, and to tightly manage chains of infection. The idea is that the measures that have been tried and tested in Africa can now be used to help Germany. Researchers at the HZI have adapted the SORMAS app for use in Germany by supplementing it with the country’s existing digital registration system. A module for COVID-19 infections suitable for worldwide use has likewise been available since the beginning of February, and is already in use in Nigeria, Ghana and on the Fiji islands.
Combating the corona pandemic and other epidemics is always a race against time. Before a vaccine can be developed, suitable active ingredients need to be found and subsequently tested in laboratory trials and clinical studies. In the future, the search could make quicker and more efficient progress thanks to the virtual testing platform developed by an international team that includes the mathematician Konstantin Fackeldey from Technische Universität Berlin. This is because Virtual Flow offers a much larger database, with geometrical models of 1.4 billion molecules, than previous simulation platforms. International cooperation is the only way to tackle a global crisis, which is why the database co-developed at TU Berlin is available as an open-source tool that can be used by drug researchers all over the world.More