SALT LAKE CITY — Dr. Anthony Wallin never knows what germs are going to come through the doors of the Intermountain Bountiful Instacare where he works, but he has some clues thanks to a weekly germ intelligence report.
It began during the 2002 Olympics as a way to detect bioterrorism threats. Intermountain Health Care, the University of Utah and the Utah Health Department set up a system to automatically gather information from emergency rooms and acute care clinics. It monitored syndromes - coughing, fever, and vomiting - that could be indicators of bioterrorism agents.
The data was analyzed at the RODS (Real-Time Outbreak and Disease Surveillance system) Laboratory at the University of Pittsburgh Medical Center which would trigger an alarm in the event of a threat.
Dr. Per Gesteland, a Primary Children's Medical Center hospitalist and an assistant professor of biomedical informatics at the University of Utah, adapted the system to track everyday germs.
GermWatch, as it's now called, gathers information from Intermountain Healthcare's labs, hospitals and clinics. Gesteland sends out a weekly email telling doctors what's been going around, and physicians can access various reports.
- Much the same as last week with lots of Rhinovirus and Parainflluenza
- Modest amounts of Influenza A (n=4) and B (n=7), similar to what is being seen nationally.
- Moderate adenovirus activity.
- Modest RSV activity continues. Still below the 10% positivity threshold used to declare "RSV season" open. The upcoming holiday gatherings are likely to help kick the season into gear.
This week (the week of Nov. 19), for example, GermWatch is reporting modest amounts of influenza and RSV, a moderate amount of adenovirus and lots of rhinovirus and parainfluenza.
The data is mapped out so doctors can also get the local picture.
"Now my clinicians can tell you, ‘oh you probably have this specific virus and here's how long you can expect to be sick,'" Gesteland says.
"It saves us a lot of time on getting to diagnoses and using less resources to do that instead of having to order tons of tests," Wallin says.
The morning we interviewed Wallin, for example, Corinne Higginson came into the clinic with a bad sore throat. After ruling out strep, Wallin diagnosed adenovirus, which, according to GermWatch, has been going around.
At the beginning of the H1N1 pandemic three years ago, doctors, using GermWatch, were able to tell many of the patients with flu-like symptoms flooding emergency rooms and clinics that they didn't have swine flu, but parainfluenza, instead.
Gesteland says the information also helps doctors limit the overuse of antibiotics, which will fight bacteria but not viruses.
"GermWatch is actually a counterforce to the pressures put on clinicians and patients who want to feel better to use antibiotics when they may not be needed," Gesteland says.
"I feel there's less pressure on me as a physician because I can give them a better idea of what they have and I actually think they understand what they have a little better," Wallin says.
GermWatch also reports how germs are responding to specific antibiotic treatments and how that varies from hospital to hospital. Bacteria in Logan, Wallin explains, can develop a different level of resistance to an antibiotic compared to the same kind of bacteria in the southern part of the state.
Gesteland says these reports are unique in the United States and are possible, in large part, because Intermountain is an integrated health care system and has such a large share of the Utah health care market.