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Am J Public Health. 2017 Jul;107(7):1130-1136. doi: 10.2105/AJPH.2017.303767. Epub 2017 May 18.

Use of a Digital Health Application for Influenza Surveillance in China.

Author information

Yulin Hswen is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Yulin Hswen, John S. Brownstein, and Jared B. Hawkins are with the Informatics Program, Boston Children's Hospital, Boston. John S. Brownstein and Jared B. Hawkins are also with the Department of Pediatrics and the Department of Biomedical Informatics, Harvard Medical School, Boston. Jeremiah Liu is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health.



To examine whether a commercial digital health application could support influenza surveillance in China.


We retrieved data from the Thermia online and mobile educational tool, which allows parents to monitor their children's fever and infectious febrile illnesses including influenza. We modeled monthly aggregated influenza-like illness case counts from Thermia users over time and compared them against influenza monthly case counts obtained from the National Health and Family Planning Commission of the People's Republic of China by using time series regression analysis. We retrieved 44 999 observations from January 2014 through July 2016 from Thermia China.


Thermia appeared to predict influenza outbreaks 1 month earlier than the National Health and Family Planning Commission influenza surveillance system (P = .046). Being younger, not having up-to-date immunizations, and having an underlying health condition were associated with participant-reported influenza-like illness.


Digital health applications could supplement traditional influenza surveillance systems in China by providing access to consumers' symptom reporting. Growing popularity and use of commercial digital health applications in China potentially affords opportunities to support disease detection and monitoring and rapid treatment mobilization.

[Indexed for MEDLINE]
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