analysed weekly, daily, and by the hour (Baker et al., 2003) and, together with data from other online sources, this would form a part of a very extensive database (DH, 2013). For the purpose of this paper, Public Health Surveillance is defined as “the ongoing systematic collection, analysis, and interpretation of data, closely integrated with the timely dissemination of these data to those responsible for preventing and controlling disease and injury” (Thacker and Berkelman, 1988, in Nsubuga et al., 2006: 997). Although public health surveillance could generally be carried out in many forms (WHO, 2008), this paper relates the concept of public health surveillance to that of information processed and collected by the government and large healthcare organisations, analysed through a variety of ICT systems. One of the more recent examples of the use of Big Data in public health surveillance lies in Google Flu Trends, a daily online surveillance platform which utilises aggregated flu-related search data on Google to estimate the level of current flu activity around the world, whose estimates are very similar to those produced by traditional flu activity indicators by the U.S. Center for Disease Control (Google, 2013). Although this, together with many other projects, appears to signal very promising opportunities, it is important to acknowledge that there are limitations surrounding utilization, and we now turn, therefore, to the evaluation of the benefits and limitations of such initiatives.
Benefits of Big Data in Public Health Surveillance
This section considers the benefits and opportunities which could arise from the use of Big Data in public health surveillance. According to the Disease Control Priorities Project, Big Data has the implicit capability to provide “real-time, early warning information (…) about health problems that need to be addressed in a particular population” (WHO, 2008: 1), which is critical in preventing disease outbreaks as decision makers could develop appropriate and rapid responses when diseases begin to spread (ibid.). This is further supported by Bravata et al. (2002: 15) who argue that “the nation’s capacity to respond to bioterrorism depends in part on the ability (…) to detect, manage, and communicate during a bioterrorism event”, and that, under circumstances of a bioterrorist attack, ICT and decision support systems could aid clinicians and health officials to respond effectively. With health surveillance systems in place, should people from the same geographical area report similar symptoms, the system could calculate the possibility of outbreaks of diseases and could alert