Measles, social media and surveillance in Baltimore City.

Background: Baltimore City was faced with two potential measles outbreaks in 2015. Both cases occurred in the wake of national media attention paid to the Disneyland outbreaks of the same year.
Methods: A comparative case study approach was used applying qualitative data to elicit best practices in infectious disease protocols in the age of social media. The research also used search engine data from Google Trends to track constituent engagement over time.
Results: Across the two case studies, the Baltimore City Health Department identified a number of best practices to inform the public via social media and minimize levels of misinformation and panic. These practices included clarity in messaging across platforms and public health jurisdictions; pre-emptor alerts of potential measles cases to control and shape the media messaging; and targeted, in-person outreach to engage groups in a culturally competent manner. Conclusions: The Baltimore City Health Department's response drew out a critical need for re-examining infectious disease protocols in the age of social media (e.g. contact notification, quarantine, media sensitivity) and anti-vaccination movements that pose new obstacles to government intervention. The benefits and challenges of greater connectivity between providers, patients, and public health officers are discussed.