Examining the Relationship Between Community Listserv Enrollment and the Evolution of the H1N1 Pandemic

Background: Challenged with conveying timely, accurate information about issues surrounding H1N1 influenza, the Baltimore County Department of Health (BCDH) created the H1N1 Community Connection Network (CCN).  On average, CCN electronic newsletters were released weekly to individuals who signed up to receive clinic and general information about H1N1.  As of 12/10/09, 8,762 households had subscribed to the CCN and ten issues have been released. 

Objectives: To evaluate the relationship between the evolution of the 2009 H1N1 pandemic and: (1) enrollment in a community H1N1 listserv and (2) action taken as a result of information received through the listserv.

Methods: The BCDH used an online survey to enroll the public in the CCN.  Initially, BCDH used an internal email system to disseminate the newsletters.  Eventually, an electronic newsletter service, which prepares reports on utilization, was employed.

Results: From October 1 – 14, when priority groups were defined publicly and the first deliveries of vaccine were anticipated, 1,686 subscribers enrolled in the CCN.  In the two subsequent weeks, with increased reports of pediatric deaths and vaccine shortages, enrollment increased by 315% to 5,314.  The following two weeks, when President Obama declared the H1N1 crisis a National Emergency, membership increased by 149% to 7,922.  The weekly peak of registration for appointments coincided with the release of an issue of CCN.  Enrollment in CCN continues, though not at the rates as during the second wave of the pandemic. 

Conclusions: Increasingly, the general public relies on the internet to proactively and passively access information about health issues.  The initiation of and rate at which this information is accessed is strongly related to information that is disseminated through various sources of media.  Local health departments can be accepted as a reliable source of information during a public health emergency and should assert their role in providing comprehensive, accurate, user-friendly information through all media, including the internet.