NHS Choices Measles outbreak: April 2013 Kenny Deighton Reporting Team 1

Contents – by data sources Webtrends Visits to measles and mmr related pages Popular pages Search terms driving traffic to Choices Splunk geo look-up Searches by cities Trends in Welsh city searches Hitwise Websites receiving traffic from related searches Changes in popular search terms Meaning-mine Measles related citations in the news Measles related citations in social media USE OR DELETE 2

Webtrends Since the 1st April 2013 we have received over 310,000 visits to measles and MMR related pages, averaging almost 24,000 visits per day over the last 7 days. We would expect this to continue throughout April as news on Weds 18th reported there are now 808 confirmed cases of measles in the Swansea area. 98.4% of the current traffic is to the Health A-Z section, 1.3% to Behind the Headlines and 0.3% to the Videos Library. The media interest heightened after the Easter break (03/04) where it was reported that confirmed cases had risen by 25%, leading to an increase in visits to over 10,000 per day.

Webtrends The measles symptoms and introduction pages are the most visited in the topic with over 172,000 visits month to date (56% of all visits). Pages within the ‘Vaccination Guide’ relating to the MMR jab have also received over 90,000 visits during April (29% of all visits). The measles symptoms and introduction pages are the 14th and 16th most popular entry pages in terms of visitor sessions during April compared to 112th and 142nd the previous month.

Webtrends The top search terms driving traffic to Choices is what you’d expect with ‘measles’ and ‘measles symptoms’ representing 63% of the total topic related searches. ‘Measles’ is also the most popular term used on the on-site search function during April with 3,459 visits so far during April, already a 38% increase on searches for the condition in the whole of March.

Splunk: Geographical Data Using the geographical location associated to a users IP address we can see the top locations in terms of searches to conditions\measles pages, with Welsh cities making up 40% of the top 5. All of the top 5 cities saw a spike on 5th April where news stories focused on the call for mass immunisation when children returned back to school after the Easter break.

Splunk: Geographical Data City wc 11/02 wc 08/04 % Variance Newport 917 - Reading 748 Southampton 576 Milton Keynes 545 Chesterfield 529 Neath 471 Bradford 450 Swansea 116 2765 2284% Cardiff 149 2127 1328% Bristol 251 1865 643% Sheffield 268 1357 406% London 2966 13930 370% Edinburgh 143 660 362% Nottingham 205 946 361% Middlesbrough 685 360% Manchester 542 2035 275% Wolverhampton 181 623 244% Birmingham 514 1699 231% Glasgow 287 947 230% Huntingdon 213 222% Leeds 366 1176 221% Leicester 270 808 199% Rotherham 743 196% Newcastle Upon Tyne 255 745 192% Stoke-on-trent 190 185% Preston 485 155% Liverpool 444 1002 126% Total 7950 40061 404% A comparison of last week (08/04/13) with the second week in February (11/02/13) shows significant increases across the board, not surprising that the 3 Welsh cities are the highest in % variance – Newport went from having 0 searches to 917 in a week whereas Swansea saw a 2284% increase to 2765 second only to London in terms of volume.

Splunk: Geographical Data Week commencing 8th April saw over 5,800 searches from the 3 Welsh cities, a 129% increase from week commencing 18th March (before the outbreak hit the headlines). The Swansea area now represents around 49% of the searches compared to 68% mid-march. Overall searches for these cities peaked on 15th April as doctors feared the start of a new school term could lead to a sharp rise in new measles cases.

Splunk: Geographical Data On January 23rd the Health Protection Agency announced that there had been 46 confirmed cases in the North East since September 2012, this figure rose to 82 by 11th February with an estimated number of suspected cases reaching 196 by early April. The searches from IP addresses located in Newcastle Upon Tyne remained fairly constant until the HPA announcement, this was followed by an even more prominent spike on the 29th Jan when the HPA described the outbreak as ‘serious’ reported across several media channels – after this the searches trend more similarly with the rest of the UK primarily driven by media coverage of the Swansea outbreak.

Hitwise Choices have received over 35% of all search terms clicks from measles related searches over the last 4 weeks (based on a search term portfolio of over 200 words/phrases), this is more than the other 9 sites in the top 10 combined. The were some search terms in the portfolio for which Choices received no traffic, the main ones being ‘measles in Swansea’, ‘measles outbreak 2013’ and ‘measles Swansea’ all of which you would expect to be driven to news websites instead.

Hitwise We have seen a shift in the most popular search terms on the topic over the last 4 weeks, with the search phrases on the increase specifically relating to Swansea or the 2013 outbreak as opposed to more generalised searches on the topic such as ‘german measles’ which saw a -3.2% reduction over recent weeks.

MeaningMine Measles related citations over the last 120 days - News The first prominent spike on the 8th Feb saw 122 measles related citations after the Health Protection Agency (HPA) announced an 18 year high in the number of cases in England and Wales. Citations reached over 200 on 29th March as parents are urged to get their children vaccinated as cases more than double in just 3 weeks. A peak of 328 citations were recorded on 13th April when the majority of stories focused on the outbreak spreading to other parts of the UK.

MeaningMine Measles related citations over the last 120 days – Social Media There was a similar spike in social media citations on 8th Feb with the HPA announcement, there was a second early spike on 28th Feb when twitter stories reported 190 confirmed cases in Swansea. The peak of social media activity around measles occurred on 13th April, twitter was the main source with many quoting that 40,000 children in Wales are still unvaccinated.