Googling for Ticks and Borreliosis in Germany: Nationwide Google Search Analysis From 2015 to 2018

Background: Borreliosis is the most frequently transmitted
tick-borne disease in Europe. It is difficult to estimate the
incidence of tick bites and associated diseases in the German
population due to the lack of an obligation to register across all
16 federal states of Germany. Objective: The aim of this study is
to show that Google data can be used to generate general trends of
infectious diseases on the basis of borreliosis and tick bites. In
addition, the possibility of using Google AdWord data to estimate
incidences of infectious diseases, where there is inconsistency in
the obligation to notify authorities, is investigated with the
perspective to facilitate public health studies. Methods: Google
AdWords Keyword Planner was used to identify search terms related
to ticks and borreliosis in Germany from January 2015 to December
2018. The search volume data from the identified search terms was
assessed using Excel version 15.23. In addition, SPSS version 24.0
was used to calculate the correlation between search volumes,
registered cases, and temperature. Results: A total of 1999
tick-related and 542 borreliosis-related search terms were
identified, with a total of 209,679,640 Google searches in all 16
German federal states in the period under review. The analysis
showed a high correlation between temperature and borreliosis
(r=0.88), and temperature and tick bite (r=0.83), and a very high
correlation between borreliosis and tick bite (r=0.94).
Furthermore, a high to very high correlation between Google
searches and registered cases in each federal state was observed
(Brandenburg r=0.80, Mecklenburg-West Pomerania r= 0.77, Saxony r=
0.74, and Saxony-Anhalt r=0.90; all P<.001). Conclusions: Our
study provides insight into annual trends concerning interest in
ticks and borreliosis that are relevant to the German population
exemplary in the data of a large internet search engine. Public
health studies collecting incidence data may benefit from the
results indicating a significant correlation between internet
search data and incidences of infectious diseases.

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Googling for Ticks and Borreliosis in Germany: Nationwide
Google Search Analysis From 2015 to 2018