Data collection in the THiS web app is conducted by staff from registered tourist accommodations, using an online questionnaire administered to an unwell guest or staff member. Accommodations are also required to confirm the absence of cases by epidemiological week using a “zero case” submission on the web app page. Also, the self-reporting page allows visitors and staff to independently report their illness using an online questionnaire located on the THiS web page: THiS.carpha.org.

The online questionnaires are similar for reporting by registered facilities and self-reporting. The questionnaire includes 11 short questions that ask the user for necessary demographic information such as age and gender, potential exposure information such as recent travel and home country, and most importantly, which symptoms they are experiencing:

1. diarrhoea (≥3 loose or watery stools in past 24 hours),
2. vomiting and/or nausea,
3. fever (sudden onset of fever >38.0◦C or 100.4◦C),
4. cough or sore throat,
5. bleeding (gums, nose, blood pooling under skin coughing, stool) not due to physical trauma
6. headache,
7. joint or muscle pains,
8. eye pain/headache/facial pain,
9. generalized rash,
10. blurred vision or convulsions or altered consciousness.

Responses to these symptoms are analyzed in the system to generate (Figure 2) potential syndromes for each case:

1. Gastroenteritis
2. Undifferentiated Fever
3. Fever & Haemorrhagic Symptoms
4. Fever & Neurologic Symptoms
5. Fever & Respiratory Symptoms
6. Fever & Rash

Figure 2. The logic used to generate syndromes from reported symptoms (based on Case Definitions for Syndromes Under Regional Surveillance, CARPHA)

Data analytics are executed on the inputs from each facility on the THiS web app. The dashboard provides interactive data visualizations and allows the user to slice the information to view cases among guests vs. staff, by facility (for national users only), by country (for regional users only), and for all users by gender, age, and time (weeks vs. months vs. year) facility and national level—for MOH users), and time (case counts by day, week, month, or year). Access is limited to hotel management (i.e. hotel manager, health and safety manager), who would be persons engaging with public health staff at the MOH in the event of a potential public health issue such as an outbreak. At the Ministry of Health, access is given to users determined by the countries health focal point and typically include an epidemiologist, surveillance officer, and/or Chief Medical Officer (CMO) or Environmental Health Officer. At CARPHA, access is limited to the THP epidemiologist and Project Coordinator.