University of Edinburgh



Differences in reporting the ragweed pollen season using Google Trends across 15 countriesJean Bousquet ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>BOUSQUET-MACVIA</Author><RecNum>39</RecNum><DisplayText>(1, 2)</DisplayText><record><rec-number>39</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">39</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>BOUSQUET-MACVIA</author></authors></contributors><titles><title> </title><secondary-title>MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France</secondary-title></titles><periodical><full-title>MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France</full-title></periodical><dates></dates><urls></urls></record></Cite><Cite ExcludeYear="1"><Author>BOUSQUET-VIMA</Author><RecNum>40</RecNum><record><rec-number>40</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">40</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>BOUSQUET-VIMA</author></authors></contributors><titles><secondary-title>INSERM U 1168, VIMA : Ageing and chronic diseases. Epidemiological and public health approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France&#xD;&#xD;</secondary-title></titles><dates></dates><urls></urls></record></Cite></EndNote>(1, 2), Ioana Agache ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>AGACHE</Author><RecNum>218</RecNum><DisplayText>(3)</DisplayText><record><rec-number>218</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">218</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>AGACHE</author></authors></contributors><titles><title>Agache</title><secondary-title>Faculty of Medicine, Transylvania University, Brasov, Romania.</secondary-title></titles><dates></dates><urls></urls></record></Cite></EndNote>(3), Uwe Berger ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>BERGER</Author><RecNum>741</RecNum><DisplayText>(4)</DisplayText><record><rec-number>741</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1485206791">741</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>BERGER</author></authors></contributors><titles><secondary-title>Aerobiology and Pollen Information Research Unit, Department of Oto-Rhino-Laryngology, Medical University of Vienna, Vienna, Austria.</secondary-title></titles><periodical><full-title>Aerobiology and Pollen Information Research Unit, Department of Oto-Rhino-Laryngology, Medical University of Vienna, Vienna, Austria.</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(4), Karl-Christian Bergmann ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>ZUBERBIER</Author><RecNum>141</RecNum><DisplayText>(5)</DisplayText><record><rec-number>141</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">141</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>ZUBERBIER</author></authors></contributors><titles><secondary-title>Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universit?tsmedizin Berlin; Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany</secondary-title></titles><periodical><full-title>Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universit?tsmedizin Berlin; Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(5), Jean-Pierre Besancenot ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>THIBAUDON</Author><RecNum>737</RecNum><DisplayText>(6)</DisplayText><record><rec-number>737</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1484345003">737</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>THIBAUDON</author></authors></contributors><titles><secondary-title>RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France.</secondary-title></titles><periodical><full-title>RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France.</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(6), Philippe J Bousquet ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>ANNE</Author><RecNum>268</RecNum><DisplayText>(7)</DisplayText><record><rec-number>268</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">268</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>ANNE</author></authors></contributors><titles><title>Annesi-Maesano</title><secondary-title>EPAR U707 INSERM, Paris and EPAR UMR-S UPMC, Paris VI, Paris, France</secondary-title></titles><dates></dates><urls></urls></record></Cite></EndNote>(7), Tom Casale ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>CASALE</Author><RecNum>437</RecNum><DisplayText>(8)</DisplayText><record><rec-number>437</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">437</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>CASALE</author></authors></contributors><titles><secondary-title>Division of Allergy/Immunology, University of South Florida, Tampa, USA </secondary-title></titles><dates></dates><urls></urls></record></Cite></EndNote>(8), Gennaro D’Amato ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>D&apos;AMATO</Author><RecNum>726</RecNum><DisplayText>(9)</DisplayText><record><rec-number>726</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1482676154">726</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>D&apos;AMATO</author></authors></contributors><titles><secondary-title>Division of Respiratory and Allergic Diseases,Hospital &apos;A. Cardarelli&apos;, University of Naples Federico II, Naples, Italy</secondary-title></titles><periodical><full-title>Division of Respiratory and Allergic Diseases,Hospital &apos;A. Cardarelli&apos;, University of Naples Federico II, Naples, Italy</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(9), Igor Kaidashev ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>KAIDASHEV</Author><RecNum>444</RecNum><DisplayText>(10)</DisplayText><record><rec-number>444</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">444</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>KAIDASHEV</author></authors></contributors><titles><secondary-title>Ukrainina Medical Stomatological Academy, Poltava, Ukraine</secondary-title></titles><dates></dates><urls></urls></record></Cite></EndNote>(10), Musa Khaitov ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>KAITOV</Author><RecNum>503</RecNum><DisplayText>(11)</DisplayText><record><rec-number>503</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1441048098">503</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>KAITOV</author></authors></contributors><titles><secondary-title>National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russian Federation</secondary-title></titles><periodical><full-title>National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russian Federation</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(11), Ralph M?sges ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>MOSGES</Author><RecNum>325</RecNum><DisplayText>(12)</DisplayText><record><rec-number>325</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">325</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>MOSGES</author></authors></contributors><titles><secondary-title>Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Germany</secondary-title></titles><dates></dates><urls></urls></record></Cite></EndNote>(12), Kristof Nekam ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>NEKAM</Author><RecNum>381</RecNum><DisplayText>(13)</DisplayText><record><rec-number>381</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">381</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>NEKAM</author></authors></contributors><titles><secondary-title>Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary</secondary-title></titles><dates></dates><urls></urls></record></Cite></EndNote>(13), Gabrielle L Onorato (1), Davor Plavec ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>PLAVEC</Author><RecNum>387</RecNum><DisplayText>(14)</DisplayText><record><rec-number>387</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="0">387</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>PLAVEC</author></authors></contributors><titles></titles><volume>Children’s Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia</volume><dates></dates><urls></urls></record></Cite></EndNote>(14), Aziz Sheikh ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>SHEIKH</Author><RecNum>516</RecNum><DisplayText>(15)</DisplayText><record><rec-number>516</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1441307998">516</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>SHEIKH</author></authors></contributors><titles><secondary-title>Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK</secondary-title></titles><periodical><full-title>Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(15), Michel Thibaudon ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>THIBAUDON</Author><RecNum>737</RecNum><DisplayText>(6)</DisplayText><record><rec-number>737</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1484345003">737</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>THIBAUDON</author></authors></contributors><titles><secondary-title>RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France.</secondary-title></titles><periodical><full-title>RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France.</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(6), Robert Vautard ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>VAUTARD</Author><RecNum>738</RecNum><DisplayText>(16)</DisplayText><record><rec-number>738</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1484345062">738</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>VAUTARD</author></authors></contributors><titles><secondary-title>LSCE/IPSL, Laboratoire CEA/CNRS/UVSQ, 91191 Gif-sur-Yvette, France</secondary-title></titles><periodical><full-title>LSCE/IPSL, Laboratoire CEA/CNRS/UVSQ, 91191 Gif-sur-Yvette, France</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(16), Mihaela Zidarn ADDIN EN.CITE <EndNote><Cite ExcludeYear="1"><Author>ZIDARN</Author><RecNum>740</RecNum><DisplayText>(17)</DisplayText><record><rec-number>740</rec-number><foreign-keys><key app="EN" db-id="0pfppewa1p5rzeesp0evpprb5f9d050ssxar" timestamp="1485206735">740</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>ZIDARN</author></authors></contributors><titles><secondary-title>University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia</secondary-title></titles><periodical><full-title>University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia</full-title></periodical><dates></dates><urls></urls></record></Cite></EndNote>(17) ADDIN EN.REFLIST 1.MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.2.INSERM U 1168, VIMA : Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France3.Faculty of Medicine, Transylvania University, Brasov, Romania.4.Medical University of Vienna, Department of Oto-Rhino-Laryngology, Aerobiology and Pollen Information Research Unit, Vienna, Austria.prehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universit?tsmedizin Berlin; Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany.6.RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France.7.EPAR U707 INSERM, Paris and EPAR UMR-S UPMC, Paris VI, Paris, France.8.Division of Allergy/Immunology, University of South Florida, Tampa, USA 9.Division of Respiratory and Allergic Diseases,Hospital 'A Cardarelli', University of Naples Federico II, Naples, Italy.10.Ukrainina Medical Stomatological Academy, Poltava, Ukraine.11.National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russian Federation.12.Institute of Medical Statistics and Computational Biology Medical Faculty, University of Cologne, Germany, CRI-Clinical Research International-Ltd, Hamburg, Germany13.Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary.14.Children’s Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia.15.Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.16.LSCE/IPSL, Laboratoire CEA/CNRS/UVSQ, Gif-sur-Yvette, France.17.University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.Short title?: Ragweed pollen allergy in Google TrendsAddressProfessor Jean Bousquet CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France Tel +33?611 42 88 47 jean.bousquet@orange.frFunding: European Union Development and Structural Funds Disclosure statementFinancial disclosure and conflict of interest statements of this work : JB reports personal fees from Almirall, Meda, Merck, MSD, Novartis, Sanofi-Aventis, Takeda, Teva, Uriach, AstraZeneca, Chiesi, GSK, Menarini. RM reports personal fees from ALK, allergopharma, Allergy Therapeutics, Bayer, FAES , Friulchem, GSK, Johnson&Johnson , Meda, MSD, Nuvo , Servier, Stada, UCB?,Klosterfrau, Hexal, grants from ASIT biotech, Leti, Optima, Ursapharm, BitopAG , Hulka, grants and personal fees from Bencard, Stallergenes, grants, personal fees and non-financial support from Lofarma, Novartis , non-financial support from Roxall, Atmos, Bionorica, Ferrero, Otonomy.AbstractBackground?: Google Trends (GT) searches trends of specific queries in Google, which potentially reflect the real-life epidemiology of allergic rhinitis. We compared GT terms related to ragweed pollen allergy in American and European Union countries with a known ragweed pollen season. Our aim was to assess seasonality and the terms needed to perform the GT searches and to compare these during the spring and summer pollen seasons. Methods?: We examined GT queries from 1 January, 2011 to 4 January 4, 2017. We included 15 countries with a known ragweed pollen season and used the standard 5-year GT graphs. We used the GT translation for all countries and the untranslated native terms for each country.Results?: The results of “pollen”, “ragweed” and “allergy?“ searches differed between countries, but “ragweed” was clearly identified in 12/15 countries. There was considerable heterogeneity of findings when the GT translation was used. For Croatia, Hungary, Romania, Serbia and Slovenia, the GT translation was inappropriate. The country patterns of “pollen”, “hay fever” and “allergy” differed in 8 of the 11 countries with identified “ragweed” queries during the spring and the summer, indicating that the perception of tree and grass pollen allergy differs from that of ragweed pollen. Conclusions?: To investigate ragweed pollen allergy using GT, the term “ragweed” as a plant is required and the translation of “ragweed” in the native language needed. Key words?: Allergy, Google Trends, Hay fever, Pollen, Ragweed, RhinitisAbbreviationsARIA: Allergic Rhinitis and its Impact on AsthmaGT: Google TrendsMASK: MACVIA-ARIA Sentinel NetworKMACVIA: Contre les MAladies Chroniques pour un VIeillissement ActifEU: European UnionWord count: 2327 wordsIntroductionFor patients allergic to pollen, knowledge regarding the onset and duration of the pollen season is of great importance YW4gVW5pb24gR2VyaWF0cmljTWVkaWNpbmUgU29jaWV0eSwgVmllbm5hLCBBdXN0cmlhLiYjeEQ7

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ADDIN EN.CITE.DATA (1-3). It is therefore essential to be able to forecast the onset of the pollen season as well as to characterise seasons in different places. Sentinel networks offer the potential to meet this need PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Dc2VwZTwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+PFJl

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ADDIN EN.CITE.DATA (8). The assessment of allergen content in the air is feasible ADDIN EN.CITE <EndNote><Cite><Author>Buters</Author><Year>2010</Year><RecNum>27638</RecNum><DisplayText>(9)</DisplayText><record><rec-number>27638</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="0">27638</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Buters, J. T.</author><author>Weichenmeier, I.</author><author>Ochs, S.</author><author>Pusch, G.</author><author>Kreyling, W.</author><author>Boere, A. J.</author><author>Schober, W.</author><author>Behrendt, H.</author></authors></contributors><auth-address>Division of Environmental Dermatology and Allergy, Helmholtz Zentrum Munchen/TUM, ZAUM - Center for Allergy and Environment, Technische Universitat Munchen, Munich, Germany.</auth-address><titles><title>The allergen Bet v 1 in fractions of ambient air deviates from birch pollen counts</title><secondary-title>Allergy</secondary-title></titles><periodical><full-title>Allergy</full-title></periodical><edition>2010/02/06</edition><dates><year>2010</year><pub-dates><date>Feb 4</date></pub-dates></dates><isbn>1398-9995 (Electronic)&#xD;0105-4538 (Linking)</isbn><accession-num>20132158</accession-num><urls><related-urls><url> [pii]&#xD;10.1111/j.1398-9995.2009.02286.x</electronic-resource-num><language>Eng</language></record></Cite></EndNote>(9), but requires sophisticated methods that may not account for all of the pollen species in the ambient air. Furthermore, measurements at individual level are challenging and expensive although feasibility has been demonstrated through some wearable devices. Meteorological data may, in the future, be of interest when it comes to predicting the onset of the season ADDIN EN.CITE <EndNote><Cite><Author>Myszkowska</Author><Year>2014</Year><RecNum>31700</RecNum><DisplayText>(10)</DisplayText><record><rec-number>31700</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="0">31700</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Myszkowska, D.</author><author>Majewska, R.</author></authors></contributors><auth-address>Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Cracow, Poland.&#xD;Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Cracow, Poland.</auth-address><titles><title>Pollen grains as allergenic environmental factors--new approach to the forecasting of the pollen concentration during the season</title><secondary-title>Ann Agric Environ Med</secondary-title><alt-title>Annals of agricultural and environmental medicine : AAEM</alt-title></titles><pages>681-8</pages><volume>21</volume><number>4</number><dates><year>2014</year></dates><isbn>1898-2263 (Electronic)&#xD;1232-1966 (Linking)</isbn><accession-num>25528901</accession-num><urls><related-urls><url>;(10). However, more data are required. Combining several sources of information using advanced data engineering may also be important, but the data generated are complex and not yet available for all pollen species PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Dc2VwZTwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+PFJl

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ADDIN EN.CITE.DATA (4-7, 11). Since forecasting remains a limited option, real-time epidemiological monitoring is an alternative. Google Trends (GT) is a Web-based surveillance tool that uses aggregated Google searches to summarize the searching trends of specific queries. Recent studies have suggested the utility of GT for assessing the seasonality of allergic diseases PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Lb25pZzwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+PFJl

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ADDIN EN.CITE.DATA (1).Ragweed is a highly allergenic pollen and its expansion in several countries is inducing increasing health issues ADDIN EN.CITE <EndNote><Cite><Author>Essl</Author><Year>2014</Year><RecNum>32626</RecNum><DisplayText>(20)</DisplayText><record><rec-number>32626</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1486048111">32626</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>F Essl</author><author>K. Biro</author><author>D. Brandes</author><author>O. Broennimann</author><author>J. M. Bullock</author><author>D. S. Chapman</author><author>B. Chauvel</author><author>S. Dullinger</author><author>B. Fumana</author><author>A. Guisan</author><author>G. Karrer</author><author>G. Kazinczi</author><author>C. Kueffer</author><author>B. Laitung</author><author>C. Lavoie</author><author>M. Leitner</author><author>T. Mang</author><author>D. Moser, H. Müller-Sch?rer</author><author>B. Petitpierre</author><author>R. Richter</author><author>U. Schaffner</author><author>M. Smith</author><author>U. Starfinger</author><author>R. Vautard</author><author>G. Vogl</author><author>M. von der Lippe </author><author>S. Follak</author></authors></contributors><titles><title>Biological flora of the British Isles: Ambrosia artemisiifolia,</title><secondary-title>J Ecology</secondary-title></titles><periodical><full-title>J Ecology</full-title></periodical><pages>1069-98</pages><volume>103</volume><number>4</number><dates><year>2014</year></dates><urls></urls></record></Cite></EndNote>(21). The present study was conceived as a preliminary step to explore the use of GT in the epidemiological surveillance of AR. We sought to assess whether there were differences in the Google searches of AR and related topics for ragweed pollen allergy. In the present study, we analysed multiple time series of Google search data on rhinitis, allergy and pollen in Europe and North America from January 2011 to January 4, 2017 with a focus on ragweed pollen allergy. The specific aims of the study were: (i) to assess whether the GT terms could accurately report both the onset of symptoms and of the ragweed pollen season accurately; (ii) to examine whether the GT translation of “ragweed” could be used without assessing the term in the native language; and (iii) to compare the seasonality of queries in American and European countries. MethodsGoogle Trends termsGT, a public web facility of Google Inc. based on Google Search, shows how often a particular search-term is entered relative to the total search-volume across various regions of the world, and in various languages. The horizontal axis of the main graph represents time (starting from 2004), and the vertical axis shows how often a term is searched relative to the total number of searches globally ().The following terms were used: “rhinitis”, “allergic rhinitis”, “hay fever”, “pollen”, “allergy” and “asthma” (disease and term). However, only the following three terms were analysed: “allergy”, “hay fever”, and “pollen” since “rhinitis” as a term or “hay fever” were labelled as “allergic rhinitis as a disease”. “Asthma” and “conjunctivitis” were not selected as we found no seasonality associated with pollen in previous analyses (unpublished observation). Only “diseases” and “subjects” are translated by Google Translator () whereas “terms” or “terms of research” are not translated directly. The GT terms for ragweed pollen include ??gender??, ??plant?? and ??subject??. We tested the three terms and ??gender?? was the term needed to assess the ragweed pollen season in all countries tested. Moreover, we used “ragweed” as a GT translation and with the native languages of the countries studied. In GT, data are normalised to the highest number of searches for each topic. A score of 100 meant that, on that day, the topic had the highest number of searches over the reference period included in the search (in the present study five years) in that particular place. Comparisons across different areas should therefore be considered with care since the score in each area depends on the series of searches during the reference period in that area. Moreover, a high level of search (e.g. “allergy”) reduces the level of the other searches. To account for this issue, we performed searches that included and excluded “allergy”.Selection of countriesCountries with a known allergy to ragweed pollen were studied (Table 1 online). They were European countries defined in a recent paper ADDIN EN.CITE <EndNote><Cite><Author>Lake</Author><Year>2016</Year><RecNum>32623</RecNum><DisplayText>(21)</DisplayText><record><rec-number>32623</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1484926067">32623</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lake, I. R.</author><author>Jones, N. R.</author><author>Agnew, M.</author><author>Goodess, C. M.</author><author>Giorgi, F.</author><author>Hamaoui-Laguel, L.</author><author>Semenov, M. A.</author><author>Solomon, F.</author><author>Storkey, J.</author><author>Vautard, R.</author><author>Epstein, M. M.</author></authors></contributors><auth-address>School of Environmental Sciences, University of East Anglia, Norwich, UK.&#xD;Earth System Physics Section, International Centre for Theoretical Physics, Trieste, Italy.&#xD;Laboratoire des Sciences du Climat et de l&apos;Environnement, IPSL, CEA-CNRS-UVSQ, UMR8212, Gif sur Yvette, France.&#xD;Institut National de l&apos;Environnement Industriel et des Risques, Parc technologique ALATA, Verneuil en Halatte, France.&#xD;Rothamsted Research, Harpenden, Hertfordshire, UK.&#xD;Department of Dermatology, Division of Immunology, Allergy and Infectious Disease, Experimental Allergy, Medical University of Vienna, Vienna, Austria.</auth-address><titles><title>Climate Change and Future Pollen Allergy in Europe</title><secondary-title>Environ Health Perspect</secondary-title></titles><periodical><full-title>Environ Health Perspect</full-title></periodical><dates><year>2016</year><pub-dates><date>Aug 24</date></pub-dates></dates><isbn>1552-9924 (Electronic)&#xD;0091-6765 (Linking)</isbn><accession-num>27557093</accession-num><urls><related-urls><url>;(22), former Yugoslavian countries ADDIN EN.CITE <EndNote><Cite><Author>Mehulic</Author><Year>2011</Year><RecNum>32606</RecNum><DisplayText>(22)</DisplayText><record><rec-number>32606</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1483604643">32606</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mehulic, M.</author><author>Mehulic, K.</author><author>Vuljanko, I. M.</author><author>Kukulj, S.</author><author>Grle, S. P.</author><author>Vukic, A. D.</author><author>Barisic, B.</author><author>Plavec, D.</author></authors></contributors><auth-address>University of Zagreb, &quot;Jordanovac&quot; University Hospital for Lung Diseases, Zagreb, Croatia.</auth-address><titles><title>Changing pattern of sensitization in Croatia to aeroallergens in adult population referring to allergy clinic during a period of 15 years</title><secondary-title>Coll Antropol</secondary-title></titles><periodical><full-title>Coll Antropol</full-title></periodical><pages>529-36</pages><volume>35</volume><number>2</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Allergens/*immunology</keyword><keyword>Ambulatory Care Facilities</keyword><keyword>Croatia/epidemiology</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypersensitivity/*epidemiology/immunology</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Retrospective Studies</keyword></keywords><dates><year>2011</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>0350-6134 (Print)&#xD;0350-6134 (Linking)</isbn><accession-num>21755728</accession-num><urls><related-urls><url>;(23), Canada, Russia, the USA and Ukraine ADDIN EN.CITE <EndNote><Cite><Author>Prank</Author><Year>2013</Year><RecNum>32639</RecNum><DisplayText>(23)</DisplayText><record><rec-number>32639</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1487019748">32639</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>M Prank</author><author>DS Chapman</author><author>JM Bullock</author><author>J Belmonte</author><author>U Berger</author><author>A Dahl</author><author>S J?ger</author><author>I Kovtunenko</author><author>D Magyar</author><author>S Niemel?</author><author>A Rantio-Lehtim?ki</author><author>V Rodinkova</author><author>I Sauliene</author><author>E Severiva</author><author>B Sikoparija</author><author>M Sofiev</author></authors></contributors><titles><title>An operational model for forecasting ragweed pollen release and dispersion in Europe</title><secondary-title>Agric Forest Meteorol</secondary-title></titles><periodical><full-title>Agric Forest Meteorol</full-title></periodical><pages>43-53</pages><volume>182-183</volume><dates><year>2013</year></dates><urls></urls></record></Cite></EndNote>(24).AnalysesWe used the 5-year GT graphs to examine GT queries from 1 January, 2011 to 4 January 4, 2017 in American and European countries with a known ragweed pollen season. A visual analysis was carried out (JB) to assess the seasonality of ragweed pollen allergy.Cultural differences exist between countries. Terms are therefore not used in the same way from one country to the next ADDIN EN.CITE <EndNote><Cite><Author>Bousquet</Author><Year>2017</Year><RecNum>32624</RecNum><DisplayText>(19)</DisplayText><record><rec-number>32624</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1485187548">32624</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>J Bousquet</author><author>I Agache </author><author>JM Anto </author><author>KC Bergmann </author><author>C Bachert </author><author>I Annesi-Maesano </author><author>PJ Bousquet </author><author>G D’Amato </author><author>P Demoly </author><author>G De Vries </author><author>E Eller </author></authors></contributors><titles><title>Google Trends terms reporting rhinitis and related topics differ in European countries</title><secondary-title>Allergy</secondary-title></titles><periodical><full-title>Allergy</full-title></periodical><volume>in press</volume><dates><year>2017</year></dates><urls></urls></record></Cite></EndNote>(20). We compared the country patterns (based on seasons) with the mean 5-year terms provided by GT, slightly modified from a previous paper in European countries (Table 1) ADDIN EN.CITE <EndNote><Cite><Author>Bousquet</Author><Year>2017</Year><RecNum>32624</RecNum><DisplayText>(19)</DisplayText><record><rec-number>32624</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1485187548">32624</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>J Bousquet</author><author>I Agache </author><author>JM Anto </author><author>KC Bergmann </author><author>C Bachert </author><author>I Annesi-Maesano </author><author>PJ Bousquet </author><author>G D’Amato </author><author>P Demoly </author><author>G De Vries </author><author>E Eller </author></authors></contributors><titles><title>Google Trends terms reporting rhinitis and related topics differ in European countries</title><secondary-title>Allergy</secondary-title></titles><periodical><full-title>Allergy</full-title></periodical><volume>in press</volume><dates><year>2017</year></dates><urls></urls></record></Cite></EndNote>(20). This classification was only carried out in the summer in countries with consistent “ragweed” queries. Moreover, the patterns had to be consistent four of the five-year survey. We did not compare the results of the 5-year trends with those of one year or less, since the goal of the paper was not to define whether GT can be used as sentinel, but to assess whether there are differences between terms across the 15 countries of interest.Results GT terms reporting symptoms or the pollen season The 5-year GT are reported in Figures 1 and 2 and Figures 1 and 2 online. When the term “allergy” was searched, different patterns could be observed at the country level. In Austria and France, the term “Ragweed” was largely used, but this did not always correlate with “allergy” peaks during the corresponding “ragweed” search peak. In Canada, Croatia, Hungary and the USA, the term “Ragweed” appeared to be less frequently searched, but there was a peak of “allergy” during the “ragweed” search peak. Using the GT-translation, many countries did not have a ragweed peak. In Italy, we searched for “Lombardia” (Lombardy) and the results were identical to the whole country (not shown).GT translation of “ragweed” in the native language We then searched for the term “ragweed” in the native language and major differences were observed in Croatia, Serbia and Slovenia (ambrozija), Hungary (parlagfü) and Romania (ambrozia) (Figure 2 and Figure 2 online). In all of these countries, the searches were considerably different when the native language was used by comparison to the GT-translation. This indicated that there were inadequate translations for some of the terms using GT. The terms in Cyrilic (Bulgaria) or Greek (Greece) were not searchable. For Germany, Italy and the Netherlands, there were no differences between GT and manually-translated terms. In all countries except Bulgaria, Greece, Italy and the Netherlands, the ragweed pollen season could be demonstrated every year during the 5-year survey. The peak of queries for “ragweed” was sharper than that of “allergy”.Seasonality of queries in American and European countries The 5-year GT differed largely between countries when the terms “ragweed” (translated and native language), “pollen”, “allergy” and “hay fever” were assessed (Figures 1 and 2, Figure 1 and 2 online and Table 2). In two countries, it was impossible to assess GT accurately (Bulgaria and Greece). In two countries (Italy and the Netherlands), there was no increase in Google searches for the different terms during the summer. The term “pollen” was only searched in the summer in Canada and Hungary. The term “ragweed” was searched during the summer for all years in 12 countries. The term “allergy” was searched between 4 and 5 years in six countries, twice or three times in four countries and none in five. On the other hand, the terms “pollen” or “hay fever” were rarely searched across the five years and never in 14 and 13 countries respectively.Patterns of pollen seasons were compared for Spring (March-June) and Summer (July-September, Figures 1 and 2, Figures 1 and 2 online and Table 2). For Canada, Croatia and Romania, a similar pattern was found in the Spring and Summer. In 8 countries, patterns differed between the Spring and the Summer. “Allergy” was searched in all countries for all five years during the spring season and in 7/11 countries during the summer season. However, except for Hungary, Serbia and Ukraine, the peaks of queries were better identified in the spring than in the summer (Figure 1 and Figure 1 online). DiscussionIn the present study, searches for “ragweed” as a plant in 15 countries with a demonstrated pollen season show that the term can be used with the GT translation in six countries. Translations in the native language by GT were needed in five countries. In four countries, we were unable to identify a GT peak for “ragweed”. However, when it exists, the peak for “ragweed” queries is easier to detect than the peak of “allergy” queries. There were apparent cultural differences in the knowledge or awareness of the terms between the spring and the summer pollen seasons in most countries. In countries with a high prevalence of ragweed pollen allergy, it is important to use ragweed (native language and GT translation) in addition to “allergy”, “pollen” and “hay fever” to account for the pollen seasons using GT.GT reflects the proportion of specific queries in relation to all queries. Although the terms were translated into the different languages using the automatic Google translator, the reporting of GT differed widely between countries. We checked for all countries if the translation was appropriate and major differences appeared to be associated with translation issues for Croatia, Hungary, Romania, Serbia and Slovenia. It appears that there are country-specific trends towards a different awareness and different use of allergy terms, which may represent cultural differences. In the present paper we did not compare GTs with pollen counts as they are not available for all countries. We are currently analyzing French data to have a direct comparison between all pollen seasons and GTs. For ragweed pollen, the time of occurrence of GTs is very similar across countries and in line with the ragweed pollen season.The selection of countries was based on a recent review in European countries ADDIN EN.CITE <EndNote><Cite><Author>Lake</Author><Year>2016</Year><RecNum>32623</RecNum><DisplayText>(21)</DisplayText><record><rec-number>32623</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1484926067">32623</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lake, I. R.</author><author>Jones, N. R.</author><author>Agnew, M.</author><author>Goodess, C. M.</author><author>Giorgi, F.</author><author>Hamaoui-Laguel, L.</author><author>Semenov, M. A.</author><author>Solomon, F.</author><author>Storkey, J.</author><author>Vautard, R.</author><author>Epstein, M. M.</author></authors></contributors><auth-address>School of Environmental Sciences, University of East Anglia, Norwich, UK.&#xD;Earth System Physics Section, International Centre for Theoretical Physics, Trieste, Italy.&#xD;Laboratoire des Sciences du Climat et de l&apos;Environnement, IPSL, CEA-CNRS-UVSQ, UMR8212, Gif sur Yvette, France.&#xD;Institut National de l&apos;Environnement Industriel et des Risques, Parc technologique ALATA, Verneuil en Halatte, France.&#xD;Rothamsted Research, Harpenden, Hertfordshire, UK.&#xD;Department of Dermatology, Division of Immunology, Allergy and Infectious Disease, Experimental Allergy, Medical University of Vienna, Vienna, Austria.</auth-address><titles><title>Climate Change and Future Pollen Allergy in Europe</title><secondary-title>Environ Health Perspect</secondary-title></titles><periodical><full-title>Environ Health Perspect</full-title></periodical><dates><year>2016</year><pub-dates><date>Aug 24</date></pub-dates></dates><isbn>1552-9924 (Electronic)&#xD;0091-6765 (Linking)</isbn><accession-num>27557093</accession-num><urls><related-urls><url>;(22) and the known ragweed pollen season in the former Yugoslavian countries ADDIN EN.CITE <EndNote><Cite><Author>Mehulic</Author><Year>2011</Year><RecNum>32606</RecNum><DisplayText>(22)</DisplayText><record><rec-number>32606</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1483604643">32606</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mehulic, M.</author><author>Mehulic, K.</author><author>Vuljanko, I. M.</author><author>Kukulj, S.</author><author>Grle, S. P.</author><author>Vukic, A. D.</author><author>Barisic, B.</author><author>Plavec, D.</author></authors></contributors><auth-address>University of Zagreb, &quot;Jordanovac&quot; University Hospital for Lung Diseases, Zagreb, Croatia.</auth-address><titles><title>Changing pattern of sensitization in Croatia to aeroallergens in adult population referring to allergy clinic during a period of 15 years</title><secondary-title>Coll Antropol</secondary-title></titles><periodical><full-title>Coll Antropol</full-title></periodical><pages>529-36</pages><volume>35</volume><number>2</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Allergens/*immunology</keyword><keyword>Ambulatory Care Facilities</keyword><keyword>Croatia/epidemiology</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Hypersensitivity/*epidemiology/immunology</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Retrospective Studies</keyword></keywords><dates><year>2011</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>0350-6134 (Print)&#xD;0350-6134 (Linking)</isbn><accession-num>21755728</accession-num><urls><related-urls><url>;(23), Canada, Russia and Ukraine ADDIN EN.CITE <EndNote><Cite><Author>Prank</Author><Year>2013</Year><RecNum>32639</RecNum><DisplayText>(23)</DisplayText><record><rec-number>32639</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1487019748">32639</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>M Prank</author><author>DS Chapman</author><author>JM Bullock</author><author>J Belmonte</author><author>U Berger</author><author>A Dahl</author><author>S J?ger</author><author>I Kovtunenko</author><author>D Magyar</author><author>S Niemel?</author><author>A Rantio-Lehtim?ki</author><author>V Rodinkova</author><author>I Sauliene</author><author>E Severiva</author><author>B Sikoparija</author><author>M Sofiev</author></authors></contributors><titles><title>An operational model for forecasting ragweed pollen release and dispersion in Europe</title><secondary-title>Agric Forest Meteorol</secondary-title></titles><periodical><full-title>Agric Forest Meteorol</full-title></periodical><pages>43-53</pages><volume>182-183</volume><dates><year>2013</year></dates><urls></urls></record></Cite></EndNote>(24). It is unclear how generalizable these findings are beyond these 15 countries under study.The association between “pollen?“, “ragweed” and “allergy” searches differed between countries. However, “ragweed” was clearly identified in 12 of the 15 countries with a known ragweed pollen season. We then attempted to assess certain regions such as Lombardia and there was no difference. In Greece and the Netherlands, searches for “ragweed” were also not significant. In Bulgaria, data were not interpretable. These differences may be related to several possibilities: (i) the word “ragweed” is not the correct term used in the country; (ii) the translation of “ragweed” by GT is often incorrect (Croatia, Hungary, Romania, Serbia and Slovenia); (iii) the pollen season did not induce severe symptoms in the country and this is possibly the case for Greece and the Netherlands. Although countries were selected from a review assessing both the amount of ragweed pollen found in the atmosphere and the prevalence of the ragweed allergic population, severity was not reported ADDIN EN.CITE <EndNote><Cite><Author>Lake</Author><Year>2016</Year><RecNum>32623</RecNum><DisplayText>(21)</DisplayText><record><rec-number>32623</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1484926067">32623</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lake, I. R.</author><author>Jones, N. R.</author><author>Agnew, M.</author><author>Goodess, C. M.</author><author>Giorgi, F.</author><author>Hamaoui-Laguel, L.</author><author>Semenov, M. A.</author><author>Solomon, F.</author><author>Storkey, J.</author><author>Vautard, R.</author><author>Epstein, M. M.</author></authors></contributors><auth-address>School of Environmental Sciences, University of East Anglia, Norwich, UK.&#xD;Earth System Physics Section, International Centre for Theoretical Physics, Trieste, Italy.&#xD;Laboratoire des Sciences du Climat et de l&apos;Environnement, IPSL, CEA-CNRS-UVSQ, UMR8212, Gif sur Yvette, France.&#xD;Institut National de l&apos;Environnement Industriel et des Risques, Parc technologique ALATA, Verneuil en Halatte, France.&#xD;Rothamsted Research, Harpenden, Hertfordshire, UK.&#xD;Department of Dermatology, Division of Immunology, Allergy and Infectious Disease, Experimental Allergy, Medical University of Vienna, Vienna, Austria.</auth-address><titles><title>Climate Change and Future Pollen Allergy in Europe</title><secondary-title>Environ Health Perspect</secondary-title></titles><periodical><full-title>Environ Health Perspect</full-title></periodical><dates><year>2016</year><pub-dates><date>Aug 24</date></pub-dates></dates><isbn>1552-9924 (Electronic)&#xD;0091-6765 (Linking)</isbn><accession-num>27557093</accession-num><urls><related-urls><url>;(22); (iv) an insufficient number of affected people in the country; and (v) cultural differences between countries which cannot be appreciated. We have previously shown that such differences exist for allergic rhinitis and pollen showing country patterns ADDIN EN.CITE <EndNote><Cite><Author>Bousquet</Author><Year>2017</Year><RecNum>32624</RecNum><DisplayText>(19)</DisplayText><record><rec-number>32624</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1485187548">32624</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>J Bousquet</author><author>I Agache </author><author>JM Anto </author><author>KC Bergmann </author><author>C Bachert </author><author>I Annesi-Maesano </author><author>PJ Bousquet </author><author>G D’Amato </author><author>P Demoly </author><author>G De Vries </author><author>E Eller </author></authors></contributors><titles><title>Google Trends terms reporting rhinitis and related topics differ in European countries</title><secondary-title>Allergy</secondary-title></titles><periodical><full-title>Allergy</full-title></periodical><volume>in press</volume><dates><year>2017</year></dates><urls></urls></record></Cite></EndNote>(20). Other possibilities are: (vi) differences in media coverage of the ragweed pollen season; and (vii) known biases of GT including the masking of some terms by a very high level of searches for one term relative to “ragweed”. However, we used two different searches (with and without “allergy”). An important finding of the paper is represented by the differences in searches between the spring and summer pollen seasons. The terms “pollen” and “hay fever” were rarely searched in the summer suggesting some cultural differences between countries and/or awareness. It would be of interest to assess whether differences in the two seasons are associated with different treatment patterns. This can be done using the MASK sentinel network IFVuaW9uIEdlcmlhdHJpY01lZGljaW5lIFNvY2lldHksIFZpZW5uYSwgQXVzdHJpYS4mI3hEO0Rl

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ADDIN EN.CITE.DATA (1) or apps that can help monitor the treatment of allergic rhinitis in a large sample size observational study.The May-June “ragweed” peaks detected in Austria and France are likely to represent awareness peaks since ragweed does not pollinate during these months. In particular, the 2015 May peak was associated with a paper on ragweed pollen and climate change that was published 25 May 2015. This paper attracted substantial media interest ADDIN EN.CITE <EndNote><Cite><Author>Hamaoui-Laguel</Author><Year>2015</Year><RecNum>32602</RecNum><DisplayText>(24)</DisplayText><record><rec-number>32602</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1483563351">32602</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L Hamaoui-Laguel</author><author>R vautard</author><author>L Liu</author><author>F Solmon</author><author>N Viory</author><author>D Khvorostyanov</author><author>I Chuine</author><author>A Colette</author><author>MA Semenov</author><author>A Schauffhauser</author><author>J Storkey</author><author>M Thibaudon</author><author>MM Epstein</author></authors></contributors><titles><title>Effects of climate change and seed dispersal on airborne ragweed pollen loads in Europe</title><secondary-title>Nat Clim Change</secondary-title></titles><periodical><full-title>Nat Clim Change</full-title></periodical><pages>766-71</pages><volume>5</volume><dates><year>2015</year></dates><urls></urls></record></Cite></EndNote>(25). In France, other peaks are found in May-June and may possibly be related to the information on Ragweed International Day, usually largely publicised. It is therefore of importance to correlate GT for “ragweed” with the expected pollen season. It is also important to correlate the pollen season with “ragweed” queries.GT may be of interest in the differentiation of pollen seasons when they overlap, as is the case for many countries including Austria, Canada, Hungary and Slovenia. However, there are other tools such as Twitter that may be used (26).The results of the current study will be used in the development of the MASK sentinel network IFVuaW9uIEdlcmlhdHJpY01lZGljaW5lIFNvY2lldHksIFZpZW5uYSwgQXVzdHJpYS4mI3hEO0Rl

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ADDIN EN.CITE.DATA (27,28). The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing YWx0aCBhbmQgQmlvc3RhdGlzdGljcywgRUEgNDA2NCwgUGFyaXMgRGVzY2FydGVzIFVuaXZlcnNp

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Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5). Clin Transl Allergy. 2016;6:29.Table 1: Patterns of countries during the spring and summer pollen seasonsPatternAPeak of “hay fever” greater than “allergy”BPeak of “hay fever”, “pollen” and “allergy”CPeak of “pollen”DPeak of “allergy”EPeak of “allergy” and “hay fever”FNo season identifiedGPeak of “allergy” and “pollen”Table 2: Google Trends in the Spring and the Summer in countries with demonstrated seasons RagweedPollen season* ADDIN EN.CITE <EndNote><Cite><Author>Lake</Author><Year>2016</Year><RecNum>32623</RecNum><DisplayText>(21)</DisplayText><record><rec-number>32623</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1484926067">32623</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lake, I. R.</author><author>Jones, N. R.</author><author>Agnew, M.</author><author>Goodess, C. M.</author><author>Giorgi, F.</author><author>Hamaoui-Laguel, L.</author><author>Semenov, M. A.</author><author>Solomon, F.</author><author>Storkey, J.</author><author>Vautard, R.</author><author>Epstein, M. M.</author></authors></contributors><auth-address>School of Environmental Sciences, University of East Anglia, Norwich, UK.&#xD;Earth System Physics Section, International Centre for Theoretical Physics, Trieste, Italy.&#xD;Laboratoire des Sciences du Climat et de l&apos;Environnement, IPSL, CEA-CNRS-UVSQ, UMR8212, Gif sur Yvette, France.&#xD;Institut National de l&apos;Environnement Industriel et des Risques, Parc technologique ALATA, Verneuil en Halatte, France.&#xD;Rothamsted Research, Harpenden, Hertfordshire, UK.&#xD;Department of Dermatology, Division of Immunology, Allergy and Infectious Disease, Experimental Allergy, Medical University of Vienna, Vienna, Austria.</auth-address><titles><title>Climate Change and Future Pollen Allergy in Europe</title><secondary-title>Environ Health Perspect</secondary-title></titles><periodical><full-title>Environ Health Perspect</full-title></periodical><dates><year>2016</year><pub-dates><date>Aug 24</date></pub-dates></dates><isbn>1552-9924 (Electronic)&#xD;0091-6765 (Linking)</isbn><accession-num>27557093</accession-num><urls><related-urls><url>;(21)5-yr Google Trends in summer Country pattern ??Ambrosia?? ?Allergy? ?Pollen??? ?Hay fever? SummerSpringLevelConsistency***Austria+High5/5 2/50/50/5GBBulgaria++Low1/50/50/50/5No RwDCanada++ (24)High5/55/55/55/5BBCroatia++High$5/54/50/50/5DDFrance+High5/50/50/50/5GCGreece++No peak0/52/50/50/5No RwDItaly++No peak0/50/50/50/5No RwDHungary++High$5/50/55/50/5FDNetherlands+No peak0/50/50/50/5No RwARomania++High$5/54/50/50/5DDRussia++ (24)High5/54/50/50/5DBSerbia++High$5/54/50/50/5DCSlovenia+High$5/50/50/50/5GDUkraine++ (24)High5/55/50/50/5DCUSA++ (24)High5/55/50/54/5$*GBRagweed pollen season* determined by data obtained from studies (21 and 24). For study 21: Between 1986 and 2005: +?: 10% of the population of the country sensitized and >1,000 grains/m3, ++?: 10% of the population of the country sensitized and >2,500 grains/m3 ADDIN EN.CITE <EndNote><Cite><Author>Lake</Author><Year>2016</Year><RecNum>32623</RecNum><DisplayText>(21)</DisplayText><record><rec-number>32623</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1484926067">32623</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lake, I. R.</author><author>Jones, N. R.</author><author>Agnew, M.</author><author>Goodess, C. M.</author><author>Giorgi, F.</author><author>Hamaoui-Laguel, L.</author><author>Semenov, M. A.</author><author>Solomon, F.</author><author>Storkey, J.</author><author>Vautard, R.</author><author>Epstein, M. M.</author></authors></contributors><auth-address>School of Environmental Sciences, University of East Anglia, Norwich, UK.&#xD;Earth System Physics Section, International Centre for Theoretical Physics, Trieste, Italy.&#xD;Laboratoire des Sciences du Climat et de l&apos;Environnement, IPSL, CEA-CNRS-UVSQ, UMR8212, Gif sur Yvette, France.&#xD;Institut National de l&apos;Environnement Industriel et des Risques, Parc technologique ALATA, Verneuil en Halatte, France.&#xD;Rothamsted Research, Harpenden, Hertfordshire, UK.&#xD;Department of Dermatology, Division of Immunology, Allergy and Infectious Disease, Experimental Allergy, Medical University of Vienna, Vienna, Austria.</auth-address><titles><title>Climate Change and Future Pollen Allergy in Europe</title><secondary-title>Environ Health Perspect</secondary-title></titles><periodical><full-title>Environ Health Perspect</full-title></periodical><dates><year>2016</year><pub-dates><date>Aug 24</date></pub-dates></dates><isbn>1552-9924 (Electronic)&#xD;0091-6765 (Linking)</isbn><accession-num>27557093</accession-num><urls><related-urls><url>;(21), ND: not determined by ADDIN EN.CITE <EndNote><Cite><Author>Lake</Author><Year>2016</Year><RecNum>32623</RecNum><DisplayText>(21)</DisplayText><record><rec-number>32623</rec-number><foreign-keys><key app="EN" db-id="pw9fa5tp00dfvieeedr5zxsr2ws0f5fdswxp" timestamp="1484926067">32623</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lake, I. R.</author><author>Jones, N. R.</author><author>Agnew, M.</author><author>Goodess, C. M.</author><author>Giorgi, F.</author><author>Hamaoui-Laguel, L.</author><author>Semenov, M. A.</author><author>Solomon, F.</author><author>Storkey, J.</author><author>Vautard, R.</author><author>Epstein, M. M.</author></authors></contributors><auth-address>School of Environmental Sciences, University of East Anglia, Norwich, UK.&#xD;Earth System Physics Section, International Centre for Theoretical Physics, Trieste, Italy.&#xD;Laboratoire des Sciences du Climat et de l&apos;Environnement, IPSL, CEA-CNRS-UVSQ, UMR8212, Gif sur Yvette, France.&#xD;Institut National de l&apos;Environnement Industriel et des Risques, Parc technologique ALATA, Verneuil en Halatte, France.&#xD;Rothamsted Research, Harpenden, Hertfordshire, UK.&#xD;Department of Dermatology, Division of Immunology, Allergy and Infectious Disease, Experimental Allergy, Medical University of Vienna, Vienna, Austria.</auth-address><titles><title>Climate Change and Future Pollen Allergy in Europe</title><secondary-title>Environ Health Perspect</secondary-title></titles><periodical><full-title>Environ Health Perspect</full-title></periodical><dates><year>2016</year><pub-dates><date>Aug 24</date></pub-dates></dates><isbn>1552-9924 (Electronic)&#xD;0091-6765 (Linking)</isbn><accession-num>27557093</accession-num><urls><related-urls><url>;(21)**: Country pattern in spring***: Number of years or ragweed pollen/allergy peak over the 5-year monitoring$*: Low peak$: With the term in native languageNA: Impossible to determine due to a large variation of baseline levelsFigure 1: Five-year Google Trends for ??allergy??, ??hay fever??, ??pollen?? and ??ragweed?? using GT translated terms“allergy” ___, “pollen”___, “hay fever”___, “ragweed”___Figure 2?: Five-year Google Trends for ??hay fever??, ??pollen?? and ??ragweed?? using GT-translated and manually-translated terms“pollen”___, “ragweed” ___, “hay fever”___Supplementary file Figure 1 online: Five-year Google Trends for ??allergy??, ??allergic rhinitis??, ??pollen?? and ??ragweed?? using GT translated terms“allergy” ___, “pollen”___, “hay fever”___, “ragweed”___Austria BulgariaCanadaCroatiaFranceGreeceHungaryItalyNetherlandsRomaniaRussiaSerbia SloveniaUkraineUSAFigure 2?online: Five-year Google Trends for ??allergic rhinitis??, ??pollen?? and ??ragweed?? using GT-translated and manually-translated terms“pollen”___, “ragweed” ___, “hay fever”___AustriaBulgariaCanadaCroatia (ambrozija) FranceGreeceHungary (parlagfü) ItalyNetherlandsRomania (ambrozia) RussiaSerbia (ambrozija) Slovenia (ambrozija) UkraineUSATable 1 online: The Ambrosia genusKingdom:?Plantae?Angiosperms?Eudicots?Asterids?Order:?Asterales?Family:?Asteraceae?Genus:?Ambrosia?Species:?A. artemisiifolia? ................
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