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Program for Monitoring Emerging Diseases (also known as ProMED-mail, abbreviated ProMED) is among the largest publicly available emerging diseases and outbreak reporting systems in the world. The purpose of ProMED is to promote communication amongst the international infectious disease community, including
scientists A scientist is a person who conducts scientific research to advance knowledge in an area of the natural sciences. In classical antiquity, there was no real ancient analog of a modern scientist. Instead, philosophers engaged in the philosophica ...
,
physicians A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
,
veterinarians A veterinarian (vet), also known as a veterinary surgeon or veterinary physician, is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, vet ...
,
epidemiologists Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decisions and eviden ...
,
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
professionals, and others interested in infectious diseases on a global scale. Founded in 1994, ProMED has pioneered the concept of electronic, Internet-based emerging disease and outbreak detection reporting. In 1999, ProMED became a program of the
International Society for Infectious Diseases The International Society for Infectious Diseases (ISID), established in 1986, is a nonprofit organization that monitors infectious diseases on a global scale. It also offers grants and fellowships, publishes a journal, and runs online learning pl ...
. As of 2016, ProMED has more than 75,000 subscribers in over 185 countries. With an average of 13 posts per day, ProMED provides users with up-to-date information concerning infectious disease outbreaks on a global scale. ProMED's guiding principles include: * Transparency and a commitment to the unfettered flow of outbreak information * Freedom from political constraints * Availability to all without cost * Commitment to
One Health One Health is an approach calling for "the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment", as defined by the One Health Initiative Task For ...
* Service to the global health community One of the essential global health priorities is the timely recognition and reporting of emerging and re-emerging
infectious diseases An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
. Early recognition can enable coordinated and rapid responses to an
outbreak In epidemiology, an outbreak is a sudden increase in occurrences of a disease when cases are in excess of normal expectancy for the location or season. It may affect a small and localized group or impact upon thousands of people across an entire ...
, preventing catastrophic
morbidity A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
and
mortality Mortality is the state of being mortal, or susceptible to death; the opposite of immortality. Mortality may also refer to: * Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock throug ...
. Additionally, early detection can alleviate grave economic hardship brought upon by
pandemics A pandemic () is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. A widespread endemic disease with a stable number of in ...
and emerging diseases. Burgeoning globalization of
commerce Commerce is the large-scale organized system of activities, functions, procedures and institutions directly and indirectly related to the exchange (buying and selling) of goods and services among two or more parties within local, regional, nation ...
,
finance Finance is the study and discipline of money, currency and capital assets. It is related to, but not synonymous with economics, the study of production, distribution, and consumption of money, assets, goods and services (the discipline of fina ...
,
manufacturing Manufacturing is the creation or production of goods with the help of equipment, labor, machines, tools, and chemical or biological processing or formulation. It is the essence of secondary sector of the economy. The term may refer to a r ...
, and services has fostered ever-increasing movement of
people A person (plural, : people) is a being that has certain capacities or attributes such as reason, morality, consciousness or self-consciousness, and being a part of a culturally established form of social relations such as kinship, ownership of pr ...
,
animals Animals are multicellular, eukaryotic organisms in the biological kingdom Animalia. With few exceptions, animals consume organic material, breathe oxygen, are able to move, can reproduce sexually, and go through an ontogenetic stage in ...
,
plants Plants are predominantly Photosynthesis, photosynthetic eukaryotes of the Kingdom (biology), kingdom Plantae. Historically, the plant kingdom encompassed all living things that were not animals, and included algae and fungi; however, all curr ...
,
food Food is any substance consumed by an organism for nutritional support. Food is usually of plant, animal, or fungal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals. The substance is inge ...
, and
animal feed Animal feed is food given to domestic animals, especially livestock, in the course of animal husbandry. There are two basic types: fodder and forage. Used alone, the word ''feed'' more often refers to fodder. Animal feed is an important input to ...
. Other contributing factors to the risk of new
pathogens In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...
emerging and known pathogens re-emerging include
climate change In common usage, climate change describes global warming—the ongoing increase in global average temperature—and its effects on Earth's climate system. Climate change in a broader sense also includes previous long-term changes to E ...
,
urbanization Urbanization (or urbanisation) refers to the population shift from rural to urban areas, the corresponding decrease in the proportion of people living in rural areas, and the ways in which societies adapt to this change. It is predominantly t ...
,
land use Land use involves the management and modification of natural environment or wilderness into built environment such as settlements and semi-natural habitats such as arable fields, pastures, and managed woods. Land use by humans has a long h ...
changes, and
political instability Political decay is a political theory, originally described by Samuel P. Huntington, which describes how chaos and disorder can arise from social modernization increasing more rapidly than political and institutional modernization. Huntington provi ...
. Outbreaks that begin in the most remote parts of the world now spread swiftly to
urban centre An urban area, built-up area or urban agglomeration is a human settlement with a high population density and infrastructure of built environment. Urban areas are created through urbanization and are categorized by urban morphology as cities, ...
s in countries far away. The
epidemiological Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decisions and evidenc ...
data in ProMED posts has been used to estimate mortality rates and
demographic Demography () is the statistical study of populations, especially human beings. Demographic analysis examines and measures the dimensions and dynamics of populations; it can cover whole societies or groups defined by criteria such as edu ...
parameters for specific diseases. The
severe acute respiratory syndrome Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, ''seve ...
(SARS) outbreak in 2003 and the
Middle East respiratory syndrome Middle East respiratory syndrome (MERS) is a viral respiratory infection caused by ''Middle East respiratory syndrome–related coronavirus'' (MERS-CoV). Symptoms may range from none, to mild, to severe. Typical symptoms include fever, cough, ...
(MERS) outbreak in 2012 demonstrated the importance of early identification for emerging disease occurrences. The initial outbreak reports in both events were posted by astute clinicians. The use of non-traditional information sources can provide prompt information to the international community on emerging infectious disease problems that have yet to be officially reported. The early dissemination of information may lead to rapid official confirmation of ongoing outbreaks. The Epicore programme, launched in March 2016 by various organizations including the patrons of ProMED-mail, makes use of volunteers throughout the world to find and report outbreaks using non-traditional methods.


History

Under the auspices of the
Federation of American Scientists The Federation of American Scientists (FAS) is an American nonprofit global policy think tank with the stated intent of using science and scientific analysis to attempt to make the world more secure. FAS was founded in 1946 by scientists who wo ...
, ProMED-mail was founded in 1994 by Dr. Stephen Morse, then of
Rockefeller University The Rockefeller University is a private biomedical research and graduate-only university in New York City, New York. It focuses primarily on the biological and medical sciences and provides doctoral and postdoctoral education. It is classif ...
, Dr. Barbara Rosenberg of the
State University of New York The State University of New York (SUNY, , ) is a system of public colleges and universities in the State of New York. It is one of the largest comprehensive system of universities, colleges, and community colleges in the United States. Led by c ...
at Purchase, and Dr. Jack Woodall, then of the
New York State Department of Health The New York State Department of Health (NYSDOH) is the department of the New York state government responsible for public health. It is headed by Health Commissioner Mary T. Bassett, who was appointed by Governor Hochul and confirmed by the S ...
(and currently an Associate Editor of ProMED). Originally envisioned as a direct scientist-to-scientist network, ProMED rapidly grew into a prototype outbreak reporting and discussion list, especially after the 1995
Ebola Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after becom ...
outbreak. The idea of a global network was first proposed by Donald A. Henderson in 1989. ProMED played a crucial role in identifying the
SARS Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, ''sever ...
outbreak early in 2003. An astute physician in Silver Spring, Maryland, Stephen O. Cunnion, MD, PhD, MPH, submitted the first report to the database for this emerging outbreak, allowing the ProMED community to track the outbreak nearly two months in advance of the worldwide alert. The email read: “Have you heard of an epidemic in Guangzhou? An acquaintance of mine . . . reports that the hospitals there have been closed and people are dying.” It was one month later before the Chinese government officially acknowledged the outbreak. In 2012, the users of ProMED were again some of the first to identify the outbreak of
MERS Middle East respiratory syndrome (MERS) is a viral respiratory infection caused by ''Middle East respiratory syndrome–related coronavirus'' (MERS-CoV). Symptoms may range from none, to mild, to severe. Typical symptoms include fever, cough, ...
. A physician was responsible for identifying the outbreak and reporting the event to the ProMED community, which was posted online. Eight days after the initial report, the Saudi Health Ministry announced the diagnosis of a new form of
coronavirus Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. Mild illnesses in humans include some cases of the com ...
. The ProMED-mail system grew from 1994 in parallel with
Public Health Agency of Canada The Public Health Agency of Canada (PHAC; french: Agence de la santé publique du Canada, ASPC) is an agency of the Government of Canada that is responsible for public health, emergency preparedness and response, and infectious and chronic dis ...
's similar
Global Public Health Intelligence Network The Global Public Health Intelligence Network (GPHIN) is an electronic public health early warning system developed by Canada's Public Health Agency, and is part of the World Health Organization's (WHO) Global Outbreak Alert and Response Netw ...
(GPHIN),. At 23:59 on 30 December 2019, ProMED-mail received its first communication about the
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was COVID-19 pandemic in Hubei, identified in Wuhan, China, in December ...
outbreak.


Disease surveillance and reporting

The importance of using unofficial sources of information for public health surveillance has become increasingly recognized. Sometimes referred to as “event-based surveillance” or “epidemic intelligence,” informal disease reporting services, pioneered by ProMED, have become a crucial component of the overall global infectious disease surveillance picture. According to the
WHO Who or WHO may refer to: * Who (pronoun), an interrogative or relative pronoun * Who?, one of the Five Ws in journalism * World Health Organization Arts and entertainment Fictional characters * Who, a creature in the Dr. Seuss book '' Horton He ...
Epidemic & Pandemic Alert & Response, more than 60% of the initial outbreak reports come from informal sources, including ProMED-mail. ProMED-mail publishes reports to the website ProMEDmail.org in addition to sending e-mails to service subscribers. There is no cost for subscription to the reporting network. ProMED encourages subscribers to contribute data, respond to requests for information, and collaborate in outbreak investigations and prevention efforts. Posts are published on a real-time basis. Reports detail infectious disease outbreaks with geotags and links to related media articles and other ProMED posts. Each report is screened and edited by a staff of expert moderators, ensuring the validity of the published information. There are 45 moderators for ProMED stationed throughout the world. Moderators review reports submitted within their region of oversight, drawing on their knowledge of the region and infrastructure to provide accurate descriptions of the outbreak event. As ProMED-mail is an independent program of the non-government, nonprofit International Society for Infectious Diseases, this ensures the avoidance of delay or suppression of disease reporting by governments for bureaucratic or strategic reasons. To provide access to a global audience, versions of ProMED are available in several languages and cover different regions, including ProMED-ESP (Spanish), ProMED-PORT (Portuguese), ProMED-RUS (Russian), ProMED-FRA (French), ProMED-MENA (Middle East and North Africa), ProMED-SoAs (South Asia and Arabic Summaries), as well as English-language versions ProMED-MBDS (Mekong Basin region of Southeast Asia) and ProMED-EAFR (Africa).


One Health

One Health One Health is an approach calling for "the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment", as defined by the One Health Initiative Task For ...
is the principle that human, animal, and environmental health are inextricably linked and should no longer be researched and learned in a siloed manner. ProMED embodied this concept in the sphere of infectious disease reporting since its inception. It is estimated that 70% of emerging human diseases originate in other animal species – termed
zoonotic diseases A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human ...
. As diseases in both animal and agriculture species have health implications for humans, ProMED includes posts on emerging animal diseases and diseases related to agriculturally important plants due to their impact on human survival.


Collaborations

ProMED-mail and
HealthMap HealthMap is a freely accessible, automated electronic information system for monitoring, organizing, and visualizing reports of global disease outbreaks according to geography, time, and infectious disease agent. In operation since September 2006, ...
were awarded a grant from Google.org's Predict and Prevent initiative in October 2008. This collaboration combined ProMED-mail's global network of human, animal, and ecosystem health specialists with HealthMap's digital detection efforts.


References


External links

* {{official website, http://www.promedmail.org/
Epicore
1994 software Epidemiology Public health and biosurveillance software Public health organizations Infectious disease organizations Bioinformatics organizations Disaster management tools Emergency communication Warning systems