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,
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,
epidemiologists,
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 p ...
. 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
* 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 d ...
. 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 and
mortality. 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 i ...
and
emerging diseases
An emerging infectious disease (EID) is an infectious disease whose incidence has increased recently (in the past 20 years), and could increase in the near future. The minority that are capable of developing efficient transmission between human ...
. 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, natio ...
,
finance,
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 ...
, and services has fostered ever-increasing movement of
people
A person ( : 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 proper ...
,
animals
Animals are multicellular, eukaryotic organisms in the Kingdom (biology), biological kingdom Animalia. With few exceptions, animals Heterotroph, consume organic material, Cellular respiration#Aerobic respiration, breathe oxygen, are Motilit ...
,
plants
Plants are predominantly photosynthetic eukaryotes of the kingdom Plantae. Historically, the plant kingdom encompassed all living things that were not animals, and included algae and fungi; however, all current definitions of Plantae exclud ...
,
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 ...
, and
animal feed. Other contributing factors to the risk of new
pathogens 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 ...
,
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 his ...
changes, and
political instability. Outbreaks that begin in the most remote parts of the world now spread swiftly to
urban centres in countries far away. The
epidemiological 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, '' se ...
(SARS) outbreak in 2003 and the
Middle East respiratory syndrome (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 ...
, ProMED-mail was founded in 1994 by Dr. Stephen Morse, then of
Rockefeller University
The Rockefeller University is a Private university, private Medical research, biomedical Research university, research and graduate-only university in New York City, New York (state), New York. It focuses primarily on the biological and medica ...
, 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 ...
at Purchase, and Dr.
Jack Woodall, then of the
New York State Department of Health (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 bec ...
outbreak. The idea of a global network was first proposed by
Donald A. Henderson
Donald Ainslie Henderson (September 7, 1928 – August 19, 2016) was an American medical doctor, educator, and epidemiologist who directed a 10-year international effort (1967–1977) that eradicated smallpox throughout the world and launche ...
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, '' s ...
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. 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.
The ProMED-mail system grew from 1994 in parallel with
Public Health Agency of Canada's similar
Global Public Health Intelligence Network (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 identified in Wuhan, China, in December 2019. The disease quickl ...
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 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 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. 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