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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 researches 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 philosophical study of nature ...
,
physicians A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis ...
,
veterinarians A veterinarian (vet) or veterinary surgeon 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, veterinarians also play a role in animal r ...
, 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 de ...
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. 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 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 adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical conditions that are asso ...
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 a sudden increase in cases and spreads across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. Widespread endemic dis ...
and emerging diseases. Burgeoning globalization of
commerce Commerce is the organized Complex system, system of activities, functions, procedures and institutions that directly or indirectly contribute to the smooth, unhindered large-scale exchange (distribution through Financial transaction, transactiona ...
,
finance Finance refers to monetary resources and to the study and Academic discipline, discipline of money, currency, assets and Liability (financial accounting), liabilities. As a subject of study, is a field of Business administration, Business Admin ...
,
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 the secondary sector of the economy. The term may refer ...
, and services has fostered ever-increasing movement of
people The term "the people" refers to the public or Common people, common mass of people of a polity. As such it is a concept of human rights law, international law as well as constitutional law, particularly used for claims of popular sovereignty. I ...
,
animals Animals are multicellular, eukaryotic organisms in the biological kingdom Animalia (). With few exceptions, animals consume organic material, breathe oxygen, have myocytes and are able to move, can reproduce sexually, and grow from a ...
,
plants Plants are the eukaryotes that form the kingdom Plantae; they are predominantly photosynthetic. This means that they obtain their energy from sunlight, using chloroplasts derived from endosymbiosis with cyanobacteria to produce sugars f ...
,
food Food is any substance consumed by an organism for Nutrient, nutritional support. Food is usually of plant, animal, or Fungus, fungal origin and contains essential nutrients such as carbohydrates, fats, protein (nutrient), proteins, vitamins, ...
, 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 ...
. Other contributing factors to the risk of new
pathogens In biology, a pathogen (, "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. The term ...
emerging and known pathogens re-emerging include
climate change Present-day climate change includes both global warming—the ongoing increase in Global surface temperature, global average temperature—and its wider effects on Earth's climate system. Climate variability and change, Climate change in ...
,
urbanization Urbanization (or urbanisation in British English) is the population shift from Rural area, 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. ...
,
land use Land use is an umbrella term to describe what happens on a parcel of land. It concerns the benefits derived from using the land, and also the land management actions that humans carry out there. The following categories are used for land use: fo ...
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 Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and Risk factor (epidemiology), determinants of health and disease conditions in a defined population, and application of this knowledge to prevent dise ...
data in ProMED posts has been used to estimate mortality rates and
demographic Demography () is the statistics, statistical study of human populations: their size, composition (e.g., ethnic group, age), and how they change through the interplay of fertility (births), mortality (deaths), and migration. Demographic analy ...
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 virus SARS-CoV-1, the first identified strain of the SARS-related coronavirus. The first known cases occurred in November 2002, and the sy ...
(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 depending on age and risk level. Typi ...
(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 1945 by a group of scient ...
, 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. It focuses primarily on the biological and medical sciences and pro ...
, Dr. Barbara Rosenberg of the
State University of New York at Purchase The State University of New York at Purchase, commonly referred to as Purchase College or SUNY Purchase, is a public liberal arts college in Purchase, New York. Established in 1967 by Governor Nelson Rockefeller, SUNY Purchase is one of 13 compr ...
, and Dr. Jack Woodall, then of the
New York State Department of Health The New York State Department of Health is the department of the Government of New York (state), New York state government responsible for public health. Its regulations are compiled in title 10 of the ''New York Codes, Rules and Regulations''. ...
. 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 in ...
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 virus SARS-CoV-1, the first identified strain of the SARS-related coronavirus. The first known cases occurred in November 2002, and the ...
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 depending on age and risk level. Typi ...
. 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 comm ...
. The ProMED-mail system grew from 1994 in parallel with
Public Health Agency of Canada The Public Health Agency of Canada (PHAC; ) is an agency of the Government of Canada that is responsible for public health, emergency preparedness and response, and infectious and chronic disease control and prevention. History The PHAC was f ...
'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 the coronavirus SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic. The symptoms of COVID‑19 can vary but often include fever ...
outbreak. On 3 August 2023, 21 out of the 38 paid moderators and editors for the service went on strike, citing lack of support from ISID.


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 The World Health Organization (WHO) is a specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has 6 regional offices and 15 ...
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 A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a virus A virus is a submicroscopic infectious agent that replicates only inside the living Cell (b ...
. 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 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