a brief history of promedfile/bwc_msp_2009_mx-guest-090827-am … · a short history of promed...

A Short History of ProMED1993-2009

Jack WoodallNew York State Dept. of Health &

Federal University of Rio de Janeiro, Brazil (retd.)

International Conference, 1993• Geneva, Switzerland

• Co-sponsored by

– Federation of American Scientists &

International Conference, 1993

BACKGROUND

• FAS had long worked on biodefense

• WHO had published theBiological & Chemical Weapons Handbook

International Conference, 1993OBJECTIVES

• Bring together scientists from all branches relevant to biowarfare (BW) defense

• Propose a mechanism for rapid identification of use/release of BW

International Conference, 1993METHODS

4 Working groups on diseases:• Human• Animal• Plant• Biowarfare agents

60 participants, 7 countries- only 40 with e-mail

International Conference, 1993

CONCLUSION

Objective:Set up chain of institutes worldwide

with capabilities for:• Clinical• Lab diagnosis• Epidemiologyto investigate outbreaks suspected of

being due to biowarfare agents

Followup Conference, 1994

Maryland, USARESULTS• Chose name suggested by Robert Shope:Program for Monitoring Emerging Diseases

– ProMED• Set up subcommittees• Procured funding

– FAS through its Biological Weapons Defense program: B. H. Rosenberg

Followup Conference, 1994

Communications CommitteeJ. Woodall, Chair, NYS Dept. Health, USAS.S. Morse, Rockefeller University, NY, USAJ. Clements, SATELLIFE, Cambridge, MA,

USA

SATELLIFE offered to host e-mail list free

Founders of ProMED-mail, 1994

Stephen S. Morse, Jack Woodall, Barbara H. Rosenberg

ProMED-mail begins

• Added “mail” to name• Launched 19 August 1994

– 40 subscribers, 7 countries– Dec 1994, 200 subscribers, 15 countries

OBJECTIVEProvide rapid communication amongparticipants in developing the ProMEDprogram

ProMED-mail begins

• 1994: No messages came in about the program– Began posting outbreak news from the media– List publicly available & free

• 1995:– 20 March: free subscribership now 500– May: Ebola outbreak in Kikwit, DR Congo– July: subscribership now 2000

• 1996: – May: subscribership now 5000

ProMED-mail now

• 2009: – Subscribership now over 50,000 in over 180 countries– Over 1 million page views on website

Early Warnings

• ProMED routinely reports outbreaks before official channels can release the information

• 98% officially confirmed • Remaining 2% usually due to official

retractions

Service to Public Health

Date: 19 Jun 1988To: ProMED-mailFrom: Dr Tan Poh Tin <tpt@fhs.unimas.my>Enterovirus 71 epidemic, children: clinical signs

– posted details of clinical cases she had treated in Malaysia, as a service to colleagues in Taiwan facing a similar epidemic of hand, foot & mouth disease

[She was threatened with the sack because the Malaysian govt.had not yet released those details officially]

Service to Public Health (cont.)

Date: Wed 8 Jul 2009To: ProMED-mail From: Rogier van Doorn <hrogier@gmail.com> Subject: Influenza pandemic (H1N1) 2009 - Viet Nam: patient data

We collected clinical … & daily virological data (nose and

throat swabs) from the first 44 pandemic (H1N1) 2009 RTPCR positive patients in Viet Nam hospitalized between 29 May and 26 June 2009. • Fever (at time patient was seen) in 91% (n=40)• cough in 55% (n=24)• sore throat in 27% (n=12)• runny nose in 20% (n=9)• diarrhea in 2% (n=1).

Service to public health (cont.)

Date: Thu 9 Mar 2006 To: ProMED-mail From: Ilaria Capua <icapua@izsvenezie.it>

The OIE/ FAO Reference Laboratory for Avian Influenza atthe IZSVe in Padova, Italy invites other[s] … to depositH5N1 sequence data into public databases as soon as theyare available…

- The Danish Institute for Food and Veterinary Research (DFVF) &Statens Seruminstitut (SSI) responded by so doing.

Plague, pneumonic - China: (QH) request for info

Date: 1 Aug 2009 To: ProMEDSource: XinHuaNet [edited] <http://news.xinhuanet.com/english/2009-08/02/content_11811126.htm>

One person has died of pneumonic plague which infected 11 others in the Hainan Tibetan Autonomous Prefecture, northwest China's Qinghai Province, said the province's health bureau.

The 11 infected patients, hospitalized in quarantined wards, are in stable conditions. Most of them are relatives of the dead person, a 32-year-old herdsman, said a press release from Health Bureau of Qinghai Province.

Plague, pneumonic - China: (QH) confirmed

Date: 11 Aug 2009 – 10 days laterTo: ProMEDSource: WHO Outbreak Reports [edited]<http://www.who.int/csr/don/2006_08_11/en/index.html>

On 1 Aug 2009, the Ministry of Health (MoH), China reported a cluster outbreak of pulmonary plague cases in the remote town of Ziketan, Qinghai province. The 1st case was a 32 year old male herdsman, referred to a hospital but died en route…

On 30 Jul 2009, 11 people who had close contact with the case … developed fever and cough, and were all hospitalized.

Latest developments

• Regional networks - East & West (francophone) Africa

• Collaboration with HealthMap.org, to wed automated and human driven disease surveillance

• IMED 2007 and IMED 2009 -- International meetings co-sponsored by ProMED in Vienna

- each drew over 600 attendees from over 60 countries

• Ongoing upgrades to ProMED's technology & infrastructure underwritten by grant from Google.org

ProMED Languages• English• French• Portuguese• Russian• Spanish

Wanted: support to provide Arabic, Chinese

The ProMED Model• Media scanning done free by participants (health workers & general public)

+ Computers owned by participants

+ Internet connections paid for by participants

+ E-mail & web hosting by a university (computer centre: free)

+ Minimal technician time for maintenance (computer centre: free)

+ Volunteer editor/supervisor (part-time, public health qualified)

+ Volunteer expert moderators (clinical, epidemiological, veterinary, plants)

= Minimal-cost, effective Early Warning System for States

What ProMED can do for the BWC

• provide early warning of outbreaks of disease or intoxication due to scheduled agents (SAs), natural or otherwise

• provide background on natural occurrence of SAs for evaluation of incidents

• send experts to help set up national outbreak early warning systems on the ProMED model

• provide a forum for posting Requests for Info (RFI) about incidents/outbreaks

What the MX can do for ProMED

• Collaborate in creation of a network of networks – to feed incident/outbreak data from all sources into a

single portal – for rapid reference

• Designate in-country partners – to correspond with us about incidents/outbreaks

• Help us find more resources

ProMED Major Funders• FAS & SATELLIFE-1994-1999

• ISID & Harvard School of Public Health- 2000-present• Anonymous

• Bill & Melinda Gates Foundation

• Oracle Corp.

• The Rockefeller Foundation

• Google.org

• User donations

The ProMED Team 2009

ISID ProgramDirector• Timothy Brewer

Editor• Lawrence C.

MadoffDeputy Editor• Marjorie P. Pollack

Associate Editors• Stuart Handysides• Donald Kaye• Daniel S. Shapiro• Jack Woodall

Sr Technical Editor• Maria Jacobs

The ProMED Team (cont.)

Moderators• Peter Cowen• Tam Garland• Dagmar Hanhold• Martin Hugh-Jones• Larry Lutwick• Eskild Petersen• Matt Levison

• Craig R. Pringle• Arnon Shimshony• Yin Myo Aye

Mekong Basin list (English)

• Benson Estambale &Joseph Frances Wamala

East Africa list

The ProMED Team (cont.)

• Luiz Jacintho da SilvaPortuguese

• Jaime TorresSpanish

• Jorge GonzalezSpanish

• Nilufar RakhmanovaRussian

• Natalia PshenichnayaRussian

• Sidi CoulibalyFrench (Africa)

Language Version Moderators

<www.promedmail.org>is a program

of the International Society

for Infectious Diseases