An early warning system for health threats: the invaluable work of ProMED

ProMED Mail is one of the most important information resources on the net, and most of us have never heard of it. It’s an email list which describes itself as a “global electronic reporting system for outbreaks of infectious diseases and acute exposures to toxins that affect human health, including those in animals and in plants grown for food or animal feed”.

Unlike the official clearinghouses run by WHO and CDC, ProMED is, in its own words, “open to all sources” and its reports are freely available to us all. ProMED was first to raise concern about the aggressive respiratory disease spreading in China in 2003, which became known as SARS. Before the Chinese authorities had permitted their officials to report the disease to WHO, Catherine Strommen, an elementary school teacher in Fremont, California, spotted a post in an international teachers’ chat room from a concerned teacher in China describing “an illness that started like a cold, but killed its victims in days”.

Alarmed, Strommen emailed an old neighbor and friend, Stephen Cunnion, M.D., a retired Navy physician and epidemiologist who now lived in Maryland. A practical, no-nonsense man, Cunnion started searching the web. With no success, he tried a new tack—sending an email to ProMED-mail, a global electronic reporting system for outbreaks of emerging infections and toxins. After quoting Strommen’s missive, he asked: “Does anyone know anything about this problem?”

The tiny ProMED staff conducted its own web search. It, too, came up empty-handed. On February 10, it sent out to tens of thousands of subscribers a posting headed: “PNEUMONIA – CHINA (GUANGDONG): RFI,” or Request for Information.

Thus did the world first learn of SARS, the new and deadly infection that would kill 774 people and infect 8,000 in 27 countries.

From an article by Madeline Drexler in The Journal of Life Sciences.

H1N1 Reports (Swine-avian-human Influenza A)

To keep up on H1N1 flu [I agree with the pig farmers, “swine flu” sounds like your big risk is getting it from pigs and pork, not human sneezes and handshakes] check the ProMED main page. While all the media is now frothing over with “news” about this disease, some of it sounds as reliable as alien abduction accounts. ProMED is timely and scientifically accurate but understandable by non-biologists. It includes valuable, and interesting, commentary on reports and questions: “this has been reported, but here’s what we don’t know, or here are local factors that must be considered in evaluating it”.

What ProMED does

ProMED is a program of the International Society for Infectious Diseases which began in 1994. It does not simply print whatever comes in—this is an extremely well-moderated list. A group of specialists checks and filters the reports, seeks more information from local sources and other experts, and provides judicious commentary. This group also “scans newspapers, the internet, health department and government alerts, and other information sources for inklings that an infectious disease, perhaps not yet reported widely, is threatening animal, plant and/or human health.”

I think I first signed up to receive the digests back when “mad cow disease” was emerging, and have since used ProMED to follow diseases such as anthrax and Ebola.
A topic of interest to me recently concerns outbreaks of measles and mumps in Western nations due to falling rates of vaccination. And as a former zookeeper I keep up on diseases of wildlife and zoo animals, including the fungal disease threatening whole populations of wild bats in the Eastern US. ProMED also covers plant diseases (mostly of crops).

All of this, infectious diseases of humans, wildlife, and crops, is of greatly increased urgency because climate change, global transport, and destruction of wild areas all lead to the spread of familiar diseases to new locales and the emergence of “new” diseases previously only found in remote wild areas. With regard to contaminants and toxins, governments are unable to deal with this effectively due to the political power of corporations and lack f oversight in producing countries. ProMED can’t make your food and furniture non-toxic, but it can sound alarms that might otherwise be silenced.References to a topic’s prior appearances on the list are attached to current reports, and archives are easy to access. Editions in French, Portuguese, Russian and Spanish are now available.

“Each posting is limited to 25 KB bandwidth—to ensure that it slips through an old-fashioned dial-up modem in the most remote areas of the world (where new infectious threats tend to smolder). ‘We use technology that was state-of-the-art in 1994. We use email—plain-text email at that. We don’t use fancy fonts,’ Madoff says. ‘The power of the Internet is its ubiquity and speed; it’s not necessarily in all the neat things you can do.’ [from Drexler’s article cited above]

You can subscribe here.

Toxins and contaminants

ProMED also collects, evaluates, and disseminates reports of health problems related to toxins and contamination of food and medicines. These can be quite unusual. For example, the case of the toxic leather sofas in Britain:


Photo: Effect on leg of reaction to toxic chemical contained in sofas. From BBC.

A judge [in the UK] is expected to order several retailers to pay millions of
pounds to people who suffered burns and rashes from faulty leather

More than 1600 people claim to have been affected by the problem. Tens
of thousands more people could have burns not yet traced to sofas.
The High Street stores, along with 11 others, may have to pay more
than 10 million pounds [USD 14.3 million] in compensation and legal
costs, the shoppers’ lawyers say. They claim that makes it “the
largest group compensation claim ever seen in British Courts.”

The sofas, which were manufactured in China, were packed with sachets
of an anti-mould chemical called dimethyl fumarate to stop them from
going moldy during storage in humid conditions.

Commonly known as DMF, the toxic, fine white powder has been used by
some manufacturers to protect leather goods like furniture and shoes
from mold. Even very small amounts can be harmful.

One sofa customer, who is well aware of the health problems caused by
her purchase, is a customer who bought a leather sofa suite from
Argos in April 2007. Almost a year later, she started to notice a
rash developing on her arms and legs. After a few weeks, her skin
started flaking off. She says the irritation was so bad, she was off
work for 2 months. This customer was seen by more than a dozen
doctors, who couldn’t work out what was causing the rash.

She said: “It was very, very painful; I couldn’t sleep at night; I
couldn’t walk about; I couldn’t drive; every time I did walk about,
the skin would fall off, and I would leave a trail of it, therefore,
I couldn’t go to work.”

Reliable histories of outbreaks/events

ProMED doesn’t just present breaking news and requests for additional reports; it frequently publishes very useful summaries of what’s been learned, and what action governmental agencies have taken. For example, “Melamine contaminated food products – Worldwide ex China” and “Prion disease Update 2009 (01)” (Mad Cow Disease and its human infectious disease, the fatal “variant Creutzfeldt-Jakob disease”.

Supporting ProMED

Believe it or not, ProMED is supported by individuals, with not a penny of funding from any government. That means they are independent (remember the movie Jaws, where the city council wants to suppress news of the shark attacks?) and fast to react. They sift a lot of news from all sorts of sources, put out calls for more information, and disseminate news in a responsible way.

If the work of this group seems like something you’d like to support, here’s your chance. They’re having a brief Spring fundraising campaign. To quote their email,

Your gift funds quick information every day – The economical, low-tech computer programs we use enable us to speed ProMED to your mailboxes, to post it online where anyone can find it, , and to provide the administrative services (accounting, office space, cell phone connections, etc.) required to support a small, agile worldwide enterprise.

ProMED-mail reaches over 50,000 public health officials, students, journalists, agricultural specialists, infectious disease professionals and others around the globe. Because it is free, subscribers in more than 187 countries have an equal opportunity to know when a disease outbreak occurs — and can spring into action when necessary to prevent or minimize its spread.

If the Spring campaign is past, here’s the main donations page.

Searching for a forgotten book?

Lately I have been re-reading science fiction novels and stories I remember from my youth. But in some cases I remembered something about the plot or setting, and nothing of title or author. For example, a story where the alien said to the protagonist, “I trade with you my mind.” Atypically for me, I had a dim recollection that it was by Clifford Simak, but no idea of the title or if maybe it had been in a novel instead.

Where to turn? BookSleuth® to the rescue. This is a branch of the discussion forums run by used-bookseller They have separate US and UK sites; each has its own forums and Booksleuth® section.

Here is the abebooks description of BookSleuthe®:

Is there a special book that you read, or perhaps had read to you, at some point in your life but you can’t remember the author and title? Perhaps you know the plot, or a character, or maybe even what the front cover looks like. BookSleuth® is here to help you find that book! Simply post a short description of what you can remember here on our board. Visitors from all over the world will read your post, and one of them is bound to know exactly what you’re talking about and post a response. Not missing anything? Why not see if you can help anyone else find their long-lost books?

Each of the two forums has some genre divisions: General, Children’s, Romance, Mystery, Non-fiction, Science Fiction. The members who answer questions are real enthusiasts with incredible memories (even for 40-year old short stories!), and their answers sometimes include valuable index-type websites where other such questions can be researched.

I have spent some time cruising questions and answers, even had a try at answering a few. I found that one frequent poster is a bookfinder for a library system, and I am sure she is not the only Booksleuther with such specialized skills.

When I wanted to find a British book, I posted my question in the UK forum. I had few details: it had to do with hand-production of daily objects in a small English village, lots about woodworking, I thought the author’s first name was George, and I read it in the early 70’s. (If you can’t give an approximate date of publication, at least you can narrow the field by saying when you encountered the book). I’d thought about this book for thirty years, longing to re-read it, and had done some searching on the web myself but never even came close. The folks on the UK BookSleuth® forum had an answer for me very soon: The Wheelwright’s Shop, by George Sturt–a book of some renown. Soon I had my very own copy courtesy of Amazon; I shared it with a friend who’s a sign painter immersed in fine hand-craftsmanship, he bought a copy and talked it up to friends, so we’ve got a mini-revival of Sturt’s masterpiece going on this side of the pond.

One tip: if you decide to post a query: use a descriptive title for your post, not “Help, looking for book title” or “Looking for old cookbook”.

Here a a few recent queries:
Kids lost in outback
American Civil War & female cat burglar
A Particular Jewish Cookbook
Children playing casting shadows 1950’s
Type 23 Frigate in an West African coup
Middle East Trucking
Suffragette Story for teen/child reader
Novel with storyline based around chess

Look out, though, cruising these forums is likely to have you adding more books to your future reading list!

And, the same day I posted my inquiry about the “I trade with you my mind” story, I had an answer: it is in the early pages of Simak’s novel Time is the Simplest Thing (1961), which I found in my local library system and am about to start reading.

Will it be as memorable as it was 40 years ago? I’ll get back to you on that. But I looked up some vintage covers of this title, from which I can predict absolutely nothing about the book. Typical of sf cover art!

These are from the Clifford Simak Fan Site, specifically Foreign covers; last two.





Online shopping:

Online shopping’s had many recognized or anticipated effects, from thinning profit margins to boosting sales of specialized items, but I’m enthusiastic about how it makes “word-of-mouth” consumer information possible again.

As an example, I was looking to buy a pair of really comfortable walking shoes. I cared about comfort, comfort, and––oh yes, sturdiness. Don’t want them to fall apart in six weeks of regular wear. I’m retired, I can wear any damn shoes I want. Fibromyalgia makes my feet hurt all the time, and most shoes aggravate it.

So I went online looking for Clarke’s walking shoes, which had been recommended highly to me about 20 years ago. Back then spending $100 on a pair of shoes was out of the question. Today it has moved up on my priority list, and if I find a pair I like, I only need one pair. My searching took me to the online shoe emporium Zappo’s. They had a bunch of styles of Clarke’s. They also had customer comments for each, dozens of them. By the time I had read through the comments for 2 styles, I was sure that Clarke’s were not for me. Once made in England––terrific; then made in Portugal––pretty good; now made in China––forget it. The Chinese-made Clarke’s were reported to be stiff, uncomfortable, not true to size, and not holding up well.

I browsed through other shoe makers’ offerings at Zappo’s, following pointers from people who said things like, “Brand XY didn’t fit my narrow heel, but Brand ZZ was perfect, ” or “This one looks comfortable but is too inflexible, not like the last three pairs I got, so I am switching to Brand A.” I arrived at Keen’s shoes and read all the comments for half a dozen styles that looked possible, made my choice, and am very happy with them.

Back when communities and stores and numbers of products were smaller, people could do this sort of thing by literal word of mouth. Not so easy now. And, many of the comments I read included very specific idiosyncratic reviews, depending on what was important to each person. One said, “Great shoe but the sole really clogs up with mud and tracks it in; okay for city wear.” I live in the country; this shoe would have been pure aggravation, though it looked good in other respects. Another said, “Really comfortable and sturdy and provides good footing, but the uppers aren’t shiny and I can’t stand that about them.” We all have our priorities.

I suppose companies will begin posting numerous false but very specific testimonials (and anti-testimonials for their competitors’ products) but until then, reading a few dozen reviews about a product seems like a good way to check out how it has worked for others.

Brands in themselves don’t necessarily mean much any more, since “branding” has become a PR effort similar in intent to Pavlov training his dogs. The food in the dish now may be made (poorly or poisonously) in China––but the bell of “brand identity” is still supposed to make us salivate. Customer reviews give us a way to get up-to-date reality checks from a variety of other folks.