The IQT Quarterly recently interviewed Larry Madoff, Editor of The Program for Monitoring Emerging Diseases (ProMED-mail). ProMED-mail reports on outbreaks and disease emergence, providing early warning information to a global audience and allowing informed discussions in real time. Mado discussed ProMED’s information dissemination process, the broader community of infectious disease reporting, and the future of outbreak detection and response.

What is ProMED? How did it begin? Who participates?

Founded in 1994, ProMED-mail was intended to harness the Internet in the service of detecting emerging infectious or toxin-mediated diseases, either natural or intentionally caused, that threatened human beings. Its goal is to provide early warning, disseminating information rapidly to a wide audience and allowing informed discussion in real time.

As of 2015, ProMED-mail has 75,000 subscribers in more than 180 countries who receive email reports on outbreaks and disease emergence. Readers can also receive reports via Twitter, Facebook, or an iPhone app. Reports are selected and interpreted by a panel of specialist moderators who provide expert commentary, supply references to previous reports and to the scientific literature, and put the report in perspective for a diverse readership. Reports are simultaneously posted to ProMED’s website. 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 the One Health concept (see below), and service to the global health community.

Background – This paper reports on a September 15, 2016 Roundtable Discussion convened by B.Next, an IQT Lab. The purpose of the discussion was to explore whether and how a biological sample containing microorganisms could be examined using current techniques and procedures to answer two questions:

  1. Is the sample likely to have been subject to genetic manipulation?
  2. If the sample was engineered, is it possible to determine the intended and actual functionality of the genetic manipulation?

It was assumed that national security imperatives would impose some urgency on the need for information, so that the time required for different approaches is of concern. It was also recognized that the sample material available for examination might be limited and possibly irreplaceable. The source and type of biological sample at issue was not defined. Both clinical samples (presumably collected in the wake of an attack) and other types of collected samples, including complex, “metagenomic” samples (e.g. environmental effluents) were considered.

The Roundtable included twenty-six participants, including scientists from academia, seven US Government agencies and the Lawrence Livermore National Lab, representatives from private sector companies engaged in DNA sequencing and bioinformatics, and IQT professional staff. The group’s expertise included bioinformatics, genetic engineering, computer science, microbiology, and biotechnology. The discussion took place over a single day, included invited presentations from three participants, and was held on a not-for-attribution basis.