3.6 Electronic surveillance
3.6.1 Data sources
ProMED
ProMED was established in 1994 as an Internet-based program to monitor emerging dis- eases (Madoff 2004). Its scope includes diseases of plants, animals and humans (Woodall 1997). Its role therefore is to serve as a global early warning and disease reporting sys- tem for emerging diseases. Information on disease outbreaks are received on a daily basis from subscribers from over 164 countries, and government and non-government agencies. These reports are verified by subject matter experts and posted to the ProMED website and emailed to the list with with comments and accompanying information regarding the disease of interest. ProMED is now a well recognised source of disease information for international agencies such as the WHO, OIE and FAO, government and non-government agencies (Jebara & Shimshony 2006).
Information gathered by the ProMED system has been used in several ways. In animal health it plays an important role in raising awareness of a potential disease threats in coun- tries that trade with, or are neighbouring a reporting country (Hugh-Jones 2001). Exam- ples include the equine encephalitis outbreak in Venezuela in 1999 (ProMED-mail 1999), the outbreaks of HPAI H5N1 in Indonesia in November 2003 (ProMED-mail 2003), and mortalities in pigs in China attributed toStreptococcus suis in 2003. Specific avian dis- ease examples include the outbreaks of Newcastle disease in double-breasted Cormorants in Canada (ProMED-mail 1995b), and poultry in Sweden in 1995 (ProMED-mail 1995a), poultry deaths in Romania attributed to mouldy feed in 1998 (ProMED-mail 1998), and poultry products contaminated with dioxin in Belgium in 1999 (ProMED-mail 1999). In addition, ProMED have been instrumental in examining the spread of HPAI H5N1 (Kil- patrick et al. 2006).
Despite claims of its usefulness as a global early detection system, only one study has attempted to evaluate the quality of information reported by ProMED. Cowen et al. (2006) reviewed 10,490 disease reports from ProMED between January 1996 to December 2004. The authors found that reporting was dominated by the USA and Great Britain, followed by Canada, Australia, Russia, and China. For Africa, Asia and South America, reporting varied across and within continents. Rabies was the most frequently reported disease in 1997 and 1999, FMD in 2001 and avian influenza in 2003 and 2004.
3.6 Electronic surveillance 77
The existence of ProMED has initiated a number of similar developments in both human public and animal health. Examples of early warning systems established in public health include the Global Public Health Intelligence Network (GPHIN), HEALTHMAP and the Global Outbreak Alert and Response Network (GOARN). Similar initiatives in animal health include the World Animal Health Information Database (WAHID) of the OIE and the EMPRES system of the FAO.
The Global Public Health Intelligence Network
The Global Public Health Intelligence Network (GPHIN)11is an electronic early warning system that provides data on outbreaks obtained from the news media, health and science web sites in a number of languages (Mykhalovskiy & Weir 2006). It is operated by the Public Health Agency of Canada on a continuous basis to provide information to a number of fee-paying subscribers such as the WHO and the FAO. Data gathered by this system are monitored by other global early warning systems such as EMPRES. GPHIN monitors disease outbreaks, infectious diseases, reports of food and water contamination, bioterrorism, exposure to chemical and radioactive agents, and natural disasters. Data are monitored by a combination of computer-based models and analysts for the presence of unusual events that would be of concern to public health.
World Animal Health Information Database
The World Animal Health Information Database (WAHID)12 is operated by the OIE and
stores reports of infectious disease outbreaks from member countries. It is intended to replace and extend the web interface system Handistatus II.13 Three categories of infor- mation are provided to WAHID by OIE member countries: (1) notifications of animal disease emergencies, (2) endemic disease situation reports (submitted every six months), and (3) annual reports detailing a country’s animal health situation, and capacity relating to diagnostic laboratories and other animal health affiliated facilities.
11http://www.phac-aspc.gc.ca/media/nr-rp/2004/2004_gphin-rmispbk-eng. php 12 http://www.oie.int/wahid-prod/public.php?page=home 13 http://www.oie.int/hs2/report.asp
EMPRES
The Emergency Prevention System for Transboundary Animal and Plant Pests and Dis-
eases (EMPRES)14 was established by the FAO in 1994 to minimise the likelihood of
transboundary diseases of plants and livestock causing major economic loss in develop- ing countries. It was initially established as a means for facilitating the sharing of data between FAO staff at head office in Rome and field staff, as well as with other entities involved in disease outbreak management and response. The scope of EMPRES includes infectious diseases such as HPAI, FMD, Rift Valley fever, contagious bovine pleuropneu- monia, African swine fever and rinderpest. Data sources monitored by the system include the official web sites of international health agencies (OIE, WHO), national animal health departments (such as the Ministry of Agriculture and Forestry in New Zealand and the Department of Agriculture, Fisheries and Forestry in Australia), and email list servers (e.g. ProMed, GPHIN, AI-watch). EMPRES provides the following information related to HPAI H5N1: (1) interactive maps showing the distribution of disease over space and time, (2) situation update reports three times per week, and (3) monthly reports of disease situation in a format suitable for the general public. The system is linked to a Geographic Information System and provides simple spatial analyses.