What scares you the most? What keeps you awake at night?

Dear Colleagues,   2018 is the 100th anniversary of a pandemic influenza that killed as many as 100 million people, about 4% of the global population. Ordinary seasonal influenza viruses normally bind only to cells in the upper respiratory tract - the nose and throat - which is why they transmit easily. In 1918, the virus did that, but it also infected cells deep in its victims' lungs and precipitated viral and bacterial pneumonias. The origin of the pandemic is unclear, but wherever it began, it spread rapidly around the world. In fifteen months, it became the deadliest outbreak in human history. Despite a hundred years of remarkable progress in what we know and do about preventing and treating infectious diseases, little has changed. Influenza remains a major threat. When asked by a Washington Post reporter, "What scares you the most? What keeps you awake at night?" Tom Frieden, former head of the CDC, said that his "biggest concern is always for an influenza pandemic.... If you have something that spreads to a third of the population and can kill a significant proportion of those it affects, you have the makings of a major disaster."   ProMED is committed to the concept of One Health that includes humans, plants, animals and the environment. ProMED is unswerving in its mission to provide you with comprehensive access to news and analysis. But we cannot do it without you. It's your support that makes it possible for ProMED to publish multiple times each day. It's your support that pays for worldwide coverage. And it's your support that allows us to provide readers with the context needed to understand events and analyze outcomes. Please help ProMED continue to achieve its mission. Please donate now.   To mark the anniversary of the 1918 epidemic and to explore pandemic risks in an ecological context, the Smithsonian Institution's National Museum of Natural History in Washington, DC is presenting "Outbreak: Epidemics in a Connected World." Focusing on land-use change, urbanization, and industrialized food production and other human causes of infectious-disease epidemics and their consequences for global population, the exhibition aims to increase understanding of how we can prevent zoonotic diseases from emerging and quickly spreading around the world.   Our mission is to inform and educate. ProMED is contributing to "Outbreak" by providing real-time infectious disease surveillance information accessible to viewers through an interactive touch-screen exhibit. Providing the public with human, animal, and environmental health reports, ProMED's presence underscores the importance of adopting a 'One Health' perspective to understanding emerging diseases. We can participate in this and other important educational undertakings only because you and the other ProMED subscribers generously support our work. Thank you.   If you haven't supported ProMED yet this year, we need your help too. Relying on a wide range of sources - media reports, official reports, online summaries, local observers - and an international staff of over 60 infectious diseases experts based all over the globe, ProMED keeps you and a global community of clinicians, researchers, public health practitioners, pharmacists, teachers, and students abreast of hot topics in infectious disease by rapidly disseminating information on microbial and toxic threats. If ProMED is valuable to you - if you support our mission - I urge you to please show it. Please contribute today.   Sincerely, Larry Madoff, MD Editor, ProMED   P.S. The International Society for Infectious Diseases has made a long-term commitment to keeping ProMED subscriptions free. Producing ProMED, however, is expensive. Putting it plainly, to ensure that ProMED is in your inbox we need you to contribute. Please donate what you can afford, but please donate.