ProMED-mail provided global coverage, but gaps in coverage for individual countries were detected. The value of a global electronic reporting system for monitoring emerging diseases over a 9-year period illustrated how new technologies can augment disease surveillance strategies. The number of animal and zoonotic diseases highlights the importance of animals in the study of emerging diseases.

There is now significant evidence that tumor necrosis factor (TNF) is involved in the pathogenesis of malaria. We have tested sera from patients presenting with a febrile illness admitted to hospital in Honiara, Solomon Islands, for the presence of TNF, interferon-gamma, and interleukin-1 (IL-1). This study differs from previous reports as the subjects were mainly adults from a semi-immune population living in an endemic area. The results from 2 different commercially-available assays for TNF were compared, and one was found to be superior to the other. Serum TNF concentrations correlated with malarial parasite density and the patients' temperatures, but not with interferon or IL-1. The results are discussed in the context of the immunopathology of this disease.

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