The latter half of the 20^th century saw a major shift in disease surveillance strategies from reliance upon manually prepared forms sent up the health services pyramid using snail mail to a high tech approach using computer technology and the internet, both for transmission of information between reporting units and as a non-traditional source of information about unusual health events occurring in the community. This chapter walks the reader through the history of the transition from a manually driven disease surveillance paper trail to the digital disease detection era, where the world is wired and wireless, and diseases and information on diseases are travelling at speeds not seen before.