Landmark Developments in Infectious Diseases

A 20-Year Look-Back: Two Steps Forward, One Step Back

Ingrid G. Hein

Disclosures

October 20, 2015

In This Article

Infectious Diseases: A Continuum of Diverse Challenges

As the world becomes smaller through global travel, we have learned that there are no limits to how far, or how fast, infectious diseases can travel. We have seen Legionnaires' disease spread through ventilation systems, HIV through transfusion of unscreened blood, and numerous animal-to-human and air travel-related infections.

We are also seeing the evolution of microbes, and some novel genetic mixes. Many new pathogens are actually genetic mutations of older ones. Infectious diseases clearly represent the Mendelian laws of survival, showing us that this field offers a continuum of diverse challenges that have been difficult to predict and sometimes difficult to control; this is unlikely to change.

Slowly, we are learning how to fight these infections. We have become more adept at genome sequencing, developed drugs that give persons with HIV a nearly normal life, and found a new treatment that wipes out Clostridium difficile without antibiotics. We have built avenues of cross-border communication during outbreaks and improved policies for healthcare workers, who can be both victims and transmitters of disease.

The first US civilian to be saved by penicillin died in June 1999 at the age of 90, showing how antibiotics save lives. At the same time, we have discovered that antibiotics are breaking down our society's collective immune system.

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