September 27, 2016
Hope in Disease Control
Be Well

Hope in Disease Control

by John Swartzberg, M.D.  |  

More cases of polio in Syria; superbugs taking over hospitals; the TB bacteria becoming resistant to all of our antibiotics, and on and on. We’re being continually bombarded with dire predictions about our war against infectious diseases. But sometimes the news isn’t all bad.

I recently attended a meeting known as ID Week. This is an annual meeting of four of the most important infectious disease organizations in the United States: the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, the Society for Healthcare Epidemiology of America and the HIV Medicine Association.

I’ve been going to infectious disease meetings for 40 years. Given recent disconcerting news about the seemingly inexorable challenges we're facing from infectious agents, I attended this one with some trepidation. However, I was delightfully surprised at how uplifted I felt by the end of the meeting. Here are three examples why:

Hospital-associated infections

We’ve been hearing about the problem of hospital-associated infections for years. One in 20 Americans develop one while hospitalized (worlwide, more than 1.4 million occur each day). Upwards of 100,000 people die as a consequence of these infections, and the costs to society are in the billions.

Even with these ominous statistics, there is encouraging news. Data presented at the meeting by the CDC showed, for the first time, substantial declines in these infections. For example, over the last decade intravenous line infections have decreased by 41 percent; surgical infections by 17 percent; urinary tract infections by 7 percent.

This is the first instance in which I have seen the percentages of these infections drop so significantly. In addition, there's great enthusiasm for the interventions (such as checklists, handwashing campaigns, better surveillance and improved design of urinary and intravenous catheters) taken to achieve this. I expect the trend will continue and that hospitals will become much safer places.

Polio

There is a real and realistic plan to eliminate polio. Few in the developed world have seen the ravages of this disease. But when I was growing up in the 1950’s, it occupied a fearful place in everyone’s mind. Now, there are only pockets of this disease left (Syria, Somalia, Kenya, Ethopia, South Sudan, Pakistan and Nigeria).

Discussions at the meeting centered on the end-game for eradication of this disease. And the proposed timetable for this is around the corner: no more cases by the end of 2014; oral vaccination ending by 2018; injectable vaccination continuing for several years after that.

Even if these projections are off by a few years; even if corrupt ideologies continue to promote the harassment, and sometimes murder, of vaccine workers; even if societies crash under the weight of war and stop vaccinating—this plan is realistic. After all, it has been more than two years since there has been a case of polio in India. And given the poverty, limited infrastructure and enormous population there, no one thought that would be possible.

HIV

The last seminar I attended focused on the history of the treatment of HIV infection. The first part was a straightforward recitation of the remarkable progress we have made in developing effective agents to suppress the reproduction of this virus in the human host.

What excited me was the last part, which addressed the future of anti-HIV drugs. Currently, there are at least five drugs in the pipeline that have a real possibility of achieving the ultimate goal—eliminating the virus from a patient's body. More than 30 years after AIDS was first described, we’re actually talking about a way to cure people.

None of these drugs have moved much beyond proof of concept, but there’s a good chance that one of them will—and might be available within a decade. We’re still going to need a vaccine to eradicate this virus, but the idea that we’re talking about cure for the first time is wonderfully encouraging.