Respiratory Infections News

Hernán Cortés and Pánfilo de Narváez brought smallpox to the Americas in 1520. Due to a lack of immunity, the native population was decimated, and Tenochtitlan fell to the Spanish in 1521. This was the subject of my fourth-grade history fair project and the beginning of my love for infectious diseases. I followed it up the next year by learning about the race for a polio vaccine. In high school, my physics teacher, Dr. Cunningham, suggested I read The Coming Plague by Laurie Garrett and the fascination continued — Ebola, Machupo, Marburg and others. I decided to go into medicine after my excellent college mentor and friend, Dr. Martín Gonzalez, suggested it as a career path toward infectious diseases fellowship. It was great advice and I love being an ID physician. I chose this career because of the allure of discovery and understanding how pathogens and people interact. I am fortunate to study just that for multidrug-resistant bacterial infections. I have excellent mentors helping me push the ID envelope: Jennie Kwon, Hilary Babcock, Margaret Olsen, Marin Kollef, Graham Colditz, Stephanie Fritz and others. Every day is a new challenge, and contrary to mid-20th century arrogance about the acquiescence of infections to modern medicine, infectious diseases are not subjugated by human egotism. ID physicians will always have important and exciting work to do.

Infectious Diseases leapt off the pages of Paul de Kruif’s Microbe Hunters in the eighth grade and has held me ever since. I was enticed by the curiosity of the early giants — Koch, Pasteur, Ehrlich. I gravitated to immunology in college, then clinical ID in medical school. There I found that ID specialists were considered the most thoughtful physicians in the hospital, performing the thorough history and examination to expose the disease, ordering the most appropriate testing and treatment, explaining the disease and remedy to patient and family. I discovered that ID specialists make brilliant discoveries at bench and bedside. They lead infection prevention, antibiotic and diagnostic stewardship, and public health, and these systems roles make ID an ideal platform for health care leadership. I could not wait for ID fellowship to join my mentors: Marty McHenry’s verbatim histories and jovial literature dives, David Longworth’s humanistic care and even-handed leadership, Tom Keys’ direct wisdom, Walt Tomford’s collegial passion, Susan Rehm’s clinical acumen and insightful mentorship, Steve Gordon’s vision and team building. I carry with me some of each of them. I would encourage anyone who finds this kind of diverse experience appealing to speak with ID specialists or IDSA and discover ID!

Infectious Disease News asked ID specialists when they chose to pursue a career in infectious diseases and why. Read more responses online at www.Healio.com/ID. You can share your story with us in 200 words or less by emailing the editors at infectiousdisease@healio.com, with the subject line “Hooked on ID.”

Influenza and pneumonia together are the eighth-leading causes of death in the United States. Two major classes of antivirals were once the only options for treatment of influenza: matrix-2 proton pump inhibitors, which are effective against only influenza A viruses, and neuraminidase inhibitors, which have shown growing evidence of resistance from influenza strains.

Implementation of the Hospital Readmissions Reduction Program was followed by an increase in 30-day post-discharge mortality for patients hospitalized for heart failure and pneumonia, according to data published in JAMA. Researchers reported that they could not determine that the program resulted in the increased mortality.

New clinical practice guidelines from the Infectious Diseases Society of America emphasize the need to test and promptly treat patients at high risk for seasonal influenza-related complications, including pregnant women, young children, patients who are extremely obese and those who have a weakened immune system.

Community-acquired respiratory viruses causing lower respiratory tract infections are a significant independent risk factor for the development of chronic lung allograft dysfunction, or CLAD, in lung transplant recipients, according to study results.

Infants aged younger than 2 months had higher rates of morbidity and death related to pertussis in the era of acellular vaccination, according to a study published in the Journal of the Pediatric Infectious Diseases Society.

Preliminary study findings linked travel on the London Underground to the spread of influenza.

The vaccine that is needed to prevent pneumococcal disease should include proteins that are present in all or nearly all pneumococci. The best option might be to alter pneumolysin so that it retains its ability to immunize but no longer acts as a toxin.