Infectious disease emerged as a specialty in the past century after significant advances had been made in the field of antibiotic therapies to treat life-threatening contagious, postoperative, and trauma-related infections. Especially during the years after World War II, the industrialized world benefited from the development of chemotherapeutic agents, the expansion of public health practices, and profound discoveries in the field of microbiology and immunology, all of which led to significant decreases in the incidence of mortality and morbidity due to infectious processes. It was in this exciting and changing environment that the ID specialty, as it is recognized today, had its beginnings.

Kass,2 in providing a historical perspective, suggested three distinct phases in the rise of ID as a specialty area of medicine. In the earliest phase, all clinicians were by default ID specialists in that a large proportion of problems addressed in an ordinary practice setting involved infectious processes. There was little to provide in terms of effective preventive measures or treatment for infections during this phase, and the medical research was focused primarily on the description of clinical syndromes and the natural history of processes rather than on treatments. Advances in public health measures and the prosperity characterizing the early 19th century heralded the second phase in the history of ID. Microbes were recognized as a cause of disease, and target vaccines were developed.

These advances began the trend toward decreasing mortality and morbidity secondary to infectious disease. A shift in the disease management focus of the general practitioner slowly took place as the scientific community was able to provide objective tools for disease recognition, vaccine, and other strategies for disease prevention as well as applicable treatments for an expanding number of disease-causing pathogens and conditions. These advances allowed clinicians who were specifically drawn to ID to focus their attention on new approaches to disease management and to emerge as clinicians whom the general practitioner could rely upon to manage previously common infections as well as emerging infections resulting from the expansion of a global economy and collapsed travel time between nearly all parts of the world. Thus, this third phase saw the differentiation of the ID specialist from other types of clinicians. As a result, the ID specialist today serves as a consultant to other clinicians in the treatment of patients affected by a myriad of infectious diseases.


Andrea jews | editorial manager

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