Welcome to the Division of Infectious Diseases at the University of Colorado School of Medicine. This message is addressed to our colleagues, patients and members of the public with an interest in the problems and challenges of infectious diseases.
Our faculty, more than 70 and growing, take care of patients with infectious diseases in the mountain west and across the world, do scientific research on major infectious disease (ID) health problems, and educate the next generation of physicians and scientists in our field.
We work mainly at three sites located across the Denver metropolitan area:
1. The Anschutz Medical Campus (AMC). The AMC, which contains the School of Medicine (SOM) and is located in Aurora, just east of the Denver city line, was built to accommodate the growth of the SOM and fulfill its need for cutting edge facilities for research, education, and clinical missions. Many of the Infectious Diseases Division faculty are located physically in Research Complex 2 in the research quadrangle, where we have state of the art laboratories and bio-containment facilities for work with infectious agents. AMC ID physicians, physician assistants and nurse practitioners take care of hospitalized patients in the University of Colorado Hospital (UCH). We take care of outpatients in our Infectious Disease Group Practice (IDGP) in the UCH outpatient pavilion.
2. Denver Health (DH). This municipal, integrated model public health care system serves a broad range of patients in Colorado, with education and research as two of its strategic pillars. DH is comprised of the Denver Health Medical Center (DHMC), a community health program with 8 centers and 16 school-based clinics in Denver, and the City and County health department (Denver Public Health, DPH). Infectious Diseases faculty are located in both DPH and the Department of Medicine of DHMC. Denver Public Health clinics include the ID Clinic and Center for Positive Health (HIV), the Denver Metro Tuberculosis (TB) Clinic serving the 7-county Metro area for diagnosis and treatment of TB and latent TB infection, and the Immunization and Travel Clinic (over 21,000 vaccinations to 10,000 patients per year). DHMC, in partnership with the Colorado Department of Health and Environment, is one of nine designated regional Ebola and other special pathogen treatment centers in the U.S.
3. The Denver Veterans Administration Medical Center (VAMC). The VA Eastern Colorado Healthcare System is a tertiary care medical center that provides comprehensive care to more than 80,000 veterans, including community based primary care and a full range of referral services. It includes an acute care hospital, on site primary and specialty care clinics, an active Emergency Department, two nursing homes in Denver and Pueblo, and ten community based outpatient clinics (CBOCs). Infectious Diseases consultation is provided in the inpatient and outpatient setting. The VAMC used to be in East Denver but now occupies a new facility in Aurora just adjacent to the AMC, such that it is just a 12 minute walk from our home in Research Complex 2.
We also have partners in the Denver Metropolitan Area and around the world and our faculty participate in medical education, treatment and research projects on several continents. Here in Colorado, we value partners across the Colorado Front Range, including National Jewish Health, a leading center for tuberculosis and other mycobacterial diseases in Denver. Some of our physicians also travel each month to see patients in Fort Collins, Pueblo and Grand Junction out on the western slope.
COVID-19. Faculty in each of these hospitals have been at the forefront of the pandemic response and the division writes the treatment guidelines for the campus (see link on main page). The division has also participated in multiple clinical trials for antivirals, monoclonal antibodies and other interventions. On the basic science side, several laboratories are working with SARS-CoV-2 to understand the innate immune response, viral replication, and other aspects of the disease. We have a first-rate laboratory infrastructure, including a large Biosafety level 3 (BSL3) facility for work with this and other Level 3 pathogens.
HIV. The Division has a very strong tradition in HIV care and research, with 1800 patients followed at the AMC ID Group Practice, about the same number at DH, and an additional 300 patients at the VAMC. We provide care for additional HIV patients at Vivent in Denver. Our Colorado AIDS Clinical Trials Unit (ACTU) has over participants enrolled in numerous active clinical trials. Our AIDS Education and Training Center (AETC) carries out educational programs for HIV providers in the mountain west.
Our Mission and Our Challenges
The ID Division’s mission is four-fold:
In many ways, our challenges are unique in medicine. No other medical specialty faces a continual threat of new diseases, which are caused by emerging viruses and other microbes. A few examples of emerging/re-emerging viruses of importance are most notably SARS-CoV-2, and also West Nile virus, Chikungunya virus, Enterovirus D68, Dengue, Zika virus, potential avian influenza viruses, and of course, HIV-1. There are also highly antibiotic-resistant disease-causing bacteria, some of which threaten to become untreatable.ID is unique in its need to grapple with the threatened loss of once dependable and powerful treatments due to the rapid evolution of microbial resistance.
Lessons Learned and the Need for Medical Research
There was a time, not so long ago, when the great mid-20th century advances in antibiotics and vaccines seemed to herald the end of infectious diseases as a major worry. In the 1960’s, a U.S. surgeon general said: “It is time to close the book on infectious diseases, and declare the war against pestilence won.” It seemed reasonable then.
Then came the relentless emergence and spread of antimicrobial-resistant organisms. Then came HIV, new influenza strains, the hepatitis C pandemic, life-threatening Coronaviruses (SARS, MERS, SARS-CoV-2) West Nile Virus, Dengue virus, Chikungunya virus, resistant malaria, a plague of Clostridium difficile colitis in the world’s hospitals, methicillin-resistant Staphylococcus aureus (MRSA), the persistent burden of “opportunistic” infections in patients with cancer or organ transplants, frequent infections of catheters and other implanted medical devices… well, the list goes on. Ebola virus alarmed the world in 2014-15, and for the first time it appeared and spread within hospitals in the US and Europe (two of our division physicians served admirably in Ebola Treatment Units in Sierra Leone in 2015). Each year, there is a risk that novel influenza viruses could emerge by genome segment re-assortment and other forms of viral evolution in birds, swine, other animals, and people, and cause a serious human pandemic.
In short, infectious diseases are among the most compelling, urgent, problems in modern medicine.
Discovering Future Treatments and Cures
The highest calling of a medical school, of an academic medical center like ours, is discovery. Discovery – of the causes of diseases and new ways to treat, cure and prevent them – requires the difficult but exciting process of scientific research. That is, while providing the best care and teaching the next generation of ID doctors to take superlative care of patients are top missions of ours, they are not enough. We aim to lead in discovery to keep ahead of and catch up with the threats I have enumerated above.
To address these great needs, our faculty are engaged in cutting edge research. They are doing exciting science. They are studying the microbiome and its amazing roles in many health problems, deciphering the genetics and replication mechanisms
of viruses, determining what human genes are involved in infectious diseases, investigating how to make better vaccines, asking how to harness the “innate” immune system against infections, asking how HIV degrades the immune system,
asking how we can cure this and other viruses, studying how aging and infections interact, going to Africa and Central America to partner with local providers and scientists, asking how we can protect transplant patients better.
Eric Poeschla, MD
Tim Gill Professor and Head
Division of Infectious Diseases