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 diseass.
Our faculty, more than 50 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 over the past decade 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 hospital is currently housed in east Denver, but will move to a brand new facility on the Anschutz campus in 2018.
We also have partners 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.
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. Our Colorado AIDS Clinical Trials Unit (ACTU) has over 250 participants enrolled in over 30 active clinical trials, including trials to evaluate strategies to cure HIV infection. Our AIDS Education and Training Center (AETC) carries out educational programs for HIV providers across 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 caused by emerging viruses and other microbes. (A few examples of emerging/re-emerging viruses of great current importance are West Nile virus, Chikungunya virus, MERs virus, Enterovirus D68, Dengue, Zika virus, potential avain influenza viruses, and of course, HIV-1). There are also highly antibiotic-resistant disease-causing bacteria, some of which threaten to become untreatable. No other medical specialty must grapple with the 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, 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 courageously and well 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 must 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. Some have MDs, some have Ph.Ds, some have both degrees. 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 study HIV, Chikungunya and Dengue, asking how we can protect transplant patients better. They are even doing “genomic microsurgery” – editing the letters of the DNA code – with remarkable new tools like CRISPR/Cas9 and TAL effector nucleases, with the purposes of fundamental scientific discovery and actual human gene therapy (to cure HIV for example).
We invite you to join our mission. In a separate link, we will explain how benefactors of all means and interests can contribute.
Eric Murnane Poeschla, MD
Professor of Medicine
Tim Gill Endowed Research Chair and
Chief, Division of Infectious Diseases