2000
• Infection preventionists (IPs) urged to take a leadership role in the burgeoning national patient safety movement after the 1999 Institute of Medicine report To Err is Human.
• Methicillin-resistant Staphylococcus aureus (MRSA) continues to emerge as a community-acquired infection in children without traditional risk factors. This follows a sentinel public health event in 1999, when four fatal community-acquired MRSA infections occurred in otherwise healthy children with no history of previous hospitalization.
2001
• Bioterrorism fears put IPs front and center after the Sept. 11 attacks and anthrax mailings that followed.
• Mass production of a new smallpox vaccine is planned to protect a susceptible planet. Surviving several recommendations by world bodies to destroy them, the last acknowledged stocks of the live virus are at the Centers for Disease Control and Prevention (CDC) in Atlanta and the Russian State Research Center of Virology and Biotechnology in Koltsovo.
2002
• The highly anticipated vancomycin-resistant S. aureus (VRSA) makes its dreaded debut but fails to become the “superbug” that many feared.
• The first cases of severe acute respiratory syndrome (SARS-1) are discovered in China. The coronavirus likely jumped from Chinese horseshoe bats into palm civet “cats” sold in exotic animal markets.
2003
• SARS-1 spreads globally to 8,098 people, resulting in 774 deaths before it disappears in 2004. In North America, hospitals in Toronto were hit particularly hard, resulting in 438 cases and 44 deaths — including three healthcare workers.
• New Year’s Eve: Seemingly defeated by IP protests and the national decline of tuberculosis (TB), the Occupational Safety and Health Administration (OSHA) revives some of the contentious portions of its scuttled TB standard into its general respiratory protection standard.
2004
• The CDC sends a team to Vietnam to assess the pandemic threat of an H5N1 avian influenza outbreak that caused a least a dozen human deaths.
2005
• The CDC issues a guidance document for the public reporting of healthcare-associated infections, setting the stage for the mandatory state and national reporting systems now in place.
• The legendary 1918 influenza A H1N1 “Spanish flu” is recreated by public health investigators, with some of the genomic material coming from an Inuit woman buried in the permafrost of an Alaskan village wiped out by the pandemic virus.
2006
• H5N1 “bird flu” is found in wild birds in the United States as part of increasing surveillance for avian influenza.
• About 6,000 mumps cases hit the United States, some in hospital outbreaks.
2007
• MRSA kills more people annually than human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the United States.
• Avian influenza H5N1 kills poultry in outbreaks in countries around the world. Bird flu is widely considered a possible pandemic virus, but it never develops the ability to effectively transmit between humans.
2008
• Public health officials notify thousands of patients at two Las Vegas endoscopy clinics that they may have been exposed to HIV and other bloodborne pathogens as the result of unsafe injection practices. It is the largest lookback investigation in medical history, with about 50,000 patients advised they may have been exposed from 2004 to 2008.
2009
• A pandemic of novel influenza A virus (H1N1pdm09) with genetic elements of swine, bird, and human, emerges in the United States and spreads globally. Although mild by pandemic standards, it shows the potential reach of such pathogens by infecting more than 1 billion people.
• Carbapenem-resistant Enterobacteriaceae (CRE) threatens to become the next big infection prevention challenge in healthcare settings.
2010
• An ongoing epidemic of Clostridium difficile in the United States kills 12,000 patients annually, in part because neither alcohol hand rubs nor even some soaps effectively remove the spore-forming bacillus.
• The New Delhi metallo-beta-lactamase (NDM-1) enzyme is detected in patients in three U.S. states. It is multidrug-resistant and has a transferable plasmid that can confer resistance in other bacteria.
2011
• Emerging multidrug-resistant gram-negative bacteria are spreading across the healthcare continuum, becoming entrenched in non-acute and long-term care settings and threatening vulnerable hospital patients with untreatable infections.
2012
• Middle East respiratory syndrome (MERS), a coronavirus that can cause severe respiratory infection and death, is found in Saudi Arabia and Jordan. Although likely of bat origin, MERS establishes a reservoir in camels in the region. With rare exceptions, it does not emerge from the Middle East in any sustainable way.
• Preexisting relationships between IPs and public health epidemiologists in Tennessee prove critical in solving a national fungal meningitis outbreak that leads to a product recall.
2013
• Hepatitis B virus transmission from a chronically infected surgeon to as many as eight patients underscores the need for providers to know their bloodborne infection status and seek the counsel of an expert review panel.
• A Tulsa, OK, dental practice rife with infection control failings becomes the site of the first documented case of hepatitis C virus infection via cross-transmission between patients in a dental office.
2014
• An Ebola outbreak begins in West Africa, and eventually becomes the largest ever, with more than 28,000 cases and 11,000 deaths over the following two years. Some IPs volunteer to help and head to Africa. The index case is thought to be a 2-year-old boy who frequently played in a hollow tree in a rural region of southeastern Guinea. When the tree caught fire in 2014, a horde of free-tailed bats flew out.
• Ebola in America: A traveler from Liberia infects two U.S. nurses in Dallas. Both survive, but the fear of Ebola in the United States is palpable. In some instances, it goes beyond science, becoming irrational and stigmatizing.
2015
• Fired drug-diverting healthcare workers are not prosecuted by hospitals, leaving them free to find a job at some other unsuspecting facility. The CDC reports that thousands of patients are put at risk by outbreaks caused by drug diverters in healthcare.
2016
• The mosquito-borne Zika virus outbreak spreads throughout the Americas, causing horrific birth defects. U.S. IPs emphasize that standard precautions and safe injection practices will prevent transmission in healthcare settings.
• The CDC alerts hospitals that hundreds of thousands of open-heart surgery patients may be at risk of invasive Mycobacterium chimaera caused by heater-cooler devices that were intrinsically contaminated during production.
2017
• The CDC urges IPs to have a high index of suspicion for emerging Candida auris, a fungus that spreads more like bacteria, can be highly drug-resistant, and survives on skin and environmental surfaces for prolonged periods.
2018
• Significant progress is being made in reducing surgical site and urinary tract infections, but C. diff and pneumonia are entrenched in CDC sentinel hospitals.
2019
• In a strangely prescient story, HIC reminds infection preventionists that the threat of an emerging infection is only a plane ride away from virtually anywhere on the globe.
• The first cases of SARS-CoV-2 infection are reported in Wuhan, China.
• The Food and Drug Administration (FDA) finds that 5% of duodenoscopes still are contaminated after reprocessing.
• The Centers for Medicare and Medicaid Services (CMS) finalizes a regulation requiring antibiotic stewardship programs in hospitals.
2020
• The first cases of COVID-19 are identified in the United States. The pandemic virus threatens to transmit in the community and hospitals in the absence of an effective treatment or a vaccine. The first case of person-to-person spread is the United States is reported Jan. 30, 2020.
• The World Health Organization declares the pandemic a Public Health Emergency of International Concern, which now will coordinate the response between nations.
• U.S. healthcare workers are seen pleading for personal protective equipment, particularly medical-surgical masks and N95 respirators. They find the just-in-time supply lines are broken and the Strategic National Stockpile suffered from neglect.
• The “heart-wrenching” toll of COVID-19 on nursing homes becomes apparent.
• The first messenger ribonucleic acid COVID-19 vaccine is approved in United States.
2021
• Investigative journalism project estimates about 3,000 healthcare worker deaths because of COVID-19. The CDC estimate is about 1,500. A bioethicist charged by government health officials to find out the number tells HIC, “We don’t know … we don’t have standardized reporting systems.”
• The CDC reports healthcare-associated infections dramatically surged in 2020 amid pandemic chaos.
• The CMS mandates COVID-19 vaccination for healthcare workers.
• OSHA issues an Emergency Temporary Standard on COVID-19 in healthcare.
• Long COVID-19 may be the most insidious wave of the pandemic. Patients report a prolonged, sometimes changing array of ill effects.
• The push to vaccinate people of color brings past atrocities to the forefront, including government “medical care” in the Tuskegee experiment.
2022
• With the SARS-CoV-2 pandemic exposing widespread inequities and deep-set systemic racism in healthcare, the Association for Professionals in Infection Control and Epidemiology opens a line of research into these critical issues.
• Generally thought of as a pediatric problem, respiratory syncytial virus takes a surprising toll on the elderly.
• The CMS states that at least part-time IPs are required in nursing homes.
• The CDC reports that drug-resistant pathogens are surging in hospitals. Candida auris infections increase 60%.
• With seeming simultaneity, mpox emerges in 29 non-endemic nations, including the United States.
• The CDC admits errors and mistakes in responding to the COVID-19 pandemic. (See Hospital Infection Control & Prevention, October 2022.)
