Infection Control and Hospital Epidemiology: Thirty Years Later

From the Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Received September 11, 2009; accepted September 11, 2009; electronically published November 24, 2009. Infect Control Hosp Epidemiol 2010; 31:1-3 2009 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2010/3101-0001$15.00. DOI: 10.1086/649763 In 1980, with strong support from Philadelphia publisher Charles Slack, a small group of us launched the first issue of a bimonthly journal, Infection Control. The associate editors and I comprised 4 young hospital epidemiologists and a passionate spokesperson for infection control nurses, supported by an advisory board of infectious diseases clinicians, microbiologists, nurses, and a surgeon (Figure). The goal of the journal was to provide evidence-based original articles, in-depth reviews, and critical perspectives focusing on the prevention of infections in hospitals. The timing of the journal was propitious: the United Kingdom had had 20 years of experience with the infection control sister; the Centers for Disease Control and Prevention had held its first International Conference on Nosocomial Infections 10 years earlier; the nascent societies, Association of Practitioners for Infection Control and Society for Hospital Epidemiologists of America, were attracting new members; and the first textbooks with widely diverse perspectives in infection control were being published. The associate editors and I sought to engage broadly all persons of all disciplines of infection control, not just physicians. Initially, 90% of our subscribers were nonphysicians. We were enthusiastic and saw the possibility of professional interest beyond the United States. To that end, we secured the financial backing of Slack for a spirited International Symposium on Infection Control held in 1983 in Vienna, Austria, the site of Semmelweis’ great observations in the 1840s. The venue was spectacular, the meeting was a huge international success, and the publication of the proceedings was well received. A second symposium scheduled to be held in London in 1986 that was again backed by Slack was reluctantly canceled because of a wave of international terror involving air travel in the mid-1980s and an increasing public fear of flying. In 1988, we initiated our formal affiliation with the Society for Hospital Epidemiologists of America and changed the name of the journal from Infection Control to Infection Control and Hospital Epidemiology (ICHE). Specifically, we sensed the early parade of federal regulations, the need to respond to the growing AIDS epidemic, and efforts with regard to cost control and antibiotic use, among other subjects. The goal was to emphasize the discipline behind our field and to note the increasing need for hospital epidemiologists and infection control nurses to address expanding issues related to safety and accountability in acute care institutions. It was the conclusion of several of us that infection control was, by that time, already established as the premier example of quality of care in US hospitals. Some were concerned that our field may eventually be swallowed up by the emerging quality of care movement, which did not always subscribe to strict epidemiological principles. Of interest, the distinctions in the evolution of infection control specialists and advocates of quality care in the past 15 years were recently outlined by Edmond. At present, ICHE is arguably the leading journal about infection control 30 years after its inception. It has continued to stay ahead of key issues, to explore a science-based approach to evidence, and to respond to the needs of all individuals engaged in the prevention and control of healthcareassociated infections. The inaugural issue included only 3 original articles, 2 medical-legal commentaries, an introduction to useful statistics, and a book review; all were written by authors from the United States. Current issues are monthly and include 8–10 original articles by authors from several countries, a review, 4–5 brief communications, and several letters to the editor. Despite 3 decades of success, it is reasonable to ask, will ICHE survive another 30 years? In fact, will any journal in its current form survive the next 30 years? The availability of free online information is at odds with increasing publication costs, new hand-held devices are being used for visual and oral data acquisition, and younger people are relying less on books and hardcopy journals. It is easy to suggest that ICHE will thrive in 30 years only by committing to remake itself continually and by meeting the challenges of new technology, the need for instant information backed by evidence, and changes in societal preferences for the language of science. Much will also depend on the necessary evolution of infection control and the value that society places on science and rigor, as opposed to unvetted opinion. In the end, only continued creativity will ensure success.