SAN DIEGO, CA— Presidents of the four respective organizations comprising IDWeek welcomed more than 6,500 attendees — including 795 fellows and 200 residents — to the first joint meeting of the Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), and the Pediatric Infectious Diseases Society (PIDS).

Calling infectious diseases “one of the most exciting, challenging, and rewarding specialties in medicine,” IDSA President Thomas G. Slama, MD, of Indiana University School of Medicine, Indianapolis, IN, said IDWeek brings together clinicians and researchers with interests in quality control, patient safety, and public health, as well as epidemiologists and colleagues in HIV and pediatrics, all of whom represent diverse backgrounds and worldviews.

SHEA President Jan E. Patterson, MD, of the University of Texas Health Sciences Center, San Antonio, TX, noted it is “critical we present a united front in combating issues that confront us in our everyday practice.” Judith A. Aberg, MD, New York University, New York, HIVMA President, said the joint meeting allows the broader infectious diseases community to keep up with the rapid pace of advances in treating patients with HIV. And PIDS President Janet A. Englund, MD, Children’s Hospital and Regional Medical Center, Seattle, WA, who in the past worked with IDSA on its pediatric track, said its expansion “is truly fantastic.”

The two plenary speakers addressed what it means to be human.

The first, Martin J. Blaser, MD, Chair of the Department of Medicine, Frederick H. King Professor of Internal Medicine, and Professor of Microbiology at New York University School of Medicine, New York, NY, presented some humbling statistics about the human microbiome — formerly called the “normal flora” —in his talk, “The War Against Bacteria: Increasing Casualties from ‘Friendly Fire.’”

Noting that the human body is composed of 1013 human cells and 1014 bacterial cells, with each body site having a different flora, the question necessarily arises, how is the equilibrium with persistently colonizing bacteria maintained?

Increasing evidence focusing on what Dr. Blaser calls “The Disappearing Microbiota Hypothesis” has found that “due to changes in human ecology, key members and functions of our microbiota are disappearing. Antibacterial agents, aimed at pathogens, may be having unintended collateral effects on the microbiota. These may be long-term and have clinical consequences, fueling the postmodern epidemics of chronic diseases that begin early in life.”

For example, he has found that Helicobacter pylori, present in humans for more than 100,000 years, is disappearing in Western cultures. While this has resulted in decreased rates of peptic ulcer disease and gastric cancer, the trade-off is increased rates of GERD, Barrett’s esophagus — with adenocarcinoma of the esophagus the fastest growing cancer in the United States — asthma and, potentially, obesity, infectious, celiac disease, and stroke, which is “not uniformly good.”

Future research that includes developing more narrow spectrum treatments, with better diagnostics for specific pathways, is needed, as is a means of archiving vanishing organisms, Dr. Blaser concluded.

The second plenary speaker, Robert K. Massie IV, MDiv, DBA, of Somerville, MA, offered perspectives and experiences drawn from his remarkable journey through the frontiers of infectious disease treatment. IDWeek attendees responded with a standing ovation — and there were few dry eyes.

Massie, President of the New Economics Institute, a national think tank on innovative models for the 21st century American economy, was born in 1956 with severe classical hemophilia. As a child, he suffered internal joint bleeding that robbed him of the ability to walk.

The author or editor of four books, his most recent work, A Song in the Night: A Memoir of Resilience, describes his early life with hemophilia and the discovery that he had HIV and hepatitis C as a result of exposure to both viruses through injections with Factor VIII concentrate for his hemophilia.

Over the years, after intensive study by physicians at Massachusetts General hospital, the discovery that he was a rare “elite controller” with genetic resistance to HIV led to new directions in the field of HIV research. In 2003, he developed advanced liver cirrhosis and was largely immobilized until his successful domino liver transplant in July 2009, which eliminated the cirrhosis and cured his hemophilia. His HIV and HCV viral loads are now undetectable.

Throughout his life, Massie has been cared for by countless clinicians and, for all them, he had two simple words: “Thank you.”