50 years of Infectious Diseases Research at UAlberta

George Goldsand's appointment at UAlberta 50 years ago marked the beginning of the infectious diseases program.

Amy Samson - 29 June 2017

On June 23, 2017, the division of infectious diseases celebrated 50 years of research at the University of Alberta. The celebration marked the golden anniversary of George Goldsand's, '59 MD, appointment at the U of A which set in motion the creation of the division of infectious diseases.

Goldsand was one of the first infectious disease (ID) specialists in Canada. He served as the first director of the division of infectious diseases at the U of A, and was actively involved in establishing the discipline as an accredited subspecialty in Canada. He was the first chair of the Royal College of Physicians and Surgeons of Canada examination committee in infectious diseases, and a founding member of the Canadian Infectious Diseases Society, which is now the Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada).

As part of the anniversary event Narmin Kassam, divisional director of general internal medicine at the U of A and governor of the Alberta chapter of the American College of Physicians (ACP), presented Goldsand with the 2016 ACP Laureate award. The Laureate award is conferred to ACP fellows and masters "who have demonstrated… an abiding commitment to excellence in medical care, education, or research," as well as dedicated service to their community, their chapter and the ACP.

Kassam remarked that Goldsand is "highly deserving and long overdue to receive this award."

In addition to Goldsand, two other Canadian ID pioneers, Alan Ronald and Harvey Rabin, were in attendance at the event. Ronald developed the ID program at the University of Manitoba, and has been recognized for his work on sexually transmitted diseases. Rabin trained with Goldsand, and was involved in developing the ID program at the U of A, and later at the University of Calgary.

To celebrate and honour the rich history of their division and ID research, Lynora Saxinger and Mark Joffe presented on 50 key events over the past 50 years. Here are some of these events and additional milestones:

1972: Anne Fanning is appointed to the division of infectious diseases. Fanning has served as director of tuberculosis services for Alberta Health (1987-1996), medical officer with the World Health Organization's global TB program (1998), and coordinator of global health at the U of A (1999-2011). Fanning was recently inducted into the City of Edmonton's Salute to Excellence, Community Service Hall of Fame, and will be inducted into the Alberta Order of Excellence this coming October.

1978: A 32-year-old pilot is cared for at the U of A Hospital (UAH) following a plane crash that led to a blood transfusion in the Republic of Zaire, now the Democratic Republic of the Congo. In 1983, the patient, who had passed away, is retroactively identified as having been HIV positive, making this one of the earliest recognized cases of HIV/AIDS in North America.

1985: Geoffrey Taylor is hired to establish the UAH Infection Control Unit. The unit, which is the first of its kind in Alberta, works to prevent and control health care-acquired infections.

1989: Working with colleagues at the California-based biotechnology company Chiron, Michael Houghton leads the team that first identifies the hepatitis C virus (HCV). His discovery results in the widespread screening of donated blood supplies, which significantly reduces the risk of acquiring HCV through blood transfusion. Houghton is now leading efforts to create the world's first vaccine capable of protecting against all strains of HCV as Canada Excellence Research Chair in Virology at the University of Alberta.

1989: Geoffrey Taylor and Lil Miedzinski establish the Northern HIV Program in response to a report prepared by the Working Group on AIDS Patient Care Services, Alberta Department of Community and Occupational Health (predecessor to Alberta Health). Stan Houston is appointed as permanent director of the program in 1991.

1994: First case of Hantavirus pulmonary syndrome (HPS) is reported in Alberta. This becomes a major area of research for Lil Miedzinski. An article published in Clinical Infectious Diseases in 2000 demonstrates that although Alberta has the highest number of cases of HPS in Canada, the mortality rate is lower than that reported in the United States, which in 1999 was 43%.

1997: Tom Marrie is involved in establishing the Pneumonia Severity of Illness score (PSI). PSI is a clinical risk assessment tool that helps physicians determine whether patients with community acquired pneumonia can safely be treated as outpatients, or whether they require inpatient care.

1998: Lorne Tyrrell discovers that Lamivudine, or 3TC, dramatically decreases human hepatitis B virus replication by up to 99.9%. As a result, it becomes the first antiviral therapy drug for the treatment of hepatitis B and leads to the restoration of liver transplantation programs for hepatitis B carriers. Tyrrell later extends his studies to hepatitis C and, along with Norman Kneteman and David Mercer, develops a way of testing hundreds of compounds as potential drugs against the virus.

2003: The SARS outbreak begins, originating at a hotel in Hong Kong, China. Nelson Lee, of the Chinese University of Hong Kong, is involved in tracking the origin of the virus and reporting on early cases in the outbreak at the Prince of Wales Hospital in Hong Kong. Lee will join the division of infectious diseases at the U of A as a faculty member on July 1st, 2017.

2005: Health Canada approves rapid or point-of-care HIV testing. Point-of-care testing refers to tests administered on site with the patient present, rather than in a laboratory, with preliminary results being returned within 30 minutes. Ameeta Singh's work focuses on point-of-care testing and explores the feasibility of introducing rapid tests for syphilis, along with HIV.

2011: Health Canada approves the first direct-acting antivirals for the treatment of HCV. Stephen Shafran is a leader in the evaluation of antiviral agents for the treatment of HCV in clinical trials.

2014: Lynora Saxinger co-authors a National Collaborating Centre for Infectious Diseases (NCCID)-sponsored report that assesses the status of antibiotic or antimicrobial use and resistance surveillance in Canada. The report provides recommendations to advance infectious disease surveillance nationally. Saxinger continues to be involved in national initiatives to promote best practices in antibiotic use.

2017: Multi-drug resistant (MDR) and extensively drug-resistant (XDR) tuberculosis are a growing health concern. Aditya Sharma co-authors a study which demonstrates that incidents of MDR and XDR tuberculosis in India, the Philippines, Russia and South Africa are increasing, despite improvements in acquired drug resistance. She calls for additional efforts to control MDR and XDR tuberculosis beyond improving acquired drug resistance rates.