What will 21th-century hospitals for the care of patients with highly infectious diseases look like?

Abstract

From the 16th to the 20th century, Europe has fought against infections by building hospitals, such as the Lazaretto in Venice, for the care of patients with infectious diseases. Such hospitals for the care of the contagious appeared in many countries, particularly in ports, where infectious diseases were propagated. Single rooms and particular circuits for the treatment of clothes and waste were set up in these hospitals. Most of these hospitals were destroyed at the end of the 20th century because of the great decrease in epidemics of the very contagious infections known until then. The replacements have been organized differently in various countries. Some countries built new hospitals to avoid contagion, such as China with the Shanghai hospital. Italy was at the forefront, with the creation of hospitals in Milan and Rome that allowed the isolation of highly contagious patients. In many other countries, only single units within a hospital are dedicated to infectious diseases, and the conditions for fighting contagion are not met. Among the challenges of the 21st century, the risk of epidemics of new infectious and contagious diseases such as flu, SARS, or haemorrhagic fever, alongside the defeat suffered in the battle against the dissemination of multiresistant bacteria carried by humans, within and among hospitals, make it clear that it will be necessary to reorganize the management of patients with contagious infections, even when these patients are asymptomatic. This reorganization of the units for care of patients with contagious diseases in modern hospitals is a challenge of the 21st century. This theme section concerns the current situation as viewed by the European CDC and EuroNet (European Network of Infectious Diseases), a group organized and funded for reflection upon hospitals for patients with highly contagious diseases, and includes their guidelines and recommendations for the immediate future which, I think, will contribute to the setting up of appropriate structures.