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Among the myriad remarkable changes in the last thousand years has been the evolution of our understanding and management of infectious diseases. To encapsulate a millennium of change is a daunting task, because the progress that has been made has been monumental in scope and breadth, with individual achievments of immense proportions. Hence, I have chosen to look at a snapshot of the last century with a focus on the years 1900 and 2000, with a brief analysis of the changes that have accounted for the obvious differences in the two eras. I have chosen this period because of the remarkable changes that have occurred and because that period provided both greater and more significant advances than in the preceding 900 years.

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