Parting Glances: From Patient Zero to Patient ‘Oh’

Charles Alexander
By | 2016-04-14T09:00:00+00:00 April 14th, 2016|Opinions, Parting Glances|

Gaetan Dugas. Recognize the name? In case you may have forgotten, Gaetan is better known in AIDS infamy as Patient O.
A pretty, blond Canadian airline steward, he purportedly brought the HIV retrovirus into the United States and — aware or unaware of this vector status — victimized many gay men in the late-1970s.
He reportedly single handedly sparked North America’s AIDS epidemic. (To date, 658,507 AIDS-related deaths. And counting.)
The March issue of Science magazine, published by the American Association for the Advancement of Science, carries a report that there’s no scientific research basis for the Gaetan Dugas accusation that surfaced first in the Randy Shilts 1987 best-selling AIDS account, “And The Band Played On.”
Shilts writes, “There’s no doubt that Gaeton played a key role in spreading the new virus from one end of the United States to the other.” Shilts doesn’t actually come out and state unequivocally that Dugan, who died of AIDS-related causes in 1984, introduced the disease to North America, but mass media worldwide turned Gaetan into a vector monster.
The New York Post was among the first major media outlets to sensationalize his role in the emerging AIDS horror story. Its headline proclaimed in bold face caps: “The Man Who Gave Us AIDS.” (According to the U.S. National Library of Medicine, the focus may have been abetted as a publisher ploy to sell Shilts’ book.)
The ASAS March news story by Boston science reporter John Cohen is captioned: “Infectious Disease: ‘Patient Zero’ no more. Sleuthing clarifies HIV’s history.”
Cohen reports, “Last week at the Boston 2016 Conference on Retroviruses and Opportunistic Infections, Michael Worobey, an evolutionary biologist at the University of Arizona, solidly debunked the claim, saying Dugas was far from what epidemiologists refer to as the ‘index patient’ in the United States.
“Worobey’s new work will help put the ‘myth of Patient Zero’ to rest, says epidemiologist Harold Jaffe of the Centers for Disease Control and Prevention (CDC) in Atlanta, who helped unravel the early spread of the disease.”
Cohen adds, “The first AIDS cases surfaced in five gay men in Los Angeles, California, and were reported in CDC’s Morbidity and Mortality Weekly Report in June 1981.
“After HIV was proven to be the culprit in 1984, researchers analyzed stored blood from gay and bisexual men collected in the late 1970s in San Francisco and New York City and found the men already carried antibodies to the virus.”
On the family tree of the early U.S. isolates, Dugan’s HIV genome fell in about the middle. “There’s nothing special about his genome,” Worobey said. The Science article concludes, “Although Dugas had been in Haiti — in 1977 — there is no sign that he was either the index patient or key to spreading the virus around the country.”
Worobey clarifies how the Zero in Patient Zero happened. “When CDC researchers were piercing together how the first AIDS cases were linked to each other, they originally referred to Dugas not by the number ‘0’ but by the letter ‘O’ because he was from ‘outside’ California. Later, for reasons that remain murky, Dugas morphed into Patient Zero.”
The ASAS Science article concludes — perhaps just a tad flippantly — “So, rather than Dugas sparking the U.S. epidemic, his case, historically speaking, really is just an “oh.” (Oh, my.)

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Charles Alexander