Patient Zero Not Responsible for HIV IN U.S.

regdog · Oct 26, 2016

A fascinating and in depth study and explanation of how HIV first came to US and how one person was wrongly blamed.

Researchers have definitively traced how HIV first spread to the US, thanks to an impressive genetic analysis of thousands of blood samples collected in San Francisco and New York in the late 1970s.

The study, published on Wednesday in Nature, focused in particular on decoding the viral strains carried by eight people who were infected with HIV. Because the HIV virus mutates rapidly from one person to the next, it’s possible for scientists to compare genetic markers in each strain to track the history of how it spread.

The paper is a technical feat, but also has a powerful human side: It definitively clears the name of “Patient Zero,” a gay French-Canadian flight attendant named Gaëtan Dugas who for decades has been accused of bringing the virus to North America.

Link 1 Buzzfeed

Link 2 The Guardian

Link 3 Nature- A reprint of the study

Alessandra Kelley · Oct 26, 2016

"Patient Zero" wasn't and he didn't and DNA tests have completely cleared his name.

Dr Michael Worobey, one of the researchers, said: "The samples contain so much genetic diversity that they could not have originated in the late 1970s.

"We can place the most precise dates on the origins of the US epidemic at about 1970 or 1971."

The researchers also analysed the genetic code of human immunodeficiency virus taken from Mr Dugas's blood.

Like a failed paternity test, the results showed that the virus in his blood was not the "father" of the US epidemic.

Dr Richard McKay, a science historian at the University of Cambridge, said: "Gaetan Dugas is one of the most demonised patients in history and one of a long line of individuals and groups vilified in the belief that they somehow fuelled epidemics with malicious intent."

The term "Patient Zero" is owed to a misreading of the original files.

The Air Canada employee was labelled Patient O (the letter, not the number) by the US Centres for Disease Control because he was a case "Out-of-California".

Over time the O became a 0 and the term Patient Zero was born. It is still used to this day to describe the index case of an outbreak

regdog · Oct 26, 2016

I remember when Dugas was originally seen as the start of the outbreak.

Decades later I became friends with a man whose first boyfriend died in the very early 80s of some unknown illness. This was even before the medical community was talking about the strange illnesses emerging in the gay community. My friend and the man had been broken up for a while and he went to visit him in the hospital. The nurses dressed him in full infection protective gear for his safety. They said they had no idea what was wrong with the patient, but he was dying of strange opportunistic infections that he 1) shouldn't be getting and 2) shouldn't be as serious as they were.

MaeZe · Oct 27, 2016

First patient I took care of with HIV was in 1982. All he had for a diagnosis was a immunodeficiency disease and an unknown lymphadenopathy. We saw him a number of times before he died. The docs were considering something to do with the fact he frequented gay bathhouses and there was discussion of a new disease. Later I met some doctors from the Bay Area that were seeing a number of cases. That was 1983 in Puerto Vallarta.

An additional bit of interest with this story is the fact And the Band Played On was at least partially responsible for misidentifying patient zero. It was still a good book.

Roxxsmom · Oct 27, 2016

I'm glad this has been definitively refuted at last (and seems to be getting some media attention). There's been skepticism among virologists and epidemiologists about the whole "patient zero" hypothesis for some time. My dad, a virologist, was griping about how stupid that story was back in the 1990s. Too many things about the epidemic in the US didn't add up for it to have been introduced and spread primarily by one person in the late 70s, but pop culture has never been one for letting a little science get in the way of a good story.

The 80s and 90s, before the more effective antiretroviral cocktail treatments became widely available, were a horrible time. So many people, especially young people, died. There were a lot of misconceptions about how it was spread, and a lot of mean spiritedness by people who smugly felt they weren't at risk.

Dawnstorm · Oct 27, 2016

Roxxsmom said:
I'm glad this has been definitively refuted at last (and seems to be getting some media attention). There's been skepticism among virologists and epidemiologists about the whole "patient zero" hypothesis for some time. My dad, a virologist, was griping about how stupid that story was back in the 1990s. Too many things about the epidemic in the US didn't add up for it to have been introduced and spread primarily by one person in the late 70s, but pop culture has never been one for letting a little science get in the way of a good story.

I distinctly remember this musical about the whole affair. A song contains the line "let's all be empiricists," in the chorus.

MaeZe · Oct 28, 2016

Roxxsmom said:
I'm glad this has been definitively refuted at last (and seems to be getting some media attention). There's been skepticism among virologists and epidemiologists about the whole "patient zero" hypothesis for some time. My dad, a virologist, was griping about how stupid that story was back in the 1990s. Too many things about the epidemic in the US didn't add up for it to have been introduced and spread primarily by one person in the late 70s, but pop culture has never been one for letting a little science get in the way of a good story.

The 80s and 90s, before the more effective antiretroviral cocktail treatments became widely available, were a horrible time. So many people, especially young people, died. There were a lot of misconceptions about how it was spread, and a lot of mean spiritedness by people who smugly felt they weren't at risk.

That's interesting. I totally bought the patient zero story because so many gay men at the time were having sex with hundreds of partners. It made sense that was the reason it spread so fast in the gay community. In fact, even without patient zero lighting the fuse in multiple cities, that much sexual interacting still accounted for how fast the disease spread. I lost a good friend during that time, a guy I grew up with.

regdog · Oct 28, 2016

I was living in NJ during the early 80s and remember the news reporting a strange illness among the NY Haitian community. Later news reports said the odd illness was in the Haitian and gay community.

ColoradoGuy · Oct 30, 2016

I had a patient in 1982 who had been ill for several years with a disorder resembling AIDS. I saved some of his blood after he died. It was positive for HIV when the test became available. I've read estimates there were isolated cases in the 1950s, if not earlier. It probably jumped from chimps to humans sometime in the 1930s in Africa.

AW Admin · Oct 30, 2016

ColoradoGuy said:
I had a patient in 1982 who had been ill for several years with a disorder resembling AIDS. I saved some of his blood after he died. It was positive for HIV when the test became available. I've read estimates there were isolated cases in the 1950s, if not earlier. It probably jumped from chimps to humans sometime in the 1930s in Africa.

I remember noticing a number of gay male friends in the early '80s who had a form of cancer I'd never heard of (Kaposi's sarcoma). They weren't even in the same continent in some cases.

James D. Macdonald · Oct 30, 2016

ColoradoGuy said:
I had a patient in 1982 who had been ill for several years with a disorder resembling AIDS. I saved some of his blood after he died. It was positive for HIV when the test became available. I've read estimates there were isolated cases in the 1950s, if not earlier. It probably jumped from chimps to humans sometime in the 1930s in Africa.

Very probably some guy who was out in the bush chimp-hunting with a open wound somewhere on his body (easy enough to do in the field with thorns and such). It took around forty years to get going, mostly because person-to-person transmission of HIV is really hard to do.

Which makes me wonder what horror is crawling around somewhere in the human population right now that will only become known ... in 2050. When the tipping point happens and suddenly it's everywhere.

Chris P · Oct 30, 2016

It makes much more sense to me that HIV would have been introduced to the US multiple times by multiple people. I never bought the story that one guy brought it once. To me, that sounds like a paranoid rationalization and a throwback to the days of it being "a gay disease." It would have come here one way or another.

If you've got 30 min, here is a fascinating Radio Lab podcast tracing the true patient zero way back. https://www.wnyc.org/radio/#/ondemand/169885

MaeZe · Oct 30, 2016

ColoradoGuy said:
I had a patient in 1982 who had been ill for several years with a disorder resembling AIDS. I saved some of his blood after he died. It was positive for HIV when the test became available. I've read estimates there were isolated cases in the 1950s, if not earlier. It probably jumped from chimps to humans sometime in the 1930s in Africa.

HIV’s unusual family tree - How the virus leapt from monkeys to chimps to humans, and why it doesn’t happen more often

But evolutionary biologists are concerned with smaller figures.

Two: the number of HIV precursor strains that merged their genetic material inside a chimpanzee to create a much more virulent bug, deadly to chimps — and which ultimately spawned HIV.

One: the unfortunate chimp first infected with that new virus, known as simian immunodeficiency virus cpz, or SIVcpz.

Four: the number of times HIV jumped from chimp to human. HIV likely arose from blood contact when humans handled bushmeat from SIV-infected apes.

In some ways it’s surprising that HIV’s chimp precursor hasn’t cropped up more often, said Fred Hutchinson Cancer Research Center virologist Dr. Michael Emerman.

The birth of SIVcpz “was a very unusual event, because it only happened one time that we know of in evolutionary history,” said Emerman, who studies the viral, chimp and human evolutionary steps that ultimately allowed HIV to come into the world. “And we know that there are lots of exposures, because chimpanzees eat a lot of monkeys and a lot of these monkeys have their own version of these SIVs.”

In a study published Tuesday in the journal PLOS Pathogens, Emerman and his colleagues describe their findings on the chimp genes that may normally protect chimps from monkey-borne SIVs — and could be the critical immune blockade that was breached only once, when SIVcpz arose. Emerman led the study along with Dr. Lucie Etienne, a former Fred Hutch postdoctoral fellow who now leads a virology research team at the International Center for Infectiology Research in Lyon, France....

...At least 40 species of African monkeys are infected with their own, specialized strains of SIV — and have been for upwards of 10 million years, Emerman said.

SIVcpz and HIV are much newer. The chimp virus arose somewhere between 1,000 and 20,000 years ago. HIV is only about 100 years old — a mere bud on the viral family tree compared to its predecessors.

Genetic research is opening so many doors of understanding.

SIVs "have been in the monkeys long enough that the hosts have now adapted to tolerate those viruses,” Emerman said. “They don’t cause disease like (HIV does) in humans.”

HIV’s very young age may explain why it’s so virulent in humans: We’re in the rocky phase of our evolutionary relationship with the virus. However, chimps also get sick from their version of SIV, so even another several thousand years’ time won’t fix our relationship problems.

Patient Zero Not Responsible for HIV IN U.S.

regdog

The Scavengers

Alessandra Kelley

Sophipygian

regdog

The Scavengers

MaeZe

Roxxsmom

Beastly Fido

Dawnstorm

punny user title, here

MaeZe

regdog

The Scavengers

ColoradoGuy

I've seen worse.

AW Admin

James D. Macdonald

Your Genial Uncle

Chris P

Likes metaphors mixed, not stirred

MaeZe