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Epidemiologic Research in America

The First Etiologic Hypothoses, page 16:

Given the difficulty conceding how the immune system could be exhausted by infectious agents, G. Shearer, Steve Witkin, and other physicians thought of sperm, which, instilled into the rectum, might act as a "natural" immuno-suppressant. Experiments were conducted to pursue the idea, but here, too, a historical objection immediately comes to mind. If true, why was this effect not noticed earlier?


In Search of "Patient Zero", pages 18-19:

David Auerbach, William Darrow, and other investigators at the Centers for Disease Control discovered that nine out of thirteen homosexual patients they questioned in Los Angeles and Orange counties, out of a total of ninetten tallied, formed a sort of sexual network. Over the last five years each of these nine patients had had sex with at least one other member of the group. In most cases their sexual relations went back to the period before the partner's symptoms had appeared. Hence apparently healthy individuals could transmit the disease. A history of relations was established between members of the California network and a similar group in New York. At the center of this diagram of homosexual contacts was a young man, Gaetan Dugas. He was nicknamed "Patient Zero".

Dugas, an Air Canada flight attendant, was both an active and receptive homosexual. Directly or indirectly through intermediate contacts, he had infected at least forty of the 248 American patients diagnosed before April 1982. He was found to have been a sexual partner of nine of the nineteen first Los Angeles cases, twenty-two of the New York patients, and nine cases in eight other cities (Miami, Chicago, etc.). As an airline steward, Dugas, on vacation, could fly free. A great traveler, handsome and generous with his charms, he had sown the disease and death all along his route, at the rate of about 250 partners per year. The investigators confirmed to their own horror that he had been contagious before experiencing the slightest symptom. According to their analysis, the incubation period for this new disease exceeded ten months.

[...]

Afflicted in June 1980 with Kaposi's sarcoma, identified in November 1982 as a carrier and warned of the risk he could pose for his partners, Dugas refused to change his lifestyle. Until his death on March 30, 1984, at the age of thirty-two, he carried on his sex life with no protective measures. Sometimes he informed his partners, but only after the act. He had thus adopted the habit of saying to them, "I've got gay cancer; I'm going to die, and so are you." A kind of deaf rage against fate had seized him, a desire for vengeance. In a medical interview, he had shamelessly declared, "I've got it; they can get it too." Every historian of disease knows that such an attitude of vengeance, or at least of recklessness, had contributed in other times to the spread of tuberculosis and syphilis.

[...]

[A]lmost all politically and socially responsible parties had reacted at first with incredulity. They simply hoped the disease was not contagious. Reluctantly, in finally admitting its contagiousness they found it inconceivable that such a strange disorder was not also foreign, an invader from beyond. Who had introduced it to the United States, at what point in time, and from what quarter? Answers could be found which at first seemed satisfactory enough, but which later came to seem insufficient and arbitrary.

Gaetan Dugas, a French-Canadian, was not an American citizen, which made him a convenient scapegoat. But there was no plausible reason to say that the disease had come from Canada. If, at the beginning of the epidemic, Dugas was an outstanding "promoter" of the contagion, that still did not prove that he should have functione effectively as "Patient Zero" in the strong sense of the term. He had certainly imparted the fatal agent to a goodly number of his American partners, but in no way did that exclude the possibility that he had received it from an American himself. It is worth nothing that some of his partners manifested the symptoms of AIDS before he did.
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Jason

March 2012

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