How Could Aids Have Remained Unidentified For 40 Years In Humans
If HIV was introduced to the human population before the Second World War, why didn’t it cause recognisable AIDS cases before the 1970s?
Kevin de Cock pointed out in his Monday presentation that the small number of HIV case reports come predominantly from academic centres, and that unusual diseases were most likely to be noticed in Europeans with access to care at academic medical centres. Unusual cases of cryptococcal meningitis went un-noted until the late 1970s, although polio researcher Stanley Plotkin said that in his experience, “you don’t recognise things unless you are prepared for them, especially if they are low incidence illnesses”.
This pattern prior to the early 1980s suggests that HIV was causing a low incidence of AIDS. If it had been causing a high incidence of illness, argues tropical medicine specialist Alan Fleming, the illness would have been recognised by local people without the aid of epidemiologists. That is what happened in Uganda, where a new disease was named Slim by local people before any epidemiological investigation was conducted.
Prevention: The Best Strategy
Even before CDC was designated in 1986 as the lead federal agency to inform and educate Americans about AIDS, the agency worked with uncommon flexibility with state and local public health agencies and community-based organizations to reach people most at risk. Science-based guidelines were translated into messages for target groups about how to make healthy choices, and how to prevent the spread of the disease. Other campaigns were designed to fight against stigma and fear by informing people about the nature of the disease, teaching tolerance and compassion for those who were HIV positive.
Displayed here are a set of slides from the HIV/AIDS Library and Narrative used by the Wisconsin Department of Health and Human Services in 1989 to train community-based AIDS service organizations. Furthermore, since testing became available in 1985, CDC began providing federal funds to establish an extensive system of alternate testing and counseling sites, leading to the first nationwide HIV- and AIDS-related prevention program. Today, testingknowing ones HIV statusis a key strategy in AIDS prevention.
Where And When Did Hiv Start
Studies of some of the earliest known samples of HIV provide clues about when it first appeared in humans and how it evolved. The first verified case of HIV is from a blood sample taken in 1959 from a man who was living in what is now Kinshasa in the Democratic Republic of Congo.
Scientists used this sample to create a ‘family-tree’ of HIV transmission. By doing this, they were able to trace the first transmission of SIV to HIV in humans, which they concluded took place around 1920, also in Kinshasa. This area is known for having the most genetic diversity in HIV strains in the world, reflecting the number of different times SIV was passed to humans. Many of the first cases of AIDS were recorded there too.
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Why Is Haiti Significant
In the 1960s, the ‘B’ subtype of HIV-1 made its way to Haiti. This is thought to have happened because many Haitians had been working in the Democratic Republic of Congo and had then returned to Haiti. Initially, Haitians were blamed for starting the HIV epidemic, and suffered severe racism, stigma and discrimination as a result.
Spread To The Western Hemisphere
Further isolated occurrences of this infection may have been emerging as early as 1966. The virus eventually entered gay male communities in large United States cities, where a combination of casual, multi-partner sexual activity and relatively high transmission rates associated with anal intercourse allowed it to spread explosively enough to finally be noticed.
Because of the long incubation period of HIV before symptoms of AIDS appear, and because of the initially low incidence, HIV was not noticed at first. By the time the first reported cases of AIDS were found in large United States cities, the prevalence of HIV infection in some communities had passed 5%. Worldwide, HIV infection has spread from urban to rural areas, and has appeared in regions such as China and India.
Is There Only One Type Of Hiv
No, there are actually two types of HIV: HIV-1 and HIV-2, and they have slightly different origins.
HIV-1 is closely related to the strain of SIV found in chimps. While HIV-2 is closely related to the strain of SIV found in sooty mangabeys monkeys. The crossover of HIV-2 to humans is believed to have happened in a similar way as HIV-1 .
HIV-2 is far more rare, and less infectious than HIV-1, so it infects far fewer people. It is mainly found in a few West African countries, such as Mali, Mauritania, Nigeria and Sierra Leone.
To complicate things further, HIV is also classified by four main groups of viral strain , each of which has different genetic make-up. HIV-1 Group M is the strain that has caused the majority of HIV infections in the world today, meaning it is the dominant strain.
The Patient Zero Myth
For decades, a French-Canadian airline employee named Gaetan Dugas, has been known as Patient Zero in the 1980s AIDS epidemic.
Dugas, a man who had sex with men , died in 1984. Since then he has been blamed by some as a primary source for the spread of HIV in North America.
Dugas was one of the primary villains in the 1987 book, And the Band Played On, by San Francisco journalist Randy Shilts.
However, the researchers now say Dugas was falsely accused and unfairly blamed.
Gaetan Dugas is one of the most demonized patients in history, and one of a long line of individuals and groups vilified in the belief that they somehow fueled epidemics with malicious intent, said Richard McKay, D.Phil., a Wellcome Trust Research Fellow in Cambridges Department of History and Philosophy of Science, in a press release.
In fact, McKay says, Dugas actually provided scientists with valuable information before he died.
Dugas told researchers after he contracted HIV that he had 750 sexual partners the previous three years. That wasnt necessarily an unusual number. Researchers said 65 percent of men in a Los Angeles cluster study at the time reported having more than 1,000 sexual partners in their lifetimes.
Much of that sexual connection was with anonymous partners, so many HIV patients couldnt give medical officials any names.
However, McKay says, Dugas provided medical officials with 72 names. That helped scientists track down a wide range of people infected with HIV.
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Why Do We Care Does All This Research Into How The Virus Got Started Tell Us Anything About How To Stop It
Hunting chimps in West Central Africa.
Research into the HIV’s origins may eventually yield practical results. It could help scientists understand why HIV’s viral ancestor, SIV, doesn’t kill or even sicken chimps who carry it. With that knowledge, researchers might be able to make drugs with fewer side effects, or broad-spectrum vaccines that protect against all the strains of the disease that infect people today.
Korber suggests that in an era of emerging diseases, looking back on the virus’ shadowy origins offers a “history lesson,” or perhaps even a fable, with a moral attached. By the time doctors realized that HIV/AIDS existed, it had already taken up permanent residence in humans. They couldn’t have known about it before then, but, Korber says, at least now they know to be wary as the virus continues its shape-shifting spread around the globe. “The fact that it could be with us for quite a long time before we even realized it was there is kind of eye-opening,” she says. “I think it’s something to keep us on our toes. It helps us understand that we can be surprised.” And of course, HIV research may have a few surprises left for us, too.
Where Did Hiv Come From A Look At The Origins Of The Pandemic Of Our Time
A chimpanzees virus has killed 35 million humans.
That virus, commonly known as HIV, is the defining pandemic of our time. More than 35 million people have been killed by the virus to date. But the virus itself didnt get its start in humans.
HIV/AIDS is, like the vast majority of emerging viruses infecting people, zoonotic in nature. The AIDS crisis, as we generally think of it, began in the 1980s. First as a mysterious illness primarily infecting gay men in urban areas in the United States. But thats not really the beginning. Before the diseases first mention in 1982 in the New York Times, people had been dying of AIDS for at least a decade, though probably not much longer. In Africa, HIVthe virus that causes AIDShad jumped from chimpanzees to humans sometime early in the 20th century.
To date, the earliest known case of HIV-1 infection in human blood is from a sample taken in 1959 from a man whod died in Kinshasa in what was then the Belgian Congo.
Its this fact which keeps me awake at night. Imagine, for a moment, that the HIV virus in that 1959 sample had been studied and identified. If, in the 1950s, the scientific community realized the potential harm this new virus could unleash. What could we have done? What therapies could we have developed before it became one of the deadliest pandemics in human history? Would we have a cure by now?
That work takes several forms, including:
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The First World Aids Day
At the beginning of the 1980s, before HIV had been identified as the cause of AIDS, the infection was thought to only affect specific groups, such as gay men in developed countries and people who inject drugs. The HIV virus was first isolated by Dr Françoise Barré-Sinoussi and Dr Luc Montagnier in 1983 at the Institut Pasteur. In November that year, WHO held the first meeting to assess the global AIDS situation and initiated international surveillance. It was then that the global health community understood that HIV could also spread between heterosexual people, through blood transfusions, and that infected mothers could transmit HIV to their babies.
United Nations commemorative stamp to raise awareness of HIV and the AIDS epidemic
How Is Hiv Spread From Person To Person
HIV can only be spread through specific activities. In the United States, the most common ways are:
- Having vaginal or anal sex with someone who has HIV without using a condom the right way every time or taking medicines to prevent or treat HIV. Anal sex is riskier than vaginal sex for HIV transmission. Learn more about the HIV risk associated with specific sexual activities.
- Sharing injection drug equipment, such as needles,syringes, or other drug injection equipment with someone who has HIV because these items may have blood in them, and blood can carry HIV. People who inject hormones, silicone, or steroids can also get or transmit HIV by sharing needles, syringes, or other injection equipment. Learn more about HIV and injection drug use.
Less common ways are:
- An HIV-positive person transmitting HIV to their baby during pregnancy, birth, or breastfeeding. However, the use of HIV medicines and other strategies have helped lower the risk of perinatal transmission of HIV to less than 1% in the United States. Learn more.
- Being exposed to HIV through a needlestick or sharps injury. This is a risk mainly for health care workers. The risk is very low.
HIV is spread only in extremely rare cases by:
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How Many Times Would Siv Need To Be Introduced Into The Human Population In Order To Seed An Epidemic Of The Size That Became Apparent By The Early 1980s
Three groups of HIV-1 exist today – group M, group O and group N. While group M is diverse, groups O and N are not, and remain highly restricted in one location. HIV-2 has one clear group with a separate path of descent, from the form of SIV found in sooty mangabeys in West Africa. This genetic tree suggests four separate transfers to humans, a puzzlingly rare chain of events given the potentially frequent contact with chimps in Central Africa, and the dating of chimp to human virus transfer back to the 18th century or even earlier.
In the opinion of Daniel Law-Beer, an epidemiologist from the University of Oxford, a star-like geography of infection would need to have been established early on in the epidemic, otherwise chance extinction events in one village could have eliminated the new virus from the human population quickly. He estimates that at least 60% of SIV transfers were dead-end infections of this sort which may have flared and died in remote locations.
Sir Robert May of Oxford University also suggested that it was quite plausible for many viral transfers to have remained confined in locations where local custom did not encourage mixing between populations in different villages.
Are There Other Theories About How The Virus Could Have Gotten Into Humans
There are several competing theories, ranging from implausible conspiracies to arguments grounded in extensive research. The best-known of the latter, the “OPV/AIDS” theory, was exhaustively detailed in the 1999 book The River, by author Edward Hooper. As many as a million Africans were given oral polio vaccines between 1957 and 1960. Hooper says witnesses have told him that a few batches of those vaccines were “grown” in chimp cells at a lab in Kisangani, a city in the Democratic Republic of the Congo — and that the chimp cells, and thus the vaccines, could have contained SIVs that jumped into humans. “There are highly significant correlations between the places where this vaccine was administered and the places where â¦ AIDS first appeared on the planet four to 20 years later,” Hooper says.
The majority of HIV researchers subscribe to the bushmeat theory and raise several arguments against the OPV theory. Hahn’s recent research confirming that HIV-1 M and N arose from Pan troglodytes troglodytes chimps in Cameroon presents one problem: The Kisangani lab is in the Democratic Republic of the Congo, and it’s home to a different subspecies of chimp than the one that was the source of HIV-1 M and N. However, it is possible that the chimps used in the Kisangani experiments were not from the area. In the spring of 2006, Hooper found a paper indicating that at least one of eight chimps at the Kisangani lab was a Pan troglodytes troglodytes.
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Homeless People And Intravenous Drug Users In New York
A volunteer social worker called Betty Williams, a Quaker who worked with the homeless in New York from the seventies and early eighties onwards, has talked about people at that time whose death would be labelled as “junkie flu” or “the dwindles”. In an interview for the Act Up Oral History Project in 2008, she said: “Of course, the horror stories came, mainly concerning women who were injection-drug users … who had PCP pneumonia , and were told that they just had bronchitis.” She continues: “I actually believe that AIDS kind of existed among this group of people first, because if you look back, there was something called junkie pneumonia, there was something called the dwindles that addicts got, and I think this was another early AIDS population way too helpless to ever do anything for themselves on their own behalf.”
Julia Epstein writes in her book Altered Conditions: Disease, Medicine and Storytelling that: “As we uncover more of the early history of HIV infection, it becomes clear that by at least the 1970s the virus was already making major inroads into the immune systems of a number of diverse populations in the United States and had for some time been causing devastation in several countries in Africa.”
Does Hiv Viral Load Affect Getting Or Transmitting Hiv
Yes. Viral load is the amount of HIV in the blood of someone who has HIV. If taken as prescribed, HIV medicine can reduce a persons HIV viral load very low level, which keeps the immune system working and prevents illness. This is called viral suppression, defined as having less than 200 copies of HIV per milliliter of blood.
HIV medicine can also make the viral load so low that a standard lab test cant detect it. This is called having an undetectable level viral load. Almost everyone who takes HIV medicine as prescribed can achieve an undetectable viral load, usually within 6 months after starting treatment.
As noted above, people with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIVto their HIV-negative partnersthrough sex.
HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only if the HIV-positive partner gets and keeps an undetectable viral load. Not everyone taking HIV medicine has an undetectable viral load. To stay undetectable, people with HIV must take HIV medicine as prescribed and visit their health care provider regularly to get a viral load test. Learn more.
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First Human Hiv Infection
Actor Rock Hudson was the first major public figure known to have died of AIDS. Tennis great Arthur Ashe also died from transfusion-related AIDS. Ryan White, a 13-year-old hemophiliac with AIDS, who eventually died, became famous for his fight to attend school. And basketball superstar Magic Johnson, 10 years after he announced that he was HIV positive, is still living a healthy life with the disease.
A plasma sample taken in 1959 from an adult male living in the Democratic Republic of Congo was found to contain HIV. The virus was found in tissue samples from an African American teenager who died in St. Louis in 1969, and HIV was found in tissue samples from a Norwegian sailor who died around 1976. Many scientists believe that HIV was probably introduced into humans around the 1940s or the early 1950s, although it has been suggested that the first case may actually have occurred in the 1930s.
Excerpted from The Complete Idiot’s Guide to Dangerous Diseases and Epidemics © 2002 by David Perlin, Ph.D., and Ann Cohen. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group Inc.