Samples Collected From Wildlife In Thailand
While its true that most emerging diseases affecting humans come from wildlife, its often human behavior that is to blame for the spillover. Humans are tearing down forests and hunting, eating, and selling wild animals at unprecedented rates. Each exotic animal shipped across the ocean to be sold as a pet is an sveacasino opportunity for a new pathogen to take root in a new continent. Each tree ripped from its roots increases interactions between humans and wild animals, and thus the odds that viruses will find new populations to infect.
But the good news is: If were the ones causing the problem, were the ones who can stop it.
At EcoHealth Alliance, were striving toward a world where pandemics like the one caused by HIV/AIDS are a thing of the past. Join us.
The Unfulfilled Promise Of Science
Another reason for urging individuals to take more responsibility for their own health was frustration at the inability of medical science to keep some of its implied promises of the 1940s and 1950s. The great advances against infectious disease of the 1940s, especially the development of effective antibiotic drugs, had been widely publicized as the beginning of a permanent revolution in medicine. During the 1950s, the budget of the National Institutes of Health and the expenditures of voluntary associations that sponsored research grew faster than ever before. Congressmen, philanthropists, the press, and the general public expected that the causes of and cures for chronic diseases would soon be found, as a result of research on basic biological processes . But medical scientists proved to be better at basic research and at devising new technologies for diagnosis and for keeping very sick patients alive than at finding cures. This technology was disseminated rapidly because third-party payers eagerly reimbursed hospitals for purchasing it, which they did at the request of growing numbers of physicians in each medical specialty. The Regional Medical Program, as it was originally conceived, proved to be redundant. But the vast expenditure for technology had little discernible impact on overall mortality from particular diseases. In the absence of new miracle drugs, the responsibility of individuals to reduce their risks was accorded greater importance.
New Guidelines: The Universal Precautions
CDC issued guidelines for health workers providing care to AIDS patients and for laboratory technicians performing tests on potentially infectious materials from AIDS patients. The recommendations became known as universal precautions, and included wearing gloves when exposed to blood and other bodily fluids. In a poster promoting health workers using safety precautions, a group of five health workers are shown wearing gloves, masks, and goggles. Since the universal precautions also established using safe needle disposal cases, a needle disposal container is on display with the body fluids barrier kit. The disposal case is a red sealed plastic container with the biohazard symbol displayed prominently on all sides and an opening at the top into which used needles are disposed.
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The Limits Of Individual Responsibility
The epidemic also offers evidence that contradicts the assumption that it is desirable or even possible to substitute individual for collective responsibility for social welfare. For more than a decade it has been fashionable among some politicians and policy intellectuals of both the left and the right to assert that, if individuals are given proper incentives, they can provide adequately for their own health and welfare. A plausible extension of this argument is that removing people who have positive antibodies to the AIDS virus from insurance pools would, in the short run, save money for other people in those pools. Proponents of individualizing risk do not seem to care that removal would also prevent those with positive antibodies who do not get AIDS from subsidizing health care for other people.
AIDS also challenges the wisdom of offering incentives to apparently healthy young people to choose the least comprehensive health insurance. The beginning of the epidemic coincided with the decision of many employers to offer their employees so-called flexible benefit plans. Under these plans, employees who considered themselves to be in excellent health could substitute other benefits or in some instances cash for the most expensive health insurance. There are no data about how many AIDS patients, most of them in their thirties and with no previous history of serious illness, chose such substitutions.
Years Of Aids: A Timeline Of The Epidemic
Over the past four decades, UCSF has led the way in its heroic and committed response to the AIDS epidemic, both locally and globally. This timeline covers some of the highlights over the past 40 years at UCSF, in the nation and around the world after a mysterious outbreak affecting gay men was first reported on June 5, 1981.
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Impact Across The Country
- Although HIV has been reported in all 50 states, the District of Columbia, and U.S. dependencies, the impact of the epidemic is not uniformly distributed.
- Ten states accounted for about two-thirds of HIV diagnoses among adults and adolescents in 2019 .31 Regionally, the South accounted for more than half of HIV diagnoses in 2019.32
- Rates of HIV diagnoses per 100,000 provide a different measure of the epidemicâs impact, since they reflect the concentration of diagnoses after accounting for differences in population size across states. The District of Columbia has the highest rate in the nation, compared to states, nearly 3 times the national rate and Georgia was the state with highest rate , twice that of the national rate.33,34 Nine of the top 10 states by rate are in the South.35
- New HIV diagnoses are concentrated primarily in large U.S. metropolitan areas , with Miami, Orlando, and Atlanta topping the list of the areas most heavily burdened.36
|Table 1: Top Ten States/Areas by Number and Rate of New HIV Diagnoses , 2019|
|CDC. HIV Surveillance Report, Diagnoses of HIV Infection in the United States and Dependent Areas, 2019 vol. 32. May 2021.|
Where We Are Now: 2000
Since 2000, additional factors have begun contribute to the the global spread of HIV. Heroin addiction in Asia has been on the rise, which brought with it dirty needles and the risk of new infections. India suffered with over 2 million diagnoses alone, in spite of the government’s refusal to admit the epidemic had adversely affected the nation.
The WHO released its comprehensive report examining HIV and AIDS in all of its 25-year history in 2010. This report had good news for developed nations: by 2008, the U.S. domestic HIV infection rate was considered effectively stable, and has remained so to this day. The report also demonstrated that while insistent public awareness campaigns about safe sex and other methods of transmission had slowed the rate of HIV infection in developed countries, there was much to be done elsewhere.
Global Education and Aid Efforts
Under President Bush, the U.S. committed funds to help African countries, but the funds were mismanaged and the spread of HIV continued unabated. Of the 4.1 million cases in sub-Saharan Africa then, only 1% received the available drugs. This led to the WHO’s declaration of the failure to treat the 6 million AIDS patients living in developing nations as a global public health emergency.
HIV Denialism Disrupts Aid
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Why Do Scientists Look At Recent Samples Of Hiv To Determine The Virus’ Overall Age Wouldn’t It Be Better To Use Older Samples That Haven’t Had As Much Time To Mutate
It would, but scientists don’t have that luxury. Other than the 1959 sample, there are very few preserved specimens of HIV-infected tissue that predate the early ’80s, when the virus was first recognized by health authorities. Researchers still hope there are forgotten samples in African freezers. “There has to be some serum or plasma somewhere, and given modern technology we could fish out the virus,” says Dr. David Ho, director of the Aaron Diamond AIDS Research Center and one of the world’s leading authorities on HIV.
But even if those samples are found someday, they won’t necessarily yield definite answers about the virus’ age, says Korber: “Often, you can’t get anything out of samples like that.” Most African samples are made of blood serum, and serum samples contain viral RNA, which degrades much faster than the DNA found in tissue samples. In fact, says Ho, the 1959 sample, which was sequenced by his laboratory, was kept in a freezer but still didn’t survive the ravages of time. “It was completely dried up,” he says. “We were only able to get small pieces , and we had to stitch them together.”
Where Did Aids Come From
Scientists have traced the origin of HIV back to chimpanzees and simian immunodeficiency virus , an HIV-like virus that attacks the immune system of monkeys and apes.
In 1999, researchers identified a strain of chimpanzee SIV called SIVcpz, which was nearly identical to HIV. Chimps, the scientist later discovered, hunt and eat two smaller species of monkeysred-capped mangabeys and greater spot-nosed monkeysthat carry and infect the chimps with two strains of SIV. These two strains likely combined to form SIVcpz, which can spread between chimpanzees and humans.
SIVcpz likely jumped to humans when hunters in Africa ate infected chimps, or the chimps infected blood got into the cuts or wounds of hunters. Researchers believe the first transmission of SIV to HIV in humans that then led to the global pandemic occurred in 1920 in Kinshasa, the capital and largest city in the Democratic Republic of Congo.
The virus spread may have spread from Kinshasa along infrastructure routes via migrants and the sex trade.
In the 1960s, HIV spread from Africa to Haiti and the Caribbean when Haitian professionals in the colonial Democratic Republic of Congo returned home. The virus then moved from the Caribbean to New York City around 1970 and then to San Francisco later in the decade.
International travel from the United States helped the virus spread across the rest of the globe.
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Stigma: Educating A Nation
The first year of the AIDS epidemic seemed isolated to a few individuals in a few cities, so it received little media attention. When cases were reported in infants and people with hemophilia, widespread panic struck Americans. Those with AIDS were often stigmatized. In 1985, Ryan White, a teenage hemophiliac living in Indiana, contracted AIDS from a blood transfusion. Parents in his community feared he would expose their children to AIDS, resulting in Ryan being barred from attending school.
In 1986, U.S. Surgeon General C. Everett Koop issued the Surgeon Generals Report on AIDS. In it, he called for a comprehensive program of sex and AIDS education, urged the widespread use of condoms, and dispelled myths that HIV could be spread by mosquitoes. In 1987, CDC launched an unprecedented national campaign, America Responds to AIDS . The goal of ARTA was to increase awareness and understanding of AIDS, to prevent HIV infection, and to encourage people to seek more information and counseling. CDC also began a program to support HIV prevention efforts with national minority organizations that provided HIV prevention expertise to community-based organizations, developed HIV prevention programs targeting minorities, especially African Americans and Hispanics, and supported groups that used culturally sensitive AIDS prevention programs to address their communities needs.
The Reassertion Of Central Authority
Finally, the AIDS epidemic may demonstrate that the American health polity best serves the public interest when institutions within it struggle to assert central authority, when they do not accept fragmentation as the goal as well as the norm of health affairs. The unwillingness of the federal government to exert strong leadership in response to AIDS has been criticized by congressmen, journalists, and victims since the beginning of the epidemic. In the absence of federal assertiveness, however, the health departments of several cities and states have coordinated the response of the health polity to the epidemic. These health departments have tried, in different ways, to counter fragmentation by linking their traditional responsibility for surveillance with their more recent mandate to manage the health system. To the extent that similar linkage of the responsibilities of public health officers occurs elsewhere, it may be a partial substitute for the abdication of federal leadership and, perhaps, a model for future national administrations.
Such lessons could be drawn from the history to early 1986 of the response to AIDS of the American health polity. If they are not, we may recall the 1980s as a time when many Americans became increasingly complacent about the consequences of dread disease and unwilling to insist that the individuals and institutions of the health polity struggle against them.
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How The Aids Epidemic Really Began
In Randy Shilts history of AIDS, And the Band Played On, he tells the story of an Air Canada steward named Gaëtan Dugas, who suffered from what Dugas called gay cancer and infected 40 people or more with HIV.
He was, Shilts wrote, Patient Zero.
Dugas, through his extensive travels and unrepentant, unprotected sex even after he was diagnosed, undoubtedly helped spread AIDS. But was he the man who brought the disease to America?
In the new book The Chimp and the River: How AIDS Emerged from an African Rain Forest , author David Quammen says no.
Dugas himself was infected by some other human, presumably during a sexual encounter and not in Africa … somewhere closer to home, Quammen writes. As evidence now shows, HIV had already arrived in North America when Gaëtan Dugas was a virginal adolescent.
Using molecular genetics, researchers have now traced the exact strain of HIV that became a pandemic HIV-1, Group M, Subtype B to its original source.
Amazingly, through examination of genetic samples from humans and chimps, Quammen reveals scientists have found exactly when and where AIDS started even a probable theory as to how.
They are the first warnings of what is happening.
Activism By Aids Patients And Families
Also in 1982, Michael Callen and Richard Berkowitz published How to Have Sex in an Epidemic: One Approach. In this short work, they described ways gay men could be sexual and affectionate while dramatically reducing the risk of contracting or spreading HIV. Both authors were themselves gay men living with AIDS. This booklet was one of the first times men were advised to use condoms when having sexual relations with other men.
At the beginning of the AIDS epidemic in the 1980s, there was very little information about the disease. Because AIDS affected stigmatized groups, such as LGBTQ people, people of low socioeconomic status, sex workers and addicts, there was also initially little mass media coverage when the epidemic started. However, with the rise of activist groups composed of people suffering from AIDS, either directly or through a loved one, more public attention was brought to the epidemic.
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A New Pattern Emerges
On June 5, 1981, CDC published a report in the MMWR describing requests for the drug pentamidine to treat a deadly disease called Pneumocystis carinii pneumonia in five previously healthy young men in Los Angeles. After the reports publication, health officials also noticed a spike in cases of Kaposis sarcoma external icon among gay men in New York. Health officials were alarmed that outbreaks of both PCP and KS, which were rare, deadly diseases associated with immune suppression, appeared in the same part of the population.
Challenges Of Virus Tracking
One of the primary challenges experts have in tracking a virus to the initial infection is that it may present as another infection. For example, when HIV first appeared in the U.S., doctors reported rare lung infections in a group of individuals.
Because of this, doctors may never identify cases as being due to HIV. People may have had HIV before these individuals, but received a diagnosis for another condition or did not seek medical attention.
Even then, if doctors determine that someone has HIV, it is challenging to identify who had the virus first because of the speed at which it spreads.
- the host of the virus
- how many introductions to humans there have been
- how it connects to previous events
- if there is evidence for local adaptation
In some cases, an emergent virus is a variation of an existing virus, such as the SARS-CoV-2 coronavirus that causes COVID-19. This knowledge allows for the rapid development of treatments and vaccines as experts already understand the mechanics of similar viruses.
Understanding the origin of a virus makes it possible to determine how it transmits from one animal or person to another. Not only does this help scientists develop treatments, but they can also work on methods to prevent its spread.
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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.