Tracing The Long Convoluted History Of The Aids Epidemic
The common narrative holds that the spread of HIV and AIDS among humans can be traced back to one flight attendant in the 1980s. But while that individual certainly did spread the virus, he was far from the first to do it.
In fact, humans had been infected with HIV as far back as at least the early 1900s, writes renowned science journalist David Quammen, who traced the genetic origins of the AIDS epidemic by reviewing scientific literature, consulting researchers and traveling to the geographic source of the deadly disease.
The story Quammen puts forward in his newly published work, “The Chimp and the River: How AIDS Emerged From an African Forest,” is an edited and reshaped version of a chapter from “Spillover,” his much larger 2012 book about zoonotic diseases.
“The AIDS pandemic results from a single spillover of what was a chimpanzee virus, from one chimpanzee to one human, in the southeastern corner of Cameroon back around 1908, give or take a margin of error,” Quammen told The Post.
But unless you’ve been paying close attention to developments in scientific literature, Quammen said, “that’s shockingly different than what we knew.”
“Knowing the origins of a disease like is crucially important for preventing instances of the same sort of thing,” Quammen said.
“She could tell from that the ancestor of all the viruses in human-causing pandemic AIDS around the world came from a chimp in southeastern Cameroon,” Quammen said.
Unresolved Questions About Hiv Origins And Emergence
The discovery of the main HIV / SIV phylogenetic relationships permits explaining broad HIV biogeography: the early centres of the HIV-1 groups were in Central Africa, where the primate reservoirs of the related SIVcpz and SIVgor viruses exist similarly, the HIV-2 groups had their centres in West Africa, where sooty mangabeys, which harbour the related SIVsmm virus, exist. However, these relationships do not explain more detailed patterns of biogeography, such as why epidemic HIV-2 groups only evolved in the Ivory Coast, which is one of only six countries harbouring the sooty mangabey. It is also unclear why the SIVcpz endemic in the chimpanzee subspecies Pan troglodytes schweinfurthii did not spawn an epidemic HIV-1 strain to humans, while the Democratic Republic of Congo was the main centre of HIV-1 group M, a virus descended from SIVcpz strains of a subspecies that does not exist in this country. It is clear that the several HIV-1 and HIV-2 strains descend from SIVcpz, SIVgor, and SIVsmm viruses, and that bushmeat practice provides the most plausible cause of cross-species transfer to humans. However, some loose ends remain.
It is not yet explained why only four HIV groups spread considerably in human populations, despite bushmeat practices being widespread in Central and West Africa, and the resulting human SIV infections being common.
The Development Of Research Treatment And Prevention
Azidothymidine, also known as zidovudine, was introduced in 1987 as the first treatment for HIV. Scientists also developed treatments to reduce mother to child transmission.
In 1997, highly active antiretroviral therapy became the new treatment standard. It caused a 47 percent decline in death rates.
The Food and Drug Administration approved the first rapid HIV diagnostic test kit in November 2002. The test kit allowed hospitals to provide results with 99.6 percent accuracy in 20 minutes.
Also in 2003, the CDC reported that 40,000 new transmissions occurred each year. More than half of those transmissions came from people who didnt know they had contracted the virus. It was later discovered the number was closer to 56,300 people living with HIV. This number remains roughly the same since the late 1990s.
The World Health Organization set a goal to bring treatment to 3 million people by 2005. By 2010, about 5.25 million people had treatment, and 1.2 million people would start treatment.
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What Is The ‘four
In 1983, the Centers for Disease Control in the United States listed the main at-risk groups, including partners of people with AIDS, people who inject drugs, haemophiliacs and people who have recently been to Haiti. At the time that cases of AIDS began to emerge in the USA, the absence of definitive information about HIV and its link to AIDS, inflated the panic and stigma surrounding the epidemic. Before long people began to talk colloquially of a 4-H Club at risk of AIDS: homosexuals, haemophiliacs, heroin addicts and Haitians, contributing to further stigmatisation.21
Case Definition For Epidemiological Surveillance
According to a study published in the Proceedings of the National Academy of Sciences in 2008, a team led by Robert Shafer at Stanford University School of Medicine has discovered that the gray mouse lemur has an endogenouslentivirus in its genetic makeup. This suggests that lentiviruses have existed for at least 14 million years, much longer than the currently known existence of HIV. In addition, the time frame falls in the period when Madagascar was still connected to what is now the African continent the said lemurs later developed immunity to the virus strain and survived an era when the lentivirus was widespread among other mammals. The study is being hailed as crucial, because it fills the blanks in the origin of the virus, as well as in its evolution, and may be important in the development of new antiviral drugs.
In 2010, researchers reported that SIV had infected monkeys in Bioko for at least 32,000 years. Previous to this time, it was thought that SIV infection in monkeys had happened over the past few hundred years. Scientists estimated that it would take a similar amount of time before humans adapted naturally to HIV infection in the way monkeys in Africa have adapted to SIV and not suffer any harm from the infection.
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Did Hiv Start In Africa
Using the earliest known sample of HIV, scientists have been able to create a ‘family-tree’ ancestry of HIV transmission, allowing them to discover where HIV started.
Their studies concluded that the first transmission of SIV to HIV in humans took place around 1920 in Kinshasa in the Democratic Republic of Congo .10
The same 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.
So Scientists Have Estimated When And Where The Most Deadly Type Of Hiv Started Infecting Humans
Most AIDS researchers believe that the “bushmeat trade” allowed the HIV-1 virus, and separately HIV-2, to enter the human bloodstream several times. Hunters who kill and butcher chimps and monkeys are regularly exposed to animal blood teeming with SIVs. If the hunters have cuts, bites, or scratches — and given the nature of their work they almost always do — they can catch the viruses from their prey. Hunters going after chimps in Cameroon could have caught the first strains of HIV-1. Sooty mangabeys, hunted and kept as pets in West Africa, could have transmitted HIV-2 to humans.
Africans have hunted chimps and monkeys and kept them as pets for centuries they’ve presumably been exposed to SIVs during most of that time. But the conditions needed for HIV to spread widely weren’t in place until after the continent was colonized and urbanized. The first victims would have found it easier to unwittingly spread the virus to sexual partners far and wide as roads and vehicles started connecting previously isolated villages and cities. Hospitals may have played a role, too. Strapped for cash, some of them probably re-used dirty needles, unknowingly infecting patients in the process.
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Who Really Discovered Hiv
In May 1983, two papers appeared in the same issue of Science claiming the same breakthrough: the identification of a virus apparently linked to AIDS. While neither the US nor the French teams were certain of the link, their claims were seized on in the search for a treatment. Further research by the US team confirmed the AIDS connection, and the virus was named the Human Immunodeficiency Virus . But the coincidence of two teams making the same claim sparked a bitter row between the team leaders: Robert Gallo of the National Cancer Institute, Maryland, and Luc Montagnier of the Pasteur Institute, Paris.
Initially the dispute focused on who should benefit from royalties for a blood test for HIV. In 1987, the US and French governments settled that dispute by declaring both teams co-discoverers. But then Gallos team were accused of having wrongfully acquired the virus from the Paris team a charge later rejected by investigators. The arguments continued until 2002, when the rivals publicly agreed that Montagniers team had discovered HIV, but its role in AIDS was first shown by Gallo. Even so, controversy flared once more in 2008 when the Nobel prize was awarded for the HIV breakthrough and Gallos contribution was overlooked.
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Origin And Epidemic Emergence
Several of the theories of HIV origin accept the established knowledge of the HIV/SIV phylogenetic relationships, and also accept that bushmeat practice was the most likely cause of the initial transfer to humans. All of them propose that the simultaneous epidemic emergences of four HIV groups in the late 19th-early 20th century, and the lack of previous known emergences, are explained by new factor that appeared in the relevant African regions in that timeframe. These new factor would have acted either to increase human exposures to SIV, to help it to adapt to the human organism by mutation , or to cause an initial burst of transmissions crossing an epidemiological threshold, and therefore increasing the probability of continued spread.
Genetic studies of the virus suggested in 2008 that the most recent common ancestor of the HIV-1 M group dates back to the Belgian Congo city of Léopoldville , circa 1910. Proponents of this dating link the HIV epidemic with the emergence of colonialism and growth of large colonial African cities, leading to social changes, including a higher degree of non-monogamous sexual activity, the spread of prostitution, and the concomitant high frequency of genital ulcer diseases in nascent colonial cities.
Social changes and urbanization
Colonialism in Africa
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When And Where Did Hiv Start In Humans
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 living in what is now Kinshasa in the Democratic Republic of Congo. The sample was retrospectively analysed and HIV detected. There are numerous earlier cases where patterns of deaths from common opportunistic infections, now known to be AIDS-defining, suggest that HIV was the cause, but this is the earliest incident where a blood sample can verify infection.9
History Of Hiv And Aids Overview
The history of the HIV and AIDS epidemic began in illness, fear and death as the world faced a new and unknown virus. However, scientific advances, such as the development of antiretroviral drugs, have enabled people with access to treatment to live long and healthy lives with HIV.
Here, we go through the key historical moments that have defined the HIV epidemic over the past 30 years.
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Canadian Flight Attendant Theory
A Canadian airline steward named Gaëtan Dugas was referred to as “Case 057” and later “Patient O” with the alphabet letter “O” standing for “outside Southern California”, in an early AIDS study by Dr. William Darrow of the Centers for Disease Control. Because of this, many people had considered Dugas to be responsible for taking HIV to North America. However, HIV reached New York City around 1971 while Dugas did not start work at Air Canada until 1974. In Randy Shilts‘ 1987 book And the Band Played On , Dugas is referred to as AIDS’s Patient Zero instead of “Patient O”, but neither the book nor the movie states that he had been the first to bring the virus to North America. He was incorrectly called “Patient Zero” because at least 40 of the 248 people known to be infected by HIV in 1983 had had sex with him, or with a person who had sexual intercourse with Dugas.
Impact On Young People
- Teens and young adults continue to be at risk, with those under 35 accounting for 57% of new HIV diagnoses in 2019 .51 Most young people are infected sexually.52
- Among young people, gay and bisexual men and minorities have been particularly affected.53
- Perinatal HIV transmission, from an HIV-infected mother to her baby, has declined significantly in the U.S., largely due to increased testing efforts among pregnant women and ART which can prevent mother-to-child transmission.54,55,56
- A recent survey of young adults found that HIV remains a concern for young people, especially for young people of color.57
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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.”
Stigma In The Early Years
When the first few cases of AIDS emerged, people believed the disease was only contracted by men who had sex with men. The CDC called this infection GRIDS, or gay-related immunodeficiency syndrome. Shortly after, the CDC published a case definition calling the disease AIDS.
Public response was negative in the early years of the epidemic. In 1983, a doctor in New York was threatened with eviction, leading to the first AIDS discrimination lawsuit.
Bathhouses across the country closed due to high-risk sexual activity. Some schools also barred children with HIV from attending.
In 1987, the United States placed a travel ban on visitors and immigrants with HIV. President Obama lifted this ban in 2010.
The United States government resisted funding needle exchange programs due to the war on drugs. NEPs were shown to be effective at reducing HIV transmission. Some believe that this resistance accounts for 4,400 to 9,700 avoidable transmissions.
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How Did Hiv Spread From Kinshasa
The area around Kinshasa is full of transport links, such as roads, railways and rivers. The area also had a growing sex trade around the time that HIV began to spread. The high population of migrants and sex trade might explain how HIV spread along these infrastructure routes. By 1937, it had reached Brazzaville, about 120km west of Kinshasa.
The lack of transport routes into the North and East of the country accounts for the significantly fewer reports of infections there at the time.11
By 1980, half of all infections in DR Congo were in locations outside of the Kinshasa area, reflecting the growing epidemic.12
A Timeline Of Hiv And Aids
The HIV.gov Timeline reflects the history of the domestic HIV/AIDS epidemic from the first reported cases in 1981 to the presentwhere advances in HIV prevention, care, and treatment offer hope for a long, healthy life to people who are living with, or at risk for, HIV and AIDS.
View a timeline of the current Ending the HIV Epidemic initiative. Please visit HIVHistory.org for a timeline of the global and domestic response to the HIV epidemic.
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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.”