The man blamed for spreading HIV across North America in the 1980s, referred to as “Patient Zero”, may not actually have been the initial source of the deadly virus on the continent, a new study suggests.
A combination of historical and genetic research shows that flight attendant Gaetan Dugas, a French-Canadian gay man, who became the human epicentre of the US AIDS crisis of the 1980s was simply one of many thousands infected in the years before HIV was recognised.
Research by a historian from the University of Cambridge in the UK and the genetic testing of decades-old blood samples by a team of US scientists has demonstrated that Dugas was not the epidemic’s ‘Patient Zero’.
Work by Richard McKay, researcher from University of Cambridge shows how the very term ‘Patient Zero’ – still used today in press coverage of outbreaks from Ebola to swine flu to describe the first known case – was created inadvertently in the earliest years of investigating AIDS.
Before death, Dugas provided investigators a significant amount of personal information to assist with studies into whether AIDS was caused by sexually transmitted agent.
McKay’s research suggests that this, combined with confusion between a letter and a number, contributed to the invention of Patient Zero and the global defamation of Dugas.
McKay’s work has added important contextual information to the latest study, led by Michael Worobey from the University of Arizona in the US, and which has compared a new analysis of Dugas’s blood with eight other archived serum samples dating back to the late 1970s.
“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 felled epidemics with malicious intent,” said McKay.
While his research traces this impulse to blame back several centuries, McKay located the immediate roots of the term “Patient Zero” in an early ‘cluster study’ of US AIDS patients.
Reports emerged in early 1982 of historical sexual links between several gay men with AIDS in Los Angeles and investigators from the US Centers for Disease Control (CDC) undertook a study to interview these men for the names of their sexual contacts.
They uncovered more links across Southern California, but one connection was named several times despite not residing in the state: Case 057, a widely travelled airline employee.
After 30 years, analysis of the HIV-1 genome taken from Dugas’s 1983 blood sample, contextualised through McKay’s historical research, shows that he was not even a base case for HIV strains at the time, and that a trail of error and hype led to his condemnation as the so-called Patient Zero.
“In the 1970s, as now, the epidemic was driven by individuals going about their lives unaware they were contracting, and sometimes transmitting, a deadly infection,” said McKay.
The study appears in the journal Nature.