Hunting for the Hidden Killers: AIDS

Disease detectives face a never ending quest

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One of the few blemishes on the CDC's record involves an epidemic that never happened. In 1976, swine flu broke out at Fort Dix, N.J., killing one soldier. Health officials worried about the similarity of the virus to one that had caused the deadly 1918 influenza pandemic that killed more than 500,000 Americans. At President Gerald Ford's urging, a $100 million program was rushed into being to immunize people across the country. Not only did no epidemic break out, but 100 or so people came down with a syndrome, apparently connected to the vaccines, that caused partial paralysis. Ninety million unused doses were left over. Officials say that the swine flu debacle was one reason why the Carter Administration decided not to reappoint Dr. David Sencer, who was then the CDC director and is now Commissioner of the New York City Board of Health. Sencer was replaced by Foege, an articulate career public health official from Washington who led the worldwide crusade to eliminate smallpox.

Sometimes serendipity plays a role in discovering a new approach to a familiar disease. Last summer a 42-year-old drug addict, unable to talk, bent over and hardly able to move, was brought to the Santa Clara Valley Medical Center. His symptoms were similiar to those of patients afflicted with Parkinson's disease, which usually affects the elderly. Dr. William Langston speculated that the cause might be something in the heroin that the victim used. The doctor and his team were able to track down others who had used the same batch of the drug and found similar reactions. Through a chance conversation with another doctor, help from police, and tips resulting from a newspaper story, Langston uncovered other cases and obtained samples of the bad drug.

Several months later Langston read an article in a medical journal about a chemist who had killed himself after contracting Parkinson's-like symptoms from a dose of artificial heroin. From a report analyzing the dead chemist's brain, Langston found that the heroin involved contained an additive similar to the one in the bad batch of heroin he had been studying. The mysterious ingredient, a chemical known as MPTP, had moved from the blood into the brain and damaged the same area affected by Parkinson's disease. No other substance is known to do that. Last April Dr. Irwin Kopin of the National Institute of Mental Health, co-author of the journal article, announced that he had used MPTP to induce Parkinsonism in rhesus monkeys. The work of these two men suggests that the previously unexplained symptoms of Parkinson's might result from exposure to MPTP, and thus that the disease itself may be caused by environmental factors.

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