Hunting for the Hidden Killers: AIDS

Disease detectives face a never ending quest

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The outbreak of an epidemic* can provoke a primal panic by raising the specter of a rampant "Andromeda strain." Indeed, perhaps the most severe side effect of AIDS has been the largely unwarranted hysteria that has accompanied the syndrome (see following story). In order to allay fears that AIDS is widely contagious, Secretary of Health and Human Services Margaret Heckler last week visited the Warren Magnuson Clinical Center in Bethesda, Md., where she shook hands with AIDS victims and sat at their bedsides. Said Heckler: "What's just as bad as the disease is the fear of the disease. The fear has become irrational." Explains Dr. James Curran, head of the AIDS task force at Atlanta's Centers for Disease Control (CDC): "For a person not in a known risk group, the risk is not only minimal but likely to remain minimal. It apparently is not spread through routine contact or through respiration, like the flu." Indeed, none of the hundreds of health-care workers who have treated patients have been infected by AIDS.

Nevertheless, Heckler stressed to the patients that "AIDS is our No. 1 health concern and the epidemic is our No. 1 priority." Her department, which includes CDC and NIH, is spending $14 million on AIDS research this year and requesting $12 million more. Some gay activists have charged that the Reagan Administration is neglecting AIDS because it primarily affects homosexuals. (In fact, the money allocated to AIDS research so far is greater than the $20 million spent over eight years on toxic shock syndrome and Legionnaire's disease.) Heckler's department also publishes a biweekly bulletin reporting the findings of researchers; next week it will start operating a toll-free hotline (800-342-AIDS) to answer questions about the syndrome.

American health officials once dreamed of eliminating infectious diseases, at least in the U.S. That Faustian ambition has been foiled by the mobility of American society, the influx of tourists and immigrants (illegal as well as legal), changes in technology that create new, inviting environments for organisms and, most notably, by casual intimacies encouraged by the sexual revolution. As many as 20 million Americans may now suffer from genital herpes, an incurable but nonfatal disease. In addition, an estimated 1 million new cases of gonorrhea and 100,000 of syphillis are reported each year. "What may be different these days is the number of persons who can be exposed in a short period," says Dr. William Foege, 47, director of the CDC. "The average AIDS victim has had 60 different sexual partners in the past twelve months."

The struggle to conquer such epidemics, and the fear they spread, is the work of a special breed. They are spiritual descendants of Dr. John Snow (1813-58), who tracked the incidence of cholera during the London epidemic of 1831 and stemmed further devastation by shutting down one of the city's water pumps. In the past few decades, his followers have significantly improved the quality of life. In much of the world they have virtually eliminated the threat of such onetime plagues as polio, smallpox, cholera and diphtheria.

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