Hunting for the Hidden Killers: AIDS

Disease detectives face a never ending quest

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Nothing in the history of disease detection compares in size or intensity with the chase now under way to solve the mystery of AIDS. It began in early 1981, when Dr. Michael Gottlieb of U.C.L.A. told Los Angeles health officials that he had five patients, all of them active homosexuals, who were suffering from an unusual and deadly form of pneumonia, pneumocystis carinii. More alarming still, their immune systems seemed to have broken down. Gottlieb and an EIS agent based in Los Angeles reported the grim news in CDC's weekly publication. Almost simultaneously, Dr. Alvin Friedman-Kien of New York University noted that several of his homosexual patients had the same weakened immune systems and were suffering from Kaposi's sarcoma, a rare cancer of the skin usually seen only in older men. Later that summer Dr. Harold Jaffe of CDC, while attending a conference in California, was told of an additional case of a young homosexual suffering from Kaposi's.

"We were struck by how strange this was," recalls Jaffe. A group of medical detectives at the CDC was organized into an AIDS task force under the direction of Dr. Curran, a venereal disease specialist. They quickly uncovered 50 cases around the country that fit the definition of what the CDC officially dubbed AIDS. Initially it seemed that the culprit might be amyl nitrate or butyl nitrate, often known as "Rush" or "poppers," which are inhalants that provide a short-lasting high. But a study comparing homosexuals with AIDS to disease-free gays showed little correlation with use of the drug. The 20-page questionnaire disclosed, however, that AIDS victims tended to be sexually promiscuous. In addition, some were the passive partners in anal intercourse.

Then came another clue: reports of drug abusers, most of them heterosexual, coming down with AIDS. This added credence to the theory that a virus or some other infectious agent, transmitted by dirty needles as well as by sexual contact, might be the cause. This conjecture was supported by evidence that sexual partners of drug users, and even a few children of those with the disease, had contracted what seemed to be AIDS. So had a few hemophiliacs and blood-transfusion recipients. One baby in San Francisco with symptoms of AIDS, it was discovered, had been given blood from a donor who turned out to have the disease.

The strongest evidence that an infectious agent was on the loose came from what has been called the Los Angeles cluster. Interviewing victims, investigators began compiling the names of their sex partners. Three different men, none of whom knew each other, each mentioned the same man in New York City; he turned out to be an AIDS victim. Since then, 40 cases in ten cities have been linked to one another by sexual relationships.

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