A 15-year-old boy went to St. Louis City Hospital in 1968 with chlamydia and died 16 months later. The autopsy revealed Kaposi’s sarcoma lesions. Two decades later, tests on tissue samples showed the presence of HIV-1. Cite.
Epidemiologists: How is it that a teenage boy in St. Louis could die from AIDS in 1969, but the disease would not reappear in this country for nearly a decade? He never left the country. Are there records of other people who died of what may have been AIDS in the U.S. in the 1950s and 60s?
Sorry if this is a stupid question, but at least on the surface, it doesn’t make sense that HIV would pop up in isolation in the middle of the country and then disappear.
It isn’t believed this was an isolated or singular case, just that it is the only confirmed case in America at this time. Several HIV information sites suggest that AIDs probably was occuring in low numbers from the 60-70s.
1981 was the first year HIV/AIDs was identified, and there were about 300 confirmed cases that year. Throughout the 80s the number of cases increased exponentially. I think some of that is people suffering from the illnesses, which had previously been unidentified were now being diagnosed correctly. And of course a lot of it was a genuine explosion in the number of infections.
I think it’s possible HIV had been around for many years prior to that, slowly maintaining its presence in a scattered few hundred patients in the United States. Once it started getting into some gay, urban communities with many members who practiced unprotected sex, that set the staging ground for the rapidly increasing number of cases.
There’s a common misconception that HIV was first brought to America from Africa by the infamous “patient zero” (a flight attendant?) from that CDC study in the eighties, and that other infections were all traced back to him.
In fact, he was notable because something like thirty of the hundreds of known AIDS patients at the time had partnered with him or someone else who had partnered with him. He wasn’t even referred to as “Patient Zero” by the CDC – it was “Patient O” (as in “Omega”) and transcription errors made by journos made it into the catchier “Patient Zero.”
There’s little doubt that many people contracted HIV long before it was identified. There were probably a good many smaller outbreaks before it crossed the threshold and became a pandemic. People just weren’t equipped to recognize what was going on.
Old blood samples made possible to find out that there had been a number of isolated cases well before the 80s in many places. For a time, the oldest contender was a Norwegian sailor who had contracted it in the mid-60s. And of course, there was necessarily many more cases than the ones latter identified. It’s not like 20 yo samples were kept for every person who died from an unclear pathology.
The number of cases had to reach a high enough threshold for the disease to spread like wildfire and become a pandemic.
The only thing I find surprising in this account is that the boy was only 15. A sailor is a much more likely candidate for a STD. Unlucky bloke, I guess.
How did the fifteen year old catch AIDS? The abstract says that he was “sexually active”, which I assume means homosex. Did they ever do any contract tracing to figure out who his partners were?
I read in a magazine article from the early 80’s (probably penthouse or playboy) that he was probably a gay prostitute. I know that went on in St. Louis in the early 70s but I don’t know about the late 60s.
Several of the top AIDS researchers have all said that we were lucky that AIDS reached epidemic proportions when it did, because had it earlier, we wouldn’t have had the technology to figure out what was going on. Imagine if we’d have had an outbreak during the Dark Ages, when very little was known about diseases in general, muchless how they were transmitted. (Don’t forget that one “cure” was bleeding the patient.)
I’m not sure HIV ever would have left Africa if it came about in the Dark Ages. HIV is generally accepted as having evolved from Simian Immunodeficiency Virus, the world was a very un-connected and un-globalized place during the dark ages, and it’s unlikely that 99.999% of Europeans would ever come into contact with anyone who had ever been exposed to an ape, and almost equal odds they’d never be exposed to someone who was exposed to someone who had been exposed to an ape.
Anyways, I don’t see how HIV would be any bigger threat than bubonic plague, smallpox, or the sweating sickness. “Bleeding the patient” probably wouldn’t even have gotten the persons involved infected. Unless you have a cut on your hand you could put your hand into a bucket full of blood from someone who has HIV/AIDs and the chances of you getting the virus are pretty low.
As it is, the three big epidemic-causing disease I mentioned are all more easily transmitted than HIV. Bubonic plague was transmitted by fleas, which could easily transfer themselves form the ever-present rats to people, fleas were quite widespread on persons in that day and age and very hard to control. Smallpox could be transmitted through the air you breathe (as could tuberculosis, another big killer.)
Sweating sickness is worse than all of them as it could cause death within hours, and often within just a day or two.
Yeah, but the incubation period is the difference there. With the Black Death you got it and died in fairly short order. With HIV a carrier is a potential vector for quite some time and is therefore capable of spreading it far and wide before symptoms that would lead to quarantine become visible.
As I tried to say before the board reset (seriously, I treid to reply about eight times before I finally got the official server reset notice):
While HIV/AIDS certainly could have spread for a longer period of time before one died or was quarentined, it still would not have spread nearly as far and wide as the plague for a couple reasons.
People didn’t travel much back then. Many people lived their entire lives in a small village, maybe going to a larger city a few times to sell livestock or something. The plague, on the other hand, was able to be spread by fleas, and rats, which more often than not hithced rides on boats, carts, wagons, etc…taking the disease all over Eurpose much quicker than if it could only be spread by humans.
HIV/AIDS is harder to contract from someone than the plague, smallpox, or many other diseases. Since odds are not a lot of people actually had much contact with other people’s blood in the first place, save for “doctors”, that leaves sex as the only real viable transmission vector for HIV back then. In the middle ages, people in general had less sex with less people than what was had in the middle/end of the 20th century when HIV appeared and started spreading.
When you combine #1 and #2, you seriously limit how far the disease would have spread back then.
IIRC, parts of the world had a very vigorous trading ports and it would have been possible for the virus to establish a toehold there. Once that happened, the disease could have spread (though at a slower rate that plague, to be sure). I’ve read acccounts that as late as the 1500s, there were pagan fertility rituals going on in Europe, which were basically orgies. If true, then such places would have been a haven for the virus. IAC, there probably would have been prostitutes in every major population center, so they could have harbored the virus (not to mention the various members of the nobility who liked to “dally” with the commoners). Also, IIRC, there were a few doctors during the plague who figured out how the plague spread, and that helped to stop the disease. It seems unlikely to me that those doctors would have been able to do the same with HIV, plus with homosexuality being punishable by death in some places, the odds of anyone confessing information which would provide clues to how the disease was commonly spread seems unlikely.
Well, sanitation proceedures were non-existant back then in most places, so it’s doubtful that the stuff would have been properly handled or disposed of. Not to mention that certain proceedures, like dentistry, were performed by just about anyone with tools. And I can’t find the column, but Cecil mentioned in one of them that a treatment for hemophillia in the past was to drink blood. Also, blood transfusions were sometimes performed (generally animal to human, but some times human to human). These were almost always unsuccessful, of course, in that they didn’t know a thing about blood typing.
Diseases which spread rapidly are also the most easy to identify and track, since you can retrace the steps of the victim, and in the case of plague, eventually figure out that rats or fleas have something to do with the disease. With the multi-year incubation period of HIV, and the taboo against homosexuality it seems unlikely to me that anyone would have been able to get enough information on the disease, before the technology necessary to discover it had been invented, to even be able to quarrantine infected individuals, much less take any other steps to slow the spread.
What is that claim based on? I know that it’s a popular perception amongst conservatives that promiscuity is a 20th century invention, but I know of very little to support such a view. Do you have any evidence to that effect?
I also doubt your claims that HIV couldn’t have spread in the middle ages. We know for example that venereal diseases such as herpes and gonorrhea were more than capable of being sustained and spread during the middle ages. Those diseases aren’t markedly harder to contract than HIV, which suggests that HIV could be spread through the same mechanisms.
The thing about diseases is that any individual carrier need not move much at all. You don’t need a “Typhoid Mary”. If the local squire has sex with one of the local villagers and then goes and has sex with the squire in the next village that is all that is needed to infect two entire villages. You don’t need the two villages to be mixing at all. And of course once the disease gets into the prostitute population of large cities it will likely spread like wildfire.
Never mind the epidemiology, I doubt that anyone would even have figured there was a specific disease. Remember that at the time death from disease was the norm. Someone with HIV would simply succumb to TB or an infected tooth or one of the other diseases that inevitably killed everyone anyway. They might die younger than expected, but I doubt that it would even be realised that there was a disease at work.
Even at the stage that parts of Africa are at, where almost the entire adult population of some towns has died, I doubt very much that anyone would make the connection with a disease rather than ascribing it to a judgement from God or foul air or similar nonsense. After all, the people wouldn’t have died from a disease, They would have died from a whole range of different and well known diseases.
That’s the problem with HIV, it simply doesn’t look like a disease, especially in the absence of antibiotics. Even in the late 20th century it took along time and a huge number of cases before trained diagnosticians started to see a pattern, and it was still years more before the virus was isolated that it became universally accepted that it was a disease and not an environmental effect. The odds of anyone in the Middle Ages realising that people dying of a hundred different diseases were all exhibiting symptoms of the same disease seems remote.