Diseases

It's "Patient O," Not "Patient Zero"

In the early 1980s, young gay men started coming down with unusual and deadly illnesses, which were eventually attributed to a mysterious immune deficiency — the condition that would come to be known as AIDS. At the end of 1981, around 300 cases of the condition were reported. By the time HIV was discovered in 1984, there were nearly 8,000 AIDS cases in the U.S. alone. Throughout this horrific epidemic, one mystery nagged: Who had unleashed this deadly disease? Who was North America's first HIV carrier? It's not who you think.

Related Video: The Forgotten Fighters of the AIDS Epidemic

Finding the Source

That's what scientist William Darrow set to find out. In 1981, the CDC asked him to find out why gay men were dying from this strange illness. He caught wind of the fact that some early AIDS victims had been lovers, cluing him into the idea that the disease might be sexually transmitted. He began interviewing AIDS patients about their sex lives and happened upon three who all named the same lover: a flight attendant from Canada. That man was Gaetan Dugas, who has since been immortalized — and made infamous — in countless books and movies about the AIDS epidemic as "patient zero": the "evil" man who brought AIDS to North America.

"O" vs "0"

The only problem is that Dugas wasn't patient zero, as in "the first patient." He was patient O, as in "a patient from outside of California." To maintain the privacy of the men in his study, Darrow identified them with a code that included their patient number and the city they lived in. For example, those in L.A. were patient LA1, patient LA2, and so on. Dugas was the only patient outside of the study area, so he was patient O.

Dugas wasn't branded with the name "patient zero" until three years after his death, in 1987. That's when Randy Shilts, a reporter in San Francisco, published his book "And The Band Played On." Shilts had noticed the patient O in the original study, and at the same time, people at the CDC had begun to refer to Darrow's letter as the number zero. Calling Dugas "patient zero" was too catchy of a prospect to pass up — especially since Shilts didn't realize it was wrong.

This is more than just semantics: For a 2016 study in Nature, scientists sequenced the HIV virus taken from Dugas, along with HIV taken from eight other men that had been infected during the 1970s. From that, the researchers estimated that HIV first made the jump from Cuba to the United States — to New York City, specifically, around 1970. But it would take several more years for doctors to take notice.

That means that by the time Dugas contracted HIV, there were already thousands of Americans infected. But that's not the only thing that changes the story of Gaetan Dugas; he was also a crucial part of the study to discover the AIDS epidemic. "I'm quite certain he shared more names of people [who were lovers] than any other person in that study," Michael Worobey, evolutionary biologist and coauthor of the 2016 study, told NPR. A simple misreading of his patient code has unfairly etched this Canadian flight attendant in history as the villain of the AIDS epidemic.

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Randy Shilts might have gotten one detail wrong, but his book "And The Band Played On" is still one of the most important stories about the AIDS epidemic. You can listen to the audiobook for free with a 30-day trial of Audible. We handpick reading recommendations we think you may like. If you choose to make a purchase, Curiosity will get a share of the sale.

Written by Ashley Hamer November 26, 2018

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