XPost: ucb.politics.progressive, chi.general, alt.hollywood   
   XPost: ca.politics   
   From: history-usa@hillaryclinton.com   
      
   It's one of the biggest medical mysteries of our time: How did   
   HIV come to the U.S.?   
      
   By genetically sequencing samples from people infected early on,   
   scientists say they have figured out when and where the virus   
   that took hold here first arrived. In the process, they have   
   exonerated the man accused of triggering the epidemic in North   
   America.   
      
   A team of researchers at the University of Arizona sequenced the   
   HIV virus taken from Canadian flight attendant Gaetan Dugas, the   
   man called "Patient Zero" in the best-selling book And the Band   
   Played On, which chronicled the early days of the AIDS epidemic   
   in America.   
      
   The scientists also sequenced the virus from eight other men   
   infected with HIV during the 1970s. From these genetic codes,   
   the scientists estimate HIV came to the U.S. from Haiti in 1970   
   or 1971, but it went undetected by doctors for years.   
      
   "The virus got to New York City pretty darn early," says   
   evolutionary biologist Michael Worobey, who led the study. "It   
   was really under the radar for a decade or so."   
      
   The disease spread around New York City for a few years, with   
   the number of infections doubling each year. Then in 1976, one   
   person took the virus across the country to San Francisco,   
   Worobey and his team found.   
      
   But the study, published Wednesday in the journal Nature, offers   
   more than just a record of HIV's path. It also finally puts to   
   rest one of the most famous narratives surrounding the AIDS   
   epidemic — an urban legend that all got started because of the   
   misinterpretation of the letter O.   
      
   Back in the early '80s, behavioral scientist William Darrow was   
   a young scientist at the Centers for Disease Control and   
   Prevention. He drew the assignment of a lifetime: Figure out why   
   gay men in Los Angeles were dying of a strange illness.   
      
   Doctors were stumped. Some scientists thought maybe it was   
   caused by "poppers," nitrite-based chemicals that are inhaled   
   recreationally. Others thought maybe "overexposure to sperm from   
   many sources was having an immune-suppressant effect," The New   
   York Times reported.   
      
   But in 1981, Darrow caught a clue: Rumor had it that some of the   
   early AIDS cases were lovers. "Whoa! This is the first   
   indication that we had that the disease might be sexually   
   transmitted from one person to another," Darrow says.   
      
   So Darrow started interviewing these men about their sex lives.   
   One day, three men — who didn't know each other — all named the   
   same lover.   
      
   "They said, 'This flight attendant from Canada. He flew for Air   
   Canada. Geez, he was such a great guy and very handsome,' "   
   Darrow remembers hearing.   
      
   The man was Gaetan Dugas. And his name popped up again and again   
   in interviews. Eventually, Darrow linked eight early AIDS cases   
   to Dugas.   
      
   When Darrow wrote up his findings inside the CDC, he didn't name   
   names. Instead, he called the men by a code, based on the city   
   they lived in. For those in LA: "There was LA1, LA2 ... and so   
   forth," Darrow says.   
      
   And for Dugas, a Canadian? "Patient O, the outside-of-California   
   case."   
      
   The letter O? Not Patient Zero? "That's correct," Darrow says.   
   "I never labeled him Patient Zero."   
      
   A few years later, in March 1984, Darrow and his colleagues   
   published their study showing that AIDS was a new, sexually   
   transmitted disease. That same month, Dugas died of AIDS near   
   his hometown in Quebec.   
      
   "And then three years later, in 1987, Dugas sort of comes back   
   to life," says Phil Tiemeyer, a historian at Kansas State   
   University.   
      
   He means Dugas comes back to life as a character, in the book   
   And the Band Played On by Randy Shilts, a reporter in San   
   Francisco. The book detailed the start of the AIDS epidemic,   
   including the story of Dugas.   
      
   "This is where Dugas really moves from Patient O to Patient Zero   
   — the epicenter, if you will, of the epidemic," Tiemeyer says.   
      
   You see, while Darrow was working on his study, someone at the   
   CDC, or working with the CDC, referred to Darrow's letter O as   
   the numeral zero instead. And people then started calling Dugas   
   "Patient Zero," Darrow tells NPR.   
      
   So when the study got written up, Dugas was labeled "Patient 0,"   
   with the numeral, not the letter.   
      
   The designation "was never meant to suggest that he was the   
   first case," Darrow says. "It only meant there was some person   
   who was very important in this cluster of cases."   
      
   Even Shilts was confused by the labeling.   
      
   "In the middle of that study was a circle with an O next to it,   
   and I always thought it was Patient O," Shilts told Life   
   magazine. "When I went to the CDC, they started talking about   
   Patient Zero. I thought, 'Ooh, that's catchy.' "   
      
   He took the idea and ran with it.   
      
   In his book, Shilts repeatedly calls Dugas "Patient Zero." The   
   book says there's no doubt Dugas "played a key role in spreading   
   AIDS across the country." And it's "a question of debate" about   
   whether Dugas brought the virus to North America.   
      
   Publicity for Shilts' book triggered a flood of media about   
   Dugas. And the media expanded his role in the epidemic further,   
   erroneously so, according to the new study.   
      
   The New York Post ran a huge headline declaring "The Man Who   
   Gave Us AIDS."   
      
   Time magazine jumped in with a story called "The Appalling Saga   
   Of Patient Zero." And 60 Minutes aired a feature on him.   
   "Patient Zero. One of the first cases of AIDS. The first person   
   identified as the major transmitter of the disease," host Harry   
   Reasoner said.   
      
   >From that point on, Tiemeyer says, Dugas became lodged in the   
   popular consciousness as Patient Zero — the source of HIV in   
   North America and the scapegoat for a horrific new pandemic. A   
   film version of the book, televised on HBO in 1993, further   
   cemented Dugas as the key figure in the epidemic.   
      
   "This character, Gaetan Dugas, has every trait of a villain that   
   America is looking for in the AIDS crisis," Tiemeyer says. "He's   
   gay and unshamed about it. He's beautiful. He's even a foreigner   
   who speaks with this seductive accent. He's the perfect villain."   
      
   But Dugas wasn't a villain — not at all.   
      
   In fact, people who knew Dugas told me he was charismatic, kind   
   and energetic. Right before he died, Dugas volunteered at a   
   nonprofit to help other people with HIV.   
      
   And he was critical to figuring out what AIDS was. Not only did   
   Dugas fly to the CDC in Atlanta to donate blood samples, Darrow   
   says, but he also offered the CDC a huge list of names of   
   potential AIDS cases   
      
   "I think this is crucial," the University of Arizona's Worobey   
   says. "In a way, it's not that surprising that you could place   
   Dugas at the center of a cluster, because I'm quite certain he   
   shared more names of people [who were lovers] than any other   
   person in that study. So there's a kind of ascertainment bias   
   [in Darrow's study]."   
      
   Worobey's research shows that by the late 1970s, nearly 7   
   percent of gay men in New York City were infected with HIV, and   
   nearly 4 percent in San Francisco were infected.   
      
      
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