Gaëtan Dugas (French: [ɡaetɑ̃ dyɡa]; February 19, 1952 – March 30, 1984) was a QuébécoisCanadianflight attendant and a relatively early HIV patient who once was widely regarded as "Patient Zero," or the primary case for AIDS in the United States. This claim was later found to be incorrect.[2][3]
In March 1984, a Centers for Disease Control and Prevention (CDC) study tracked the sexual liaisons and practices of gay and bisexual men, especially in California and New York. Dugas was code-named "Patient O" (meaning out of state) to indicate his role in a cluster of 40 AIDS cases in the United States.[4] This was misinterpreted as "Patient Zero" and media later extrapolated this information to mean that he was the original carrier of AIDS in the country,[5] although the report itself made no such claim. After a new genetic analysis of stored blood samples, bolstered by some historical detective work, scientists declared that he did not bring HIV to the United States and was not Patient Zero.[6]
A 1984 paper[4] linked 40 AIDS patients by sexual contact. Of those patients, Dugas was the first to experience an onset of symptoms of AIDS. In the above graph, Dugas is represented by the number 0. Because Dugas was very forthcoming in helping researchers, Michael Worobey concludes there may be ascertainment bias in the study.[5]
A study published in The American Journal of Medicine in 1984 titled Cluster of Cases of the Acquired Immune Deficiency Syndrome examined the sexual contacts of gay men infected with AIDS to determine if their histories were consistent with the hypothesis that AIDS was caused by an infectious agent. A graph included with the paper traced the sequence of infection among 40 men and labelled one of the nodes as "Patient 0" (with other nodes including the place of residence and a number indicating the sequence in which they developed AIDS symptoms, such as "NY 14").[4] The paper later stated:
If the infectious-agent hypothesis is true, Patient 0 may be an example of a "carrier" of such an agent. He had had sexual contact with eight other AIDS patients and was the possible source of AIDS for at least three of them. Two of these three men had been his partners before he had overt signs of Kaposi's sarcoma.
The researchers later stated they had originally intended to designate Dugas as "Patient O", with "O" standing for "Out-of-California" but at some point it was changed to a "0".[1]
"Patient Zero" designation
Dugas is featured prominently in Randy Shilts's 1987 book And the Band Played On: Politics, People, and the AIDS Epidemic (1987), which documents the outbreak of the AIDS epidemic in the United States. Shilts refers to Dugas as "Patient Zero" and portrays him as having almost sociopathic behaviour by allegedly intentionally infecting, or at least recklessly endangering, others with the virus. Dugas is described as being a charming, handsome sexual athlete who, according to his own estimation, averaged hundreds of sex partners per year.[1] He claimed to have had over 2,500 sexual partners across North America since becoming sexually active in 1972.[9] In David France's 2016 book How to Survive a Plague, Shilts's editor expressed his regret for having "made a conscious decision to vilify Dugas in the book and publicity campaign in order to spur sales."[10]
Genetic analysis historically provided some support for the Patient Zero theory, in which Dugas was believed to be part of a cluster of homosexual men who travelled frequently, were extremely sexually active, and died of AIDS at a very early stage in the epidemic.[11]
A number of authorities have since voiced reservations about the implications of the CDC's Patient Zero study and characterizations of Dugas as being responsible for bringing HIV to cities such as Los Angeles and San Francisco.[1] In the Patient Zero study, the average length of time between sexual contact and the onset of symptoms was 10+1⁄2 months.[4] While Shilts's book does not make such an allegation, the rumour that Dugas was the principal disseminator of the virus became widespread.[12] In 1988, Andrew R. Moss published an opposing view in The New York Review of Books.[13]
In 2016, a group of researchers led by evolutionary biologist Dr. Michael Worobey conducted a genetic study that looked at blood samples taken from gay and bisexual men in 1978 and 1979 as part of a hepatitis B study, and based on the results of the data, concluded that Dugas was not the source of the virus in the U.S. "On the family tree of the virus, Dugas fell in the middle, not at the beginning."[14] "Beliefs about Patient Zero," Worobey concludes, "are unsupported by scientific data."[14] Worobey's paper, published in Nature in October 2016, finds "neither biological nor historical evidence that he was the primary case in the US or for subtype B as a whole."[3][2][15]
A study by historian Richard McKay of Cambridge and others identified several causes for the Patient Zero myth. During early CDC analysis of cases in California, patient 057 (Dugas) was nicknamed patient "O" for "Out-of-California", but this was interpreted by others as Patient Zero.[1] Dugas was particularly helpful in tracing his network of partners, providing names and addresses for many of them, which was further expanded because others remembered his distinctive name.[12] Although many of the patients analysed reported in excess of 1000 sexual partners, most remembered "only a handful" of names, making their contacts to other cases more difficult to trace.[16][15] Richard McKay later extended this study into a book, "Patient Zero and the Making of the AIDS Epidemic."[17] This book also contains the most definitive biography of Dugas' life, constructed through numerous interviews with friends, family, and lovers.
Robert M. Grant, an AIDS researcher at the University of California, has stated: "No one wants to be the Patient Zero of their village. But this may be helpful because it says, 'Just because you are the first to be diagnosed doesn't mean you started the epidemic.'"[2]
^ abGallagher, James (October 26, 2016). "HIV Patient Zero cleared by science". BBC News Online. Retrieved October 26, 2016.
^ abcdAuerbach, David M.; Darrow, William W.; Jaffe, Harold W.; Curran, James W. (1984). "Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact" (PDF). The American Journal of Medicine. 76 (3): 487–92. doi:10.1016/0002-9343(84)90668-5. PMID 6608269. Retrieved March 3, 2014.
^ abDoucleff, Michaeleen (October 26, 2016). "Researchers Clear 'Patient Zero' From AIDS Origin Story". NPR.com.
^McNeil, Donald G. Jr. (October 26, 2016). "H.I.V. Arrived in the U.S. Long Before 'Patient Zero'". The New York Times. ISSN 0362-4331. Retrieved August 19, 2021.
^ [Discovering the illness — AIDS, the first years]. Radio-Canada (in French). January 17, 1992. Archived from the original on August 18, 2004.
^Kuiken, C; Thakallapalli, R; Esklid, A; de Ronde, A (November 1, 2000). "Genetic analysis reveals epidemiologic patterns in the spread of human immunodeficiency virus". American Journal of Epidemiology. 152 (9): 814–22. doi:10.1093/aje/152.9.814. PMID 11085392. Retrieved March 3, 2014.
^ abCrewe, Tom (September 27, 2018). "Here was a plague". London Review of Books. Retrieved September 29, 2018.
^ abStraube, Trenton (May 16, 2016). "Mapping Out Early AIDS in the U.S." POZ.
^ abWorobey, Michael; Thomas D. Watts; et al. (October 26, 2016). "1970s and 'Patient 0' HIV-1 genomes illuminate early HIV/AIDS history in North America". Nature. 539 (7627): 98–101. Bibcode:2016Natur.539...98W. doi:10.1038/nature19827. PMC5257289. PMID 27783600.
^"New research reveals accidental making of 'Patient Zero' myth during 1980s AIDS crisis". University of Cambridge. October 26, 2016.
^Patient Zero and the Making of the AIDS Epidemic.
^Ahearn, Victoria (April 25, 2019). "Documentary Killing Patient Zero seeks to restore reputation of Quebec man unfairly targeted in AIDS epidemic". Toronto Star.
^Knegt, Peter (July 25, 2019). "Killing Patient Zero: How a Quebec flight attendant was falsely accused of bringing AIDS to America". CBC Arts. Retrieved March 21, 2022.
External links
Halifax Rainbow Encyclopedia page for Dugas—he lived in Halifax for several years.
AidsVancouver February 2, 2014, at the Wayback Machine - archive footage of Gaetan Dugas speaking at an Aids Vancouver forum (beginning at ~5:45)
‘Patient Zero’ no more - study reported in Science Magazine (Vol. 351, Issue 6277, pp. 1013), American Association for the Advancement of Science (AAAS) (Article)
January 07, 2023
gaëtan, dugas, french, ɡaetɑ, dyɡa, february, 1952, march, 1984, québécois, canadian, flight, attendant, relatively, early, patient, once, widely, regarded, patient, zero, primary, case, aids, united, states, this, claim, later, found, incorrect, born, 1952, f. Gaetan Dugas French ɡaetɑ dyɡa February 19 1952 March 30 1984 was a Quebecois Canadian flight attendant and a relatively early HIV patient who once was widely regarded as Patient Zero or the primary case for AIDS in the United States This claim was later found to be incorrect 2 3 Gaetan DugasBorn 1952 02 19 February 19 1952Quebec City Quebec CanadaDiedMarch 30 1984 1984 03 30 aged 32 Quebec City Quebec CanadaCause of deathKidney failure due to AIDS related infectionsNationalityCanadianOccupationFlight attendantKnown forLong misdescribed as Patient Zero of the North American AIDS epidemic 1 In March 1984 a Centers for Disease Control and Prevention CDC study tracked the sexual liaisons and practices of gay and bisexual men especially in California and New York Dugas was code named Patient O meaning out of state to indicate his role in a cluster of 40 AIDS cases in the United States 4 This was misinterpreted as Patient Zero and media later extrapolated this information to mean that he was the original carrier of AIDS in the country 5 although the report itself made no such claim After a new genetic analysis of stored blood samples bolstered by some historical detective work scientists declared that he did not bring HIV to the United States and was not Patient Zero 6 Dugas worked as a flight attendant for Air Canada 1 7 and died in Quebec City in March 1984 as a result of kidney failure caused by AIDS related infections 8 Contents 1 1984 cluster study 2 Patient Zero designation 3 Re examination 4 See also 5 References 6 External links1984 cluster study Edit A 1984 paper 4 linked 40 AIDS patients by sexual contact Of those patients Dugas was the first to experience an onset of symptoms of AIDS In the above graph Dugas is represented by the number 0 Because Dugas was very forthcoming in helping researchers Michael Worobey concludes there may be ascertainment bias in the study 5 A study published in The American Journal of Medicine in 1984 titled Cluster of Cases of the Acquired Immune Deficiency Syndrome examined the sexual contacts of gay men infected with AIDS to determine if their histories were consistent with the hypothesis that AIDS was caused by an infectious agent A graph included with the paper traced the sequence of infection among 40 men and labelled one of the nodes as Patient 0 with other nodes including the place of residence and a number indicating the sequence in which they developed AIDS symptoms such as NY 14 4 The paper later stated If the infectious agent hypothesis is true Patient 0 may be an example of a carrier of such an agent He had had sexual contact with eight other AIDS patients and was the possible source of AIDS for at least three of them Two of these three men had been his partners before he had overt signs of Kaposi s sarcoma The researchers later stated they had originally intended to designate Dugas as Patient O with O standing for Out of California but at some point it was changed to a 0 1 Patient Zero designation EditDugas is featured prominently in Randy Shilts s 1987 book And the Band Played On Politics People and the AIDS Epidemic 1987 which documents the outbreak of the AIDS epidemic in the United States Shilts refers to Dugas as Patient Zero and portrays him as having almost sociopathic behaviour by allegedly intentionally infecting or at least recklessly endangering others with the virus Dugas is described as being a charming handsome sexual athlete who according to his own estimation averaged hundreds of sex partners per year 1 He claimed to have had over 2 500 sexual partners across North America since becoming sexually active in 1972 9 In David France s 2016 book How to Survive a Plague Shilts s editor expressed his regret for having made a conscious decision to vilify Dugas in the book and publicity campaign in order to spur sales 10 Genetic analysis historically provided some support for the Patient Zero theory in which Dugas was believed to be part of a cluster of homosexual men who travelled frequently were extremely sexually active and died of AIDS at a very early stage in the epidemic 11 Re examination EditSee also History of HIV AIDS A number of authorities have since voiced reservations about the implications of the CDC s Patient Zero study and characterizations of Dugas as being responsible for bringing HIV to cities such as Los Angeles and San Francisco 1 In the Patient Zero study the average length of time between sexual contact and the onset of symptoms was 10 1 2 months 4 While Shilts s book does not make such an allegation the rumour that Dugas was the principal disseminator of the virus became widespread 12 In 1988 Andrew R Moss published an opposing view in The New York Review of Books 13 In 2016 a group of researchers led by evolutionary biologist Dr Michael Worobey conducted a genetic study that looked at blood samples taken from gay and bisexual men in 1978 and 1979 as part of a hepatitis B study and based on the results of the data concluded that Dugas was not the source of the virus in the U S On the family tree of the virus Dugas fell in the middle not at the beginning 14 Beliefs about Patient Zero Worobey concludes are unsupported by scientific data 14 Worobey s paper published in Nature in October 2016 finds neither biological nor historical evidence that he was the primary case in the US or for subtype B as a whole 3 2 15 A study by historian Richard McKay of Cambridge and others identified several causes for the Patient Zero myth During early CDC analysis of cases in California patient 057 Dugas was nicknamed patient O for Out of California but this was interpreted by others as Patient Zero 1 Dugas was particularly helpful in tracing his network of partners providing names and addresses for many of them which was further expanded because others remembered his distinctive name 12 Although many of the patients analysed reported in excess of 1000 sexual partners most remembered only a handful of names making their contacts to other cases more difficult to trace 16 15 Richard McKay later extended this study into a book Patient Zero and the Making of the AIDS Epidemic 17 This book also contains the most definitive biography of Dugas life constructed through numerous interviews with friends family and lovers Robert M Grant an AIDS researcher at the University of California has stated No one wants to be the Patient Zero of their village But this may be helpful because it says Just because you are the first to be diagnosed doesn t mean you started the epidemic 2 Two films John Greyson s musical comedy film Zero Patience 1993 18 and Laurie Lynd s documentary Killing Patient Zero 2019 19 have also discussed the Patient Zero myth around Dugas 20 See also Edit Biography portalTimeline of early HIV AIDS cases Timeline of HIV AIDSReferences Edit a b c d e f Johnson Brian D April 17 2019 How a typo created a scapegoat for the AIDS epidemic Maclean s Retrieved April 20 2019 a b c McNeil Donald G October 26 2016 H I V Arrived in the U S Long Before Patient Zero The New York Times Retrieved October 26 2016 a b Gallagher James October 26 2016 HIV Patient Zero cleared by science BBC News Online Retrieved October 26 2016 a b c d Auerbach David M Darrow William W Jaffe Harold W Curran James W 1984 Cluster of cases of the acquired immune deficiency syndrome Patients linked by sexual contact PDF The American Journal of Medicine 76 3 487 92 doi 10 1016 0002 9343 84 90668 5 PMID 6608269 Retrieved March 3 2014 a b Doucleff Michaeleen October 26 2016 Researchers Clear Patient Zero From AIDS Origin Story NPR com McNeil Donald G Jr October 26 2016 H I V Arrived in the U S Long Before Patient Zero The New York Times ISSN 0362 4331 Retrieved August 19 2021 La decouverte de la maladie Sida les premieres annees Discovering the illness AIDS the first years Radio Canada in French January 17 1992 Archived from the original on August 18 2004 Shilts Randy 1988 And The Band Played On Penguin pp 439 ISBN 978 0 14 011130 9 Gladwell Malcolm 2000 The Tipping Point Little Brown and Company pp 21 ISBN 978 0 316 34662 7 France David December 1 2016 How to Survive a Plague The Story of How Activists and Scientists Tamed AIDS Pan Macmillan p PT79 ISBN 978 1 5098 3941 4 Retrieved December 28 2016 Kuiken C Thakallapalli R Esklid A de Ronde A November 1 2000 Genetic analysis reveals epidemiologic patterns in the spread of human immunodeficiency virus American Journal of Epidemiology 152 9 814 22 doi 10 1093 aje 152 9 814 PMID 11085392 Retrieved March 3 2014 a b Crewe Tom September 27 2018 Here was a plague London Review of Books Retrieved September 29 2018 Moss Andrew R December 8 1988 AIDS Without End The New York Review of Books Retrieved December 2 2006 a b Straube Trenton May 16 2016 Mapping Out Early AIDS in the U S POZ a b Worobey Michael Thomas D Watts et al October 26 2016 1970s and Patient 0 HIV 1 genomes illuminate early HIV AIDS history in North America Nature 539 7627 98 101 Bibcode 2016Natur 539 98W doi 10 1038 nature19827 PMC 5257289 PMID 27783600 New research reveals accidental making of Patient Zero myth during 1980s AIDS crisis University of Cambridge October 26 2016 Patient Zero and the Making of the AIDS Epidemic Baumgarten Marjorie April 1 1994 Zero Patience Austin Chronicle Ahearn Victoria April 25 2019 Documentary Killing Patient Zero seeks to restore reputation of Quebec man unfairly targeted in AIDS epidemic Toronto Star Knegt Peter July 25 2019 Killing Patient Zero How a Quebec flight attendant was falsely accused of bringing AIDS to America CBC Arts Retrieved March 21 2022 External links EditHalifax Rainbow Encyclopedia page for Dugas he lived in Halifax for several years Gaetan Dugas at Find a Grave AidsVancouver Archived February 2 2014 at the Wayback Machine archive footage of Gaetan Dugas speaking at an Aids Vancouver forum beginning at 5 45 Patient Zero no more study reported in Science Magazine Vol 351 Issue 6277 pp 1013 American Association for the Advancement of Science AAAS Article Retrieved from https en wikipedia org w index php title Gaetan Dugas amp oldid 1130211826, wikipedia, wiki, book, books, library,
