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'Patient Zero' - Gaëtan Dugas (1953-84)

Patient Zero was a concept born out of the early years of the AIDS epidemic in America. In 1987 pioneering gay journalist Randy Shilts explored this period in his book And the Band Played On. One of his most controversial claims was that he had identified ‘Patient Zero’ - the original carrier of the HIV virus who had therefore brought AIDS into the country. He was named as Gaëtan Dugas, a Canadian who had died in 1984.

The idea of a single identifiable patient gave a personal identity to the disease. In this case, the description of the original carrier as a promiscuous gay flight attendant confirmed and directed mainstream media and public attitudes to the new disease. AIDS had a face. Here was a latter-day Typhoid Mary.

In fact Dugas was wrongly identified as an initial source of infection. In reality he had been a patient in an epidemiological study in which he was identified by the letter ‘O’. At some point ‘O’ became ‘zero’. Further studies clearly demonstrated that he could not be singled out as having brought AIDS to the gay bath houses of San Francisco and Los Angeles, from where it was believed to have spread. However, the idea of Patient Zero has lived on. The concept is now routinely used not only to describe index cases in new epidemics, but in the creation of characters used to encapsulate the social meanings attached to different diseases.

Bibliography

D M Auerbach et al, 'Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact' American Journal of Medicine, 76 (1984), pp 487-492

R Shilts, And the Band Played On: Politics, People, and the AIDS Epidemic (New York: St. Martin's Press, 1987)

Glossary:

Aids

Acquired Immune Deficiency Syndrome (AIDS) is a disease caused by infections resulting from a weakened immune system due to the HIV virus. It leads to failure of the immune system and is usually fatal. It is spread through direct contact with bodily fluids.

Epidemic

A sudden widespread occurance of an infection with high numbers of people affected.

Hiv

Human Immunodeficiency Virus (HIV) is a virus that weakens vital cells in the immune system, and leads to AIDS. There are two strands: HIV-1, which leads to immunity suppression; and HIV-2, which is not as potent and is only common in West Africa. HIV is spread through direct contact with bodily fluids.