I thought that for those who are truly interested, I'd recommend a book called "And The Band Played On", which was also made into an award winning HBO movie.

It's about the discovery of HIV/AIDS, the search by the CDC and others for patient-zero (who turned out to be a gay Canadian male flight attendent), the infighting of the different government agencies about whose jurisdiction the disease fell under (funding, funding, funding!), the fact that American researchers took credit for the discovery of the virus when it was actually a French team that found it first, and how the whole thing affected the gay community.

A fascinating read, and a mostly faithful adaptation into the HBO movie...

-- Modified on 6/15/2009 8:17:40 PM

Hey Ed. A lot of people don't believe the Flight Attendant story. But the movie is probably a good documentary. Is it the same title?

Movie is the same title.  It was made as an HBO original movie and is long.  In fact, if I remember correctly it was a two-parter, which is appropriate since the book itself was long.

As for your first comment, you're right.  the fact is that the media really made that a key point, much more so than Randy Shilts, the author.

From Wikapedia:

The book includes extensive discussion of Gaëtan Dugas, a Canadian flight attendant who died in 1984. Dugas was labeled Patient Zero of AIDS, because he was linked directly or indirectly with 40 of the first 248 reported cases of AIDS in the U.S., and after he was told of his ability to infect others, defiantly continued to have unprotected sex.

Many book reviews concentrated their material on Dugas, or led their assessment of the book with discussion of his behavior. Some reviewers interpreted Shilts' naming Dugas "Patient Zero" to mean that Dugas brought AIDS to North America; the National Review called Dugas the "Columbus of AIDS" and in their review of And the Band Played On states, "[Dugas] picked up the disease in Europe through sexual contact with Africans. Traveling on his airline-employee privileges, he spread it here from coast to coast."[65]

Shilts never stated this in the book, instead writing, "Whether Gaetan Dugas actually was the person who brought AIDS to North America remains a question of debate and is ultimately unanswerable ... there's no doubt that Gaetan played a key role in spreading the new virus from one end of the United States to the other."[66]

Time magazine titled their review of And the Band Played On "The Appalling Saga of Patient Zero", erroneously confirming again that Dugas brought AIDS to the continent.[67] Even a press release by St. Martin's Press made the connection between Dugas and the introduction of AIDS to the Western World in its title, but not its text.[68]

When the book was released, Dugas' story became a particular subject in Canadian media; Shilts claimed, "the Canadian press went crazy over the story," and that "Canadians...saw it as an offense to their nationhood."[1]

The original study identifying Dugas as the index case had been completed by William Darrow, but it was called into question by University of California San Francisco epidemiologist Andrew Moss. Moss wrote in a letter to the editor of The New York Review of Books, "There is very little evidence that Gaetan was 'patient zero' for the US or for California," also stating that Shilts did not overstress the role of Dugas even though he did identify Dugas.[69]

Sandra Panem in Science uses Shilts' treatment of Dugas as an example of his "glib" treatment of the science involved in the epidemic.[62]

Author Douglas Crimp suggests that Shilts' representation of Dugas as "murderously irresponsible" is in actuality "Shilts' homophobic nightmare of himself," and that Dugas is offered as a "scapegoat for his heterosexual colleagues, in order to prove that [Shilts], like them, is horrified by such creatures."[68]



-- Modified on 6/15/2009 10:52:42 PM

I saw it a long time ago. It was a 2 hour or so movie wth Mathew Modine and alan alda.Not a bad movie, interesting and like you said america was a little cocky about taking credit,

Saw the movie but never read the book.  I thought it was very good and showed how the lack of money (funding) and the battle for credit of discovery of the virus overshadowed the humanity of it all.

It was an interesting movie. The interesting thing about the gov't agencies being incompetent and infighting, ironic it is the same gov't who wants to run health care (no matter what they say now, they do).  

My general comeback each time is tell me something the gov't does well and why we should have so much more of it.  And unfortunately this comes from someone who has known and seen public ineptitude from the inside.  My apologies to Ed...

Sorry about this being a double post...the dangers of my being moderated since I can't edit my first post. At any rate...

Randy Shilts, the author of "And the Band Played On", had a unique perspective on the early AIDS epidemic in San Francisco, as he was both a staff reporter for the SF Chronicle covering the "AIDS beat" and gay. As an AIDS researcher (both then and now), I found both the book and movie (produced by the late Aaron Spelling, of all people) to be singular achievements.

Shilts' reporting on the in-fighting between Luc Montagnier (Pasteur Institute) and Robert Gallo (NIH-National Cancer Institute) as to who first found the AIDS virus was accurate. Independent genetic testing indicated that Gallo's HIV viral isolate was a contaminant derived from Montagnier's original HIV^Lav virus that had been sent to his NIH laboratory ~1 year before for comparison. Because it was the two principal Pasteur Institute scientists who first isolated and characterized HIV, the Nobel prize in Medicine (2008) was awarded to Montagnier and Barre-Sinnousi (co-shared with zur Hausen for his discovery that HPV causes cervical cancer).

This thread is indeed correct that the "Patient Zero" aspect of both the book and movie is more weakly grounded. There were likely multiple, overlapping disease vectors (i.e., HIV infected patients) spreading the virus in the early epidemic in the U.S. (~1978-1981). It does make for an exciting literary device, though, because it appears that if only Gaetan Dugas could have been stopped in time, the AIDS epidemic in the U.S. would not have exploded in the various at-risk groups.

The relatively good news is that we now have decent treatments for HIV infection (e.g., protease and fusion inhibitors) which not only lengthen the life-span of AIDS patients but also render them less infectious. Interestingly, most of these effective AIDS therapies were largely due to U.S. research, funded by the NIH and the pharmaceutical industry.

The other good news is that there is voluminous epidemological research indicating that consistent and proper use of condoms is effective in blocking HIV transmission.

Unfortunately, the possibility of developing a safe and effective HIV vaccine is as bleak as ever, despite the best efforts of AIDS researchers and funding from both NIH and the Bill and Melinda Gates Foundation.

That movie had me starting to cry at the end.  The day they cure that disease will be a good day indeed.