How doctors first noticed the existence of AIDS

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Although AIDS, and the virus that causes it, had been quietly at work around the world since, probably, the 1950s, yesterday marked the 30th anniversary of the public health community's discovery of the disease. Science journalist Maryn McKenna marked the occasion with a fascinating, heart-wrenching excerpt from her 2004 book Beating Back the Devil, about the Epidemic Intelligence Service disease detectives. These men and women are on the front lines of spotting and (ideally) stopping outbreaks early. Naturally, when AIDS cases began to cluster in Southern California in 1981, the EIS were among the first to know about it.

There was something percolating through Southern California that spring.

Some of the health department's epidemiologists heard reports from doctors they knew, that patients in practices in the San Fernando Valley were complaining of swollen lymph nodes and stubborn low-grade fevers. There was no obvious diagnosis. Those symptoms could signal the start of lymphoma, a cancer of the immune system that attacks a particular type of white blood cell, but tests were finding no trace of cancer.

Most of the patients, the doctors said, were men.

At about the same time, a pathologist at the University of Southern California called Shandera's cubicle-mate Frank Sorvillo. He had evidence of cancers in a cluster of six male patients. But there was something odd about what he was seeing through the microscope; the pathology of these lymphomas was like nothing he knew.

… The man's name was Michael. He was 33 years old, tall and good-looking, with short, peroxided hair and prominent cheekbones. He was a model, he confided; he'd had his face enhanced with cheekbone implants.

He was also quite sick. He had been ill since October with a fluctuating fever and swollen glands in his neck and under his collarbone. The glands had gone down, but the fever would not go away. He had lost a lot of weight, and now he was losing his hair. He had raw patches of fluffy white growths — candidiasis, a yeast-like fungus, as well as herpes virus — inside his mouth, between his buttocks, and on his index fingers. The medical ward had run some tests already: He had an organism called cytomegalovirus in his urine, his white blood cell count was low, and one particular class of white cell, the T-lymphocytes, were much fewer than they ought to be.

All the findings pointed to the same conclusion: His immune system was not working the way it should.

30 Years of AIDS, and How It Began Part 1, Part 2, Part 3

Image courtesy Flickr user TimoStudios via CC