For years, the origin of the U.S. HIV epidemic centered around one person: A French-Canadian flight attendant named “Patient 0.” Gaetan Dugas was blamed for setting off the crisis which has since infected almost 2 million people.
Only Patient 0 wasn’t actually Patient 0. He was actually Patient O.
The difference between “zero” and the letter “O” was a reporting error that led to the false impression that prevailed for decades that Dugas was the source of infection in the U.S., a study published in Nature revealed. O stood for “out-of-California,” the state where the Center for Disease Control and Prevention was studying infections.
“Although the authors of the cluster study repeatedly maintained that Patient 0 was probably not the ‘source’ of AIDS for the cluster or the wider U.S. epidemic, many people have subsequently employed the term ‘patient zero’ to denote an original or primary case, and many still believe the story today,” the study authors wrote. “We therefore recovered the complete HIV-1 genome of Patient 0 and examined it against the backdrop provided by the 1970s sequences.”
The examination, led by University of Arizona Professor Michael Worobey, tested blood samples of gay men in New York City and San Francisco that were drawn before HIV was known in the U.S., in 1978 and 1979. Researchers were able to conclude that 6.6 percent of the New York samples and 3.7 percent of the San Francisco samples tested positive for HIV antibodies, which indicated the virus had been present and spreading in those cities before Dugas was blamed for spreading the disease.
“In short, we found no evidence that Patient 0 was the first person infected by this lineage of HIV-1,” the study said. “Thus, while he did link AIDS cases in New York and Los Angeles through sexual contact, our results refute the widespread mis-interpretation that he also infected them with HIV-1.”
HIV evolved from a virus in sub-Saharan Africa that was infecting primates, which is believed to have begun infecting humans in the early 1900s. The disease is thought to have come to the U.S. from the Caribbean. When researchers studied the virus genome in the blood samples, they found enough differences that indicated the virus had likely been spreading for several years before the samples were drawn in the late 70s.
Dugas was the subject of the 1987 book “And the Band Played On” written by journalist Randy Shilts, who got HIV and died in 1994.