appears that either HIV existed in very low levels in the United States in periods prior to 1981, or it may have gone extinct in the United States at times, with the present infection established in the USA about 1976. HIV in Africa likewise was at first at levels too low to be noticed. In the United States and Africa HIV was at first mostly found only in residents of large cities. The infection is now more widespread in rural areas, and has appeared in regions such as China and India, where it was previously not evident.
Author Randy Shilts mentioned that what was later called AIDS became evident in the gay community in the Fire Island, New York area in the four years after the 1976 Bicentennial celebrations. The infection tended to double in numbers about every nine to ten months. It therefore took a couple of years before a new disease was suspected because there were at first not enough symptomatic individuals to be noticed.
The earliest documented HIV-1 infection dates from 1959, and was discovered in the preserved blood sample of a man from Kinshasa in the Democratic Republic of the Congo.[7] In 1969, a 15-year-old African-American male died at the St. Louis City Hospital from aggressive Kaposi's sarcoma. AIDS was suspected as early as 1984, and in 1987, researchers at Tulane University School of Medicine confirmed this, finding HIV-1 in his preserved blood and tissues. The doctors who worked on his case at the time suspected he was a male prostitute, though the patient did not discuss his sexual history with them in detail. [8] [9] [10] [11] [12]
In 1976, a Norwegian sailor named Arvid Noe, his wife, and his nine-year-old daughter died of AIDS. The sailor had first presented symptoms in 1966, four years after he had spent time in ports along the West African coastline. Tissue samples from the sailor and his wife were tested in 1988 and found to contain the HIV-1 virus (Group O).[13] [14] The next documented western death from AIDS was that of Dr. Grethe Rask in 1977. Rask, a Danish surgeon, had worked in the Congo in the early 1970s.
The official date for the beginning of the AIDS epidemic is marked as June 5, 1981, when the US Centers for Disease Control and Prevention reported in its Morbidity and Mortality Weekly Report newsletter that unusual clusters of Pneumocystis jiroveci pneumonia (formerly Pneumocystis carinii) had been discovered in gay men in Los Angeles in the early 1980s.[15] Over the next eighteen months, more Pneumocystis jiroveci clusters were discovered among otherwise healthy men in cities throughout the country, along with other opportunistic diseases (such as Kaposi's sarcoma[16] and lymphadenopathy[17]), common in immunosuppressed patients.
In June 1982, a report of a group of cases amongst gay men in Southern California suggested that a sexually transmitted infectious agent might be the etiological agent [18] and was initially termed 'GRID' (Gay Related Immune Deficiency[19]). However, the same opportunistic infections also began to be reported among hemophiliacs [20], heterosexual IV drug users, and Haitian immigrants [21]. By August 1982, the disease was being referred to by its new name, Acquired Immune Deficiency Syndrome (AIDS) [22]. An anagram of AIDS, SIDA, was then created for use in French (Syndrome d'Immuno-Déficience Acquise) and Spanish (Síndrome de Inmunodeficiencia Adquirida) [23].
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