Robert Rayford
| Robert Rayford | |
|---|---|
| Born | 1953 United States |
| Died | May 16, 1969 United States |
| Known for | Alleged patient zero for AIDS |
Robert Rayford (c. 1953 – May 15[1] or May 16,[2] 1969), sometimes identified as Robert R., due to his age, was an American teenager from Missouri who had the earliest confirmed case of HIV/AIDS in North America. His death, at the age of 16, baffled doctors at the time. It was not until 1989 that his cause of death was identified.
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[edit] Illness
In early 1968 Rayford admitted himself to Barnes-Jewish Hospital (then called Barnes Hospital) in St. Louis, Missouri. His legs and genitals were covered in warts and sores. He also had severe swelling of the testicles and pelvic region, which later spread to his legs, causing a misdiagnosis of lymphedema. He had grown thin and pale, and suffered from shortness of breath. Rayford told the doctors that he'd had these symptoms since at least late 1966. Tests discovered a severe chlamydia infection. Robert declined a rectal examination request from hospital personnel.[2] Doctors treating Rayford suspected that he had engaged in passive anal intercourse.
In late 1968 Rayford's condition seemed to have stabilized, but by March 1969 his symptoms reappeared, and had worsened. He had increased difficulty breathing and his white blood cell count had plummeted. The doctors found that his immune system was dysfunctional. He developed a fever and died at 11:20pm on May 15, 1969.
[edit] Autopsy
On the day of Rayford's death, an autopsy uncovered several abnormalities. Led by Dr. William Drake, the autopsy revealed small purplish lesions on Rayford's left thigh and his soft tissue. Drake concluded that the lesions were Kaposi's sarcoma, a rare type of cancer that, up to that time, mostly affected elderly men of Mediterranean or Ashkenazi Jewish heritage[3]. Kaposi's sarcoma was later determined to be an AIDS defining illness.
These findings baffled the attending doctors, and a review of the case was eventually published in Lymphology, a medical journal, in 1973.[4] After the autopsy, blood and tissue samples were kept in cold storage at the University of Arizona and at the laboratory of Dr. Memory Elvin-Lewis, who had assisted in Rayford's autopsy.
[edit] Later investigations
[edit] Tests
In 1984, when HIV was first discovered (originally misidentified as HTLV-3), and was spreading rapidly in New York City and Los Angeles, Dr. Marlys Witte, one of the doctors who, like Elvin-Lewis, had cared for Robert before death and also assisted in the autopsy, thawed and tested preserved tissue samples from Robert's autopsy, which tested negative.[2] Three years later, in June 1987, Witte decided to test the tissue samples again using more recent technology, the Western blot, the most sensitive test for antibodies then available. The Western blot test found that antibodies against all nine detectable HIV proteins were present in Robert's blood. A second test found identical results.
[edit] Impact on AIDS origin research
Robert had never traveled outside the United States and, indeed, never left the Midwest, and had told doctors that he had never received a blood transfusion. Since Rayford's infection was almost certainly through sexual contact and he had never left the country, he may have received the virus from somebody else already living with it in the United States, meaning that AIDS may have been present in North America before Robert began showing symptoms in 1966.[1] He also never ventured into cosmopolitan cities such as New York, Los Angeles, or San Francisco, which were the sites where the HIV-AIDS epidemic was first observed in the United States.[5]
Doctors who subsequently investigated the case in the early 1980's, speculated that he may have been a male prostitute.[2] This assumption was made when the medical community thought that the progression from initial infection to the diagnosis of AIDS took only two-and-a-half years.
In his 1999 book The River, journalist Edward Hooper questioned whether Rayford had really died from AIDS. Hooper noted that Rayford's grandfather had reportedly suffered from similar symptoms (suggesting a congenital immunodeficiency) and that he may have been exposed to toxins in his childhood. Hooper claimed that Robert's symptoms were (with the exception of his Kaposi's sarcoma) not wholly typical of AIDS patients. Hooper also noted that Robert's sexual history may have been more prosaic than suspected. Hooper also claimed that the HIV testing carried out might have used a technique (a more powerful form of the Western blot test developed by Biotech) that he claimed could generate false positives. Hooper is most known for his promotion of the OPV AIDS hypothesis, and his ideas about AIDS remain controversial.[6][7][8][9][10]
[edit] See also
[edit] References
- ^ a b Gorman, Christine (November 9, 1987). "Strange Trip Back to the Future". Time. http://www.time.com/time/magazine/article/0,9171,965934-1,00.html. Retrieved 2007-11-24.
- ^ a b c d Crewdson, John (October 25, 1987). "Case Shakes Theories of AIDS Origin". Chicago Tribune. http://www.aegis.com/news/ct/1987/CT871003.html. Retrieved 2007-11-24.
- ^ Kaposi's Sarcoma, USA Today, http://www.healthscout.com/ency/68/297/main.html
- ^ Elvin-Lewis M, Witte M, Witte C, Cole W, Davis J (September 1973). "Systemic Chlamydial infection associated with generalized lymphedema and lymphangiosarcoma". Lymphology 6 (3): 113–21. PMID 4766275.
- ^ Gina Kolata (October 28, 1987). "Boy's 1969 Death Suggests Aids Invaded U.S. Several Times". New York Times. http://query.nytimes.com/gst/fullpage.html?res=9B0DEFD6173AF93BA15753C1A961948260&sec=health&pagewanted=all. Retrieved February 13, 2012.
- ^ Hillis DM (2000). "AIDS. Origins of HIV". Science 288 (5472): 1757–9. doi:10.1126/science.288.5472.1757. PMID 10877695.
- ^ Birmingham K (2000). "Results make a monkey of OPV-AIDS theory". Nat Med 6 (10): 1067. doi:10.1038/80356. PMID 11017114.
- ^ Cohen J (2001). "AIDS origins. Disputed AIDS theory dies its final death". Science 292 (5517): 615. doi:10.1126/science.292.5517.615a. PMID 11330303.
- ^ Origin of Human Immunodeficiency Virus (HIV/AIDS) Centers for Disease Control and Prevention website , Accessed 30th January 2007
- ^ Worobey M, Santiago M, Keele B, Ndjango J, Joy J, Labama B, Dhed'A B, Rambaut A, Sharp P, Shaw G, Hahn B (2004). "Origin of AIDS: contaminated polio vaccine theory refuted". Nature 428 (6985): 820. doi:10.1038/428820a. PMID 15103367.
