Timeline of early HIV/AIDS cases
This article is a timeline of early AIDS cases.
An AIDS case is classified as "early" if the death occurred before 18 June 1981, when the AIDS epidemic was formally recognized by medical professionals in the United States.
Human blood samples from 1959 and 1960 from Kinshasa, the capital and the largest city of the Democratic Republic of the Congo on the Congo River, led scientists to extrapolate the virus back to the early 1900s, likely around 1908 in Africa. Around that time the virus may have been transmitted from another species. Paralleling the HIV discoveries, primate researchers found Simian immunodeficiency virus (SIV), which was widespread among many species of chimpanzees.
In 2006, scientists reported the origin of HIV came from a species of chimpanzees that were "penned in" a 100-square-mile section of Cameroon bracketed by the Boumba River to the west, the Sangha River to the east, "this patch of tropical forest is sealed into an inland peninsula to the south by the Ngoko River." One hypothesis is that a Bantu hunter became infected while processing a chimpanzee. In the early 1900s the area was experiencing an upheaval as the German Empire took over the land in 1884, naming the colony Kamerun. The hypothesis follows that the infected hunter would have visited or moved to a more densely populated area and passed the infection on via sexual contact.
Using the same virus tracing technologies, scientists extrapolate about a "chimp patient zero" that existed within a million years ago, although it is likely impossible to further limit the time frame. This chimp would have had to have eaten SIV-infected monkeys from two distinct species, a red-capped mangabey, and a spot-nosed guenon. Normally these viruses would have been defeated separately, or never interacted. But in "chimp zero", a relatively rare occurrence of pieces of the two viruses combined and thrived, leading to the virus that later was introduced to humans and became one virus. Scientists have found a dozen HIV strains spread from chimps, monkeys, and gorillas, but one is responsible for the majority of the human infections causing a high percentage of the almost 36 million people who have died as of 2014. The research is being used to study the prevention of other "patient zero" events with other viruses.
The strain of HIV viruses most closely related to the lineage of HIV-1 subgroup M (responsible for the global pandemic) may have first emerged in the 1920s in Kinshasa, then part of the Belgian Congo. A team of scientists from the universities of Oxford and Leuven concluded this "estimated location of pandemic origin" in 2014 by applying computational methods of evolutionary analysis to archived samples of HIV's genetic code.
Sadayo Fujisawa, a sixty-year-old Japanese-Canadian chiropractor-masseuse, died on 28 June 1945 of pneumocystis pneumonia with CMV, diarrhea, and wasting which some authors conclude would have led to an automatic diagnosis of AIDS in the early 1980s. The British writer Edward Hooper argues that it was not a case of AIDS based on polymerase chain reaction tests by Dr. Serge Jothy and Fergal Hill performed on slides from Mrs. Sadayo's autopsy and that were not able to find HIV by 1993's standards.
Richard Edwin Graves, Jr., a 28-year old World War II veteran who had been stationed in the Solomon Islands, died on 26 July 1952 in Memphis, Tennessee with pneumocystis pneumonia, CMV and what some authors suggest are a sufficient number of opportunistic infections for a clinical course suggestive of an AIDS diagnosis. Again, by contrast, Hooper disagrees (p. 146), citing Lester Wold, the chair of pathology at the Mayo Clinic, and Sebastian Lucas, an AIDS specialist, to suggest that "Dick G." died of HTLV-1 and Non-Hodgkins lymphoma.
Until 2008, the earliest known sample of HIV-1 was from Kinshasa, Democratic Republic of the Congo (DRC) (formerly Zaïre, formerly Belgian Congo). The sample, named ZR59, was isolated from tissues collected from "a Bantu male" in 1959 and was found with retrospective genetic analysis to be most closely related to subtype D strains. In 2008, partial HIV viral sequences were identified from a specimen of lymph node collected from an adult female in Kinshasa, DRC in 1960. This specimen, named DRC60, was around 88% similar to ZR59, but was found to be most closely related to subtype A HIV-1 strains. These specimens are significant not only because they are the oldest specimens of the virus known to cause AIDS, but because they show that the virus already had an extensive amount of genetic diversity in 1960. This suggests the virus had either undergone recombination or been circulating for years or perhaps decades in the Kinshasa population.
Notable potential individual cases of AIDS from this period include:
David Carr: (Contested, see below.) A Manchester printer (sometimes mistakenly referred to as a sailor) who died 31 August 1959 following the failure of his immune system; he succumbed to pneumonia. Doctors, baffled by what he had died from, preserved 50 of his tissue samples for inspection. In 1990, the tissues were found to be HIV-positive. However, in 1992, a second test by AIDS researcher David Ho found that the strain of HIV present in the tissues was similar to those found in the late 1980s rather than an earlier strain (which would have mutated considerably over the course of 30 years). Ho's discovery has cast doubt on David Carr's death being caused by AIDS.[medical citation needed]
Ardouin Antonio, a 49-year-old Haitian,[medical citation needed] has been identified as a possible early AIDS case. Antonio had emigrated to the United States in 1927, and at the time of death was working as a shipping clerk for a garment manufacturer in Manhattan. He developed similar symptoms to David Carr's, and died on 28 June 1959, apparently of the same very rare kind of pneumonia as Carr. Many years later, Dr. Gordon R. Hennigar, who had performed Antonio's autopsy, was asked whether he thought his patient had died of AIDS; he replied "You bet ... It was so unusual at the time. Lord knows how many cases of AIDS have been autopsied that we didn't even know had AIDS. I think it's such a strong possibility that I've often thought about getting them to send me the tissue samples." Some doctors disagree. Edward Hooper disputes this in his book, "The River" based on a PCR performed by Fergal Hill.
Researchers drew blood from 75 children in Uganda to serve as controls for a study of Burkitt's lymphoma. In 1985, retroactive testing of the frozen blood serum indicated that 50 of the children had antibodies to a virus related to HIV.
Arvid Noe: Arvid Darre Noe (an anagram of his birth name Arne Vidar Røed) was a Norwegian sailor and truck driver who was probably infected in Cameroon some time between 1961 and 1965, and died on 24 April 1976, fifteen months after his daughter. Tissues of Noe, his wife and daughter all tested positive for HIV in an epidemiology study in 1988.
Grethe Rask: A Danish surgeon who traveled to Zaïre in 1972 to aid the sick. She was likely directly exposed to blood from many Congolese patients, one of whom infected her. She returned to Denmark in late 1976, with her colleagues baffled by her symptoms. She died in December 1977. Her tissues were examined and tested positive by her colleagues in 1984.
Senhor José (English: Mr. Joseph): A Portuguese man who is the first confirmed case of HIV-2. He was believed to have been exposed to the disease in Guinea-Bissau in 1966. He was treated at the London Hospital for Tropical Diseases by Professor Anthony Bryceson until finally succumbing to the disease in 1978.
Herbert Heinrich: Bisexual German concert violinist who died in 1979. Tests in 1989 found that he was HIV-positive, and there has been speculation that he was infected by a prostitute who was infected by Noe, but as of 1997, this had not been proven.
- Nathan Wolf (author of The Viral Storm), Carl Zimmer (author of A Planet of Viruses), Michael Worobey (of MicrobeWorld.org's "Meet the Scientist Podcast"), David Quammen (author of Spillover), and Beatrice H. Hahn (of Penn Center for AIDS Research). "The Cell That Started a Pandemic". Radiolab.
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