Index case
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The index case, primary case or patient zero is the initial patient in the population sample of an epidemiological investigation.[citation needed] Patient zero is a somewhat less specific term than index case and is sometimes used to refer to the central patient in an epidemiological investigation rather than the first patient.[citation needed] When used in general to refer to such patients in epidemiological investigations, the term is not capitalized. When the term is used to refer to a specific person in place of that person's name within a report on a specific investigation, the term is capitalized as Patient Zero[citation needed]. Often scientists search for the index case to determine how the disease spread and what reservoir holds the disease in between outbreaks. Note that the index case is the first patient that indicates the existence of an outbreak. Earlier cases may be found and are labeled primary, secondary, tertiary, etc.[citation needed]
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[edit] Gaëtan Dugas case
In the early years of the AIDS epidemic, there was controversy about a so-called Patient Zero, who was the basis of a complex transmission scenario compiled by Dr. William Darrow and colleagues at the Centers for Disease Control (CDC).[citation needed] This epidemiological study showed how 'Patient Zero' had given HIV to multiple partners, who then in turn transmitted it to others and rapidly spread the virus to locations all over the world (Auerbach et al., 1984). In all, at least 40 of the 248 people diagnosed with AIDS by April 1982 were thought to have had sex either with him or with someone who had.[citation needed]
A journalist, Randy Shilts, subsequently wrote about Patient Zero — based on Darrow's findings[citation needed] — in his 1987 book And the Band Played On, which identified Patient Zero as Gaëtan Dugas[1]. For several years, Dugas was vilified as a "mass spreader" of HIV and the original source of the HIV epidemic among gay men.[citation needed]
A 2007 study published in the Proceedings of the National Academy of Sciences by Michael Worobey and Dr. Arthur Pitchenik claimed that, based on the results of genetic analysis, HIV probably moved from Africa to Haiti and then entered the United States around 1969,[2] probably through a single immigrant.[1]
[edit] Other Patients Zero
- Mary Mallon (a.k.a. Typhoid Mary) was a real Patient Zero.[citation needed] An apparently healthy carrier of typhoid, she infected 47 people while working as a cook.[citation needed] She eventually had to be quarantined to prevent her from spreading the disease to others.[citation needed]
- The first recorded case of the Ebola virus was a 44-year-old schoolteacher named Mabalo Lokela, who died 8 September, 1976, 14 days after symptom onset.[citation needed]
- 64-year-old Liu Jianlun, a Guangdong doctor, transmitted SARS during a stay in the Hong Kong Metropole Hotel in 2003.[citation needed]
- a baby in the Louis House at 40 Broad Street is credited as being Patient Zero in the 1854 cholera outbreak in the Soho neighoborhood of London.
[edit] Patients Zero in fiction
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- Patient Zero was a character in the Canadian film Zero Patience.
- Patient Zero is the title of the first entry in a proposed series of bioterrorism thriller novels by Bram Stoker Award-winning author Jonathan Maberry, featuring hero Joe Ledger, an agent of a secret government organization called the Department of Military Science (DMS).
- In the third Sliders episode, "Fever", Quinn's double is alleged to be Patient Zero of a global plague.
- The movie Outbreak dealt with government officials charged with finding the index case of an outbreak of an Ebola-like virus .
- Patient Zero was the name of a minor enemy in the computer game City of Heroes.
- In Max Brooks's World War Z, a Chinese youth is patient zero for a worldwide zombie epidemic.
- The 2006 television series Heroes features a super-powered man named Sylar who is described as "Patient Zero" of a genetic study into human evolution.
- In the TV series Mutant X, a hyper-advanced "new mutant" named Gabriel Ashlock is described as "Patient Zero", as he was the first to exhibit mutant abilities. Like Sylar in Heroes, Ashlock is the most powerful of all (but also the least stable).
- In the television show Numb3rs, Patient Zero was a concept used to find the origin of the spread of the Spanish Flu virus.
- Also in the television show The Outer Limits, the term Patient Zero was used to a describe a person allegedly responsible for an epidemic.
- In Stargate SG-1s The Fourth Horseman, Lt. Fisher who was infected with a plague meant to wipe out Earth was referred to as "Patient Zero".
- Chuck Palahniuk's 2007 book, Rant, is about a Patient Zero for rabies, called a superspreader.
- In Stephen King's The Stand, Patient Zero is a soldier who escapes with his wife and child from the military base where the superflu was created.
- In the film Dracula 2000, Dracula is referred to as the vampire Patient Zero.
[edit] See also
[edit] References
- Auerbach DM, Darrow WW, Jaffe HW, Curran JW. (1984) Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact. Am J Med. 76, 487-492 PMID 6608269
[edit] External links
- The Centers for Disease Control (CDC) use contact tracing & social network analysis to map recent TB outbreak from a patient zero in Oklahoma. See if you can spot Patient Zero on the network outbreak map.
- Letter to the New York Review of Books (vol. 35, no. 19, December 8, 1988) by Dr. Andrew Moss, Dept. of Epidemiology and International Health, San Francisco, regarding the Patient Zero myth.
