In the gay community it's being referred to as "pre-Rock" and "post-Rock."
Since the widely publicized announcement a month ago that actor Rock Hudson has AIDS-- acquired immune deficiency syndrome--the number of phone calls to Jeanette Shelly's Santa Ana office have tripled.
"The number of phone calls has been phenomenal," said Shelly, AIDS Project coordinator-investigator for the Orange County Health Care Agency.
"Ever since Rock Hudson made his announcement, there has been an increase in public awareness. It was there before, but it was submerged: People didn't want to accept the fact that the problem was out there."
Shelly said that the Health Care Agency's Special Disease Clinic, the nonprofit AIDS Response Program in Garden Grove and personal physicians also have been "bombarded" with phone calls.
"Yesterday alone," she said, "we had 10 calls from the public on the HTLV-3 antibody test, which detects antibodies to the AIDS virus. They want information: 'What is it (the test) and where do I get it?' "
Despite the increased public awareness about AIDS, Shelly said that many of the calls to her office reflect both an uninformed and misinformed public. And because the callers are either uninformed or misinformed, she said, "they're panicked.
"I've received several calls from people wanting to know if it is safe to go into a public swimming pool. Well, that's one of the safest (places) you could be because it has chlorine in it and bleach is felt to be one of the best disinfectants for killing the AIDS virus."
She has also received calls from people asking, "Can I send my kids to school this year?" and "Can I go to this health club; they have a lot of gays there."
She has even received calls from people who say they want to visit San Francisco or Laguna Beach and want to know if they can get the disease if a person with AIDS breathes on them.
"The most important thing to get across," Shelly said, "is that this is not a casually contagious disease, and it requires intimate contact to be spread. And it is not spreading rapidly into the general population."
Flurry of Inquiries
To keep pace with the flurry of calls, Susan Holley, Shelly's secretary, has had additional lines added to her phone.
Typical of some of the calls Holley has fielded is the one from a young woman in her early 20s who, Holley said, "was scared to death she was going to get AIDS because she had slept with a guy twice about a month ago."
The woman had since found out the man is bisexual and that he had stopped using intravenous drugs only three months ago. (Intravenous drug users, Shelly noted, are the second highest group of people considered to be at risk for getting AIDS. Gay or bisexual males are the highest at-risk group.)
"People," Shelly observed, "are starting to look at their life styles."
Since 1981, 12,599 cases of AIDS have been diagnosed in the United States and 6,338 people have died from it, according to the latest figures supplied by the federal Centers for Disease Control in Atlanta.
In addition, an estimated 500,000 to 1 million people nationwide have been exposed to the AIDS virus. All of those exposed do not necessarily die of AIDS, but they do have an increased risk of developing it. The incubation period ranges from about six months to five years. A CDC spokesman noted that out of the 500,000 to 1 million people who have been exposed to AIDS, "we believe only 5 to 20% will go on to develop AIDS."
As of late last week, 139 cases of AIDS had been diagnosed in Orange County, according to Shelly; of those, 78 have died. Orange County also has 80 cases of AIDS Related Complex (ARC), a combination of "clinical findings" and laboratory abnormalities that persist for at least three months and for which there is no other explanation. There also are 140 cases with AIDS Related Findings (ARF), which include yeast infections of the mouth, swollen lymph nodes in several parts of the body or a positive HTLV-3 blood test.
"Since January, Orange County has been averaging eight or nine new AIDS cases a month," said Shelly, former head nurse at the internal medicine clinic at UCI Medical Center, who assumed the newly created position of AIDS Project coordinator-investigator in February, 1984.
Shelly said her federally funded position was created in order to develop "active surveillance" (finding and reporting) of the growing number of cases of AIDS and ARC in Orange County. Orange County ranks third--behind San Francisco and Los Angeles--in numbers of AIDS cases in California.
In addition to surveillance, Shelly's job entails interviewing persons with AIDS and reporting her findings to the state Health Services Department and the CDC.
She also provides counseling to persons with AIDS and conducts educational lectures, primarily to health care workers and paraprofessionals, on topics such as AIDS and AIDS Related Complex, the epidemiology of the disease, infection-control precautions, blood testing and psychosocial issues.
Call From a Doctor
"I find my lectures have greatly improved our surveillance; now people call me with cases, which really helps," said Shelly, mentioning one doctor who attended one of her lectures and called her a week later to report that "we have our first one."
Although Shelly now frequently works 11-hour days to keep up with surveillance and requests for literature and lectures, a large portion of her time is spent on the phone answering questions from the public related to how AIDS is transmitted.
Using information provided by the U.S. Public Health Service, Shelly advises callers that:
- AIDS is transmitted primarily through sexual contact or through blood from a person who has AIDS. Most of the cases have been in homosexual and bisexual men.
- AIDS has been found in intravenous drug abusers, which has led investigators to suspect that AIDS is transmitted by blood on shared needles.
Other evidence for transmission of AIDS through blood products was found in the occurrence of AIDS in hemophilia patients receiving large amounts of Factor VIII, a clotting substance in blood.
Shelly noted that "only 2% of the (AIDS) cases nationwide have been transfusion-associated, and only 1% have been hemophiliacs, but now with the blood test to screen donors, the blood supply should no longer pose a risk to transmitting AIDS."
- No cases have been found where AIDS has been transmitted by casual or normal household contact with AIDS patients or persons in the high-risk groups. That includes casual contact such as touching or shaking hands and normal household contact such as using the same bathroom, cooking and sharing eating utensils with a person who has AIDS, according to Shellie Lengel, director of public affairs for the U.S. Public Health Service.
- Although the AIDS virus has been isolated in saliva and tears, the CDC reports that there have been no cases in which saliva or tears were shown to be the route of transmission.
- As for the possibility of mother's milk transmitting AIDS, Lengel said, "We have a case in Australia where mother's milk may be involved. But in babies, most of the cases have been transmitted before or during birth where (there is) blood-to-blood transmission."
- Despite a news report last April speculating that mosquitoes could be part of the reason Belle Glade, a rural southern Florida farming town, has the highest rate of AIDS in the world, the CDC reports that there is no epidemiological evidence that AIDS is transmitted by mosquitoes.
- Regarding cases of AIDS being found among heterosexual men and women, Lengel said, "We know that heterosexual partners of high-risk people have always been at risk so that the wife of a hemophiliac, the wife of a male intravenous drug abuser or the wife of a bisexual man will be at risk."
What is unclear, Lengel said, is whether women can pass the AIDS virus to men.
The CDC reports 14 cases of males having acquired AIDS through heterosexual contact. According to a CDC spokesman, "some may have gotten it from prostitutes, but we don't know how many."
Lengel said the increase in calls to health agencies and physicians since a spokesman for Rock Hudson announced that the star has AIDS is a nationwide phenomenon. But, she noted, a Gallup Poll released last week and conducted prior to the publicizing of Hudson's case shows that 95% of the people in the country know what AIDS is and most know how the disease is transmitted.
Explaining the flood of calls in the past month, Lengel said, "I think people are looking for reassurance, that's all."
Jeannette Shelly is hopeful that continued public education about the disease will ease the sense of panic based on lack of information.
"Some people you're never going to convince," she said. "But I've found that once people are informed, they tend to deal with it more rationally."
For further information about AIDS, call the AIDS Project office at (714) 834-2198 or the AIDS Response Program at (714) 534-3261.