AIDS Adds to Epidemic History
Anne C. Roark’s article (Feb. 23), “AIDS Adds to History of Epidemics,” presents us with a picture of AIDS as no more than the most recent of a long line of epidemic diseases--leprosy (the Antonine plague of ancient Rome), cholera, syphilis, and, in our century, influenza and polio. Like these diseases, so Roark would have us think, acquired immune deficiency syndrome (1) is highly contagious, (2) is of unknown cause, and (3) produces the “need to mythologize disease” to explain the seemingly unexplainable.
This last citation comes from my colleague, Prof. George S. Rousseau of the UCLA English Department who has, according to Roark, done research “on the connections between medicine and literature.” Unfortunately, his commentary, as that of a number of other “experts” cited by Roark in her article, is closer to literature and mythology than to actual fact.
1--Unlike the cholera or smallpox epidemics of earlier centuries, AIDS is not “highly contagious.” On the contrary, as study after study has shown, it is difficult to transmit except by repeated sexual contact between male homosexuals or by IV drug abuse.
2--Roark cites Rousseau as saying, “If you look at what’s happening today with AIDS . . . and you look back (six centuries ago) and see what was happening with bubonic plague, it seems to me we aren’t so far ahead from previous eras, despite all our sophistication.”
This is simply untrue. Causative HTLV III (human T lymphocyte virus) has been identified and has yielded to one of the most focused and productive investigative efforts now mounted by the Center for Communicable Diseases. Epidemiologically, it is now generally held that the virus entered the United States from central Africa via Haiti. Effective treatment remains elusive, but the investigative methods needed for resolving that important problem are clear enough.
3--”One of the myths about epidemics,” says Rousseau, “is that there is somebody to blame--somebody is responsible.” And Roark goes further, discussing the “politics” of disease as if some sinister social group were legislating the quarantine of an innocent “scapegoat.”
Certainly, segments of the American public have been cruel and unsympathetic to AIDS victims, certainly we must do all we can to help these victims and to erase prejudice about them. But it is not correct to say that nobody is to blame. Like syphilis, but UNLIKE bubonic plague, influenza, or polio, AIDS can be traced to certain modes of human behavior. Ninety percent of all AIDS cases are contracted by either specific sexual acts or specific IV drug abuse.
The remaining 10%--recipients of blood transfusions, children of female AIDS patients, hemophiliacs--may well be regarded as mere “victims.” But when a specific effect follows from a particular cause, it is rather silly to talk about the scapegoat myth that “somebody to blame has to be found.”
JOSEPH K. PERLOFF MD
Los Angeles
Perloff is Streisand/American Heart Assn. Professor Medicine and Pediatrics at the UCLA School of Medicine.
