



In a study published Wednesday in the journal Nature, researchers used newly available genetic evidence to show that Gaetan Dugas — who has been dubbed “Patient Zero” — could not have been the first person in the United States to have the virus that causes AIDS.  

For the record:
1:38 AM, Aug. 19, 2019 An earlier version of this article said that Gaetan Dugas was cleared of being “Patient Zero” in the U.S. AIDS epidemic more than 40 years after his death. It has been more than 30 years.





(Worobey et al. / Nature )


The men were participating in a study of hepatitis B, which was prevalent in the gay community at the time. They weren’t tested for HIV because it wasn’t known to exist back then. However, if any of them had it, there should be evidence in their blood in the form of antibodies, the proteins that our immune systems make to fight an infection. 



The presence of antibodies can show whether a person has contracted a certain virus, but they can’t provide much detailed information about the virus itself, Worobey said. So his group’s next step was to scour the serum samples for fragments of HIV RNA that may have been circulating in these men’s bloodstreams.



“It took a mixture of patience and insanity, but these old sequences are as good as a time machine,” Worobey said.



Imagine you are staring at a saguaro with a tall central column and a couple of branches curving up like arms. If you have just a single time point — now — it’s difficult to gauge the cactus’ age.



“That’s what we do with HIV molecular clocks,” Worobey said. 






“It appears that New York City was a key turning point,” Worobey said. “New York City acts as a hub from which the virus moved to the West Coast — and eventually to Western Europe, Australia, Japan, South America and other places.” 




“It always helps to nail it,” she said. 




“In short, we found no evidence that Patient Zero was the first person infected by this lineage of HIV-1,” they wrote.

So, how did this myth start? 



Dugas was placed near the center of this cluster, and identified as patient O for “Outside of California.” But when investigators numbered the cases according to the date when each patient’s symptoms started to appear, the letter O was mistaken for the number 0, and the Canadian flight attendant entered the literature with that dubious label.

In actuality, Dugas’ symptoms were not reported until 1979 and 1980, considerably later than other cases in the cluster. 

The medical community never released Dugas’ name to the public, but journalist Randy Shilts identified him in his 1987 book ”And the Band Played On” about the first five years of the American AIDS epidemic. (Shilts himself died of AIDS in 1994.)

Dugas told researchers that he averaged 250 sexual partners a year, and Shilts portrayed him as a vain and arrogant playboy who ignored doctors’ orders to stop having sex to keep his infection from spreading. Media reviewers took the idea of a villainous Patient Zero and ran with it.

“Despite attempts at clarification and protest then and since, many still believe the story today,” the study authors wrote.

While there are epidemiological benefits to knowing how an outbreak begins, the researchers say that doesn’t mean anyone is at fault.  

“Nobody should be blamed for the spread of a virus that nobody even knew about,” Worobey said.



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5:10 p.m.: This article was updated with information about the death of Randy Shilts, the journalist who identified Gaetan Dugas as “Patient Zero.”

This article was originally published at 10 a.m.