AIDS Patient Zero – InfoBarrel

Somewhere, there was a Patient Zero, the epidemiological well-spring from which this plague spewed forth.

“I’m Candy – Fly Me!”

Update note:Dr. Memory Elvin-Lewis, thank you so much for not only your contributions to science but to my humble efforts at disseminating it for general readership.  I truly appreciate it.

The airline industry developed glamour.  The titillation of a sexy stewardess in uniform, pandering to any business traveler’s ego, was priceless.  These were women without boundaries, women who went anywhere, anytime.  Therefore, they must be promiscuous.  The unspoken possibility of sex with a globe-trotting gal was also alluring.  Married women were aggressively discouraged from working as stewardesses.  The single women, all within a certain preferred range of body type, height, and attractiveness, were wanton women (in the minds of the average male of the day).  Although morbid obesity was not the problem in the 1940s it is today, there were no “big girls” on board.

The criteria for entry were pure sadism: one night only women might be allowed in; other times, a sloppily dressed man might be sent away while another, looking exactly like that man but “famous”, would be let in.  Gay-themed parties were held there often, and casual sex in the bathrooms and the “exclusive” privacy lounge was common among attendees.

Homophobia was so great by the late 1950s almost no airlines in the United States would hire men as flight attendants – even Eastern and Pan Am stopped hiring stewards.  Stewardesses, however, were very desirable.  They were marketed as young, beautiful, and sexually available–this was hardly an acceptable career choice for any he-man.  In the same way that the sexual orientation of male nurses was suspect, only “pansies” wanted to be stewards.

Certainly, the African-American teenager Robert Rayford (who had never been outside the city of his birth) was not Patient Zero, either – somebody had to give it to him in the first place.

Diverting conversations occurred between Rayford and his primary care givers when questioned about his sexual activities.  His doctors had not considered homosexuality initially, and all conversations, such as they were, seemed to be taken as referring to female sexual contacts.

Gaëtan Dugas fit right in with the gay community of the bath houses.  He was blond, voluble, and open.  Sex for him was a series of anonymous engagements, many times conducted hastily in bathroom stalls.  He took on whatever he felt like.  As well as many other men, he was developing what would become known as “The Clone Look”: close-cropped hair, largish but well-groomed mustache, muscle shirts, short shorts.  [The quintessential version of “The Clone Look” would be Freddie Mercury (rock band Queen’s lead vocalist who died of AIDS) after about 1981.] 

In America, the results of further research led to the conclusion that Gaëtan Dugas had not been the true “Patient Zero” after all.

Omega Man

Certainly it was not Gaëtan Dugas (though, like Typhoid Mary over half a century before him, many deaths could be placed squarely on his doorstep). 

Occasionally, medical mysteries initially thought solved are found later to have very different truths at their cores.

From a front-line perspective

Dugas, meanwhile, knew he was sick.  He didn’t know exactly what was wrong, but he had developed the skin lesions, associated with “gay cancer”.  But one can’t spread cancer, of course, because cancer isn’t contagious.  He indiscriminately continued having sex with men as his whims overtook him.  His “advantage” was his mobility – as a flight attendant, he might be in any part of the US, Canada, or the world on a moment’s notice.  His bitterness about having gay cancer crossed over into his lackadaisical attitude about possibly harming others.

The dubious distinction of being America’s “Patient Zero” – the first documented and verifiable case of AIDS in the country – belongs not to Dugas but to a mildly mentally retarded black teenager named Robert Rayford (born ca.

Less Than Zero

The very first air flight attendants (in the 1920s) were men.  These positions were desirable; the men who did these jobs executed their duties more like up-scale, futuristic train porters and ship stewards than as menials.  As with many professions in that era (especially in service jobs such as telephone operators, bank tellers, et al) the sky porters known as “stewards” were exclusively male.  World War I saw the shift from male to female telephone operators and bank tellers; with a dearth of male workers during World War II, employers turned to the fairer sex to fill their employment needs in the airline industry, too. 

In 1976, a Norwegian sailor, designated with the alias “Arvid Noe”, died; his wife and nine-year-old daughter died the next year of the same wasting disease.  In 1961, the 15-year-old Noe had sailed on his first voyage to Africa.  He worked a merchant vessel that plied along Africa’s west coast from mid-1961 to mid-1962; during this voyage he was treated for gonorrhea.  He sailed again to Africa in 1964, with a port of call in Kenya in eastern Africa.  In 1966, Noe started suffering from chronic joint pain and recurrent lung infections.  By 1968, he could no longer pass a physical to sail, so he worked as a long-haul truck driver. 

Tracing backward from Haiti (the source of the US strain in 1966) put the disease firmly in Central Africa. .  

Mr. 1952-1953).

Without a precise diagnosis, Rayford’s cause of death was attributed to the catch-all vagary “loss of vitality”.  Intractable fluid imbalance and lung disease were listed as contributors.  An autopsy revealed a surprise – his body carried a very rare cancer called Kaposi’s sarcoma internally (though he had but one external lesion on his right thigh).  [Today, this cancer and its lesions are bellwethers of AIDS.] 

Before Robert Rayford in the US, there was a possible case found in a dead Jamaican native named Ardouin Antonio.  He came to the US in 1927.  He was working as a shipping clerk for a clothier when he died at age 49 on June 28, 1959, in Manhattan.  He had developed a very rare kind of pneumonia, seemingly out of the blue.  Decades later the doctor who had performed Antonio’s autopsy was asked to re-evaluate the case.  Did he think Antonio possibly died of AIDS?  “You bet . Kramer was a writer in New York and a part of the gay culture.  He, however, decided that merely watching his friends die quietly wasn’t enough. 

Because of the baffling nature of his case, doctors preserved several tissue and blood samples for later evaluation.  In 1987, eighteen years after his death, molecular biologists at New Orleans’ Tulane University tested specimens of Rayford’s preserved blood and tissues.  Their findings were stunning: a virus “closely related or identical to” HIV-1 was detected.  Further confirmation testing in 1989  proved Robert Rayford (African-American teenage male of St. Louis City Hospital, then transferred to Barnes Hospital (now Barnes-Jewish Hospital) in St. . Louis. 

Air Canada

This virus, after much international wrangling for recognition of discovery (with a particularly aggressive and bombastic US virologist lobbying for a claim that he had found it first–he did not) was later named Human Immunodeficiency Virus or HIV. 

False Positive

Running Dugas to ground, however, was pointless.  At the time, there were no criminal laws penalizing the willful spread of a known fatal disease (since then, law changes allow charges of attempted and pre-meditated murder to be brought in many states against anyone who is HIV-positive purposefully engaging in unprotected sexual intercourse with an unwitting partner).

Concern for dying gay men was not paramount on America’s mind.  As more cases of the mysterious killer emerged, the name was changed from “gay cancer” to “gay-related immune deficiency” (GRID).  This, at least, was an open recognition that whatever was causing the disease was compromising a body’s immune system.  It didn’t explain, however, the rather esoteric choice of gay men (and soon discovered, IV drug users) by an unintelligent, non-sentient pathogen as victims.  It wasn’t until the first heterosexual cases of “gay cancer” emerged that the disease was examined more closely.

By the 1950s, this homophobia was rampant, and in the conservative times of Eisenhower and McCarthyism, men were slowly pushed out of the steward jobs.

Gay and straight partiers alike finally found their Valhalla, however, in New York City in a crummy little club in the 1970s called Studio 54.  This rat hole was converted into a hot spot known all over the world.  Celebrities fell all over themselves to get in and be seen there.  Its allure was its faux air of exclusivity.  No club before or since carried the cachet of Studio 54.  Co-founded and owned by a cabaret-style, (almost a caricature) flamboyantly gay man, Steve Rubell, and a straight-laced heterosexual lawyer, this kitschy club defined hipsters in the Seventies. 

AIDS in the United States was isolated in pockets of contagion until the promiscuity (homosexual or otherwise) of the 1970s gave the disease a clear path of propagation in humans.  IV drug use, on the rise in the 1970s and early 1980s, also provided another avenue of blood-exchange necessary for the virus to thrive. 

Rayford lived in a brownstone in a poor neighborhood in St. many cases of AIDS have been autopsied that we didn’t even know had AIDS.”

Dating America’s exposure to AIDS is irrelevant: AIDS is a global problem.  And continuing research has led to many more interesting facts about the spread of HIV.

The disease it spawned was rechristened, in light of its indiscriminate virology, to Acquired Immune Deficiency Syndrome or AIDS.  That same year that 248 cases of the disease were reported, local health departments in conjunction with the Centers for Disease Control (CDC) in Atlanta began investigating.

Of the 248 cases known before the detection of the virus, interviewing led to the shocking revelation that at least 40 AIDS victims had one thing in common: all had either had sex with a certain male, blond, gregarious Air Canada flight attendant, or they had sex with someone who did.  This networking connection was made in 1984, and it was critical – it meant medical and public health officials investigating the source of AIDS might have finally gotten the breakthrough they needed. 

The End of Days was seemingly at hand.

Instead, about the only thing that can be said of HIV is that its “Ground Zero” location was almost certainly Central Africa.  

Gay men realized the danger.  Many made the intuitive leap early that perhaps certain activities, such as anal intercourse, might be transmitting the causative agent.  Others flatly refused to believe that their lifestyles might be endangering the health of themselves and of others.  They felt it was a perceived backlash against gay men.  Higher-profile gay men (many closeted during their lifetimes) and activists within the gay community began dying as well as underground sub-culture members (the “Crisco, leather, and fisting” set).

On October 31, 1980 – ominously enough, Halloween night – the French-Canadian gay male steward Gaëtan Dugas visited a gay bathhouse for the first time on a layover in New York City.

Author’s note

Larry Kramer was actively and aggressively involved with what was then known as “gay cancer” in the early 1980s when the disease first made its poisonous presence visibly known in the United States as “gay cancer”. 

The term “velvet rope” came into existence then – a red velvet rope (as one might see in a museum keeping patrons at a safe distance from a particularly priceless exhibit) became the literal and symbolic barrier between the plebes on the street and the hipsters within.  Each night crowds gathered outside Studio 54’s doors; admission was granted whimsically by a group of door men and many times by Steve Rubell himself. 

There is an interesting correlation between homosexuality and the airline industry.  At least, there is a publicly perceived correlation as it pertains to airline flight attendants.

Gaëtan Dugas died in Quebec City, Quebec, Canada, on March 30, 1984, at the age of 31.  His cause of death was kidney-failure brought on by his weakened condition from an onslaught of infections and ailments from AIDS.

The teen seemed stabilized by late 1968 (when he was around 15 years old).  He had been transferred to Deaconess Hospital by then, and in March 1969, however, all of his symptoms reappeared and rapidly worsened.  His breathing labored; his white blood cell count (as part of routine blood work) was noted to have dropped dramatically.  The only thing concurred at the time was that Rayford’s immune system had been somehow compromised.  He developed a fever and died either in the late hours of May 15, 1969, or the early hours of May 16 (sources differ).  His primary physician recalled, “Eventually his entire body constituted almost one wave of hard lumps and watery swellings.”

As early as his 13th year or sooner, he was sexually active.  Beginning in 1966, he started having some physical problems that seemed chronic.  His legs swelled, and he developed sores on his genitals and body. 

Anal scarring also indicated repeated sexual penetration.

The discrimination in the labor market meant the United States Supreme Court had to step in and force airlines to hire male flight attendants.  This happened in 1971 after nearly 20 years of female-dominated service.  Even then, the Court’s decision forcing US airlines to hire men was greeted with derision in the press.  It also raised homophobic fears of placing men in such a servile and sexualized role. Doctors, helpless to find the cause of death for the Noe family, preserved some tissue samples.  In 1988, further testing showed Noe, his wife, and his daughter had all been HIV-positive

Grethe Rask was a Danish surgeon who had traveled to Zaire in 1972 to lend medical aid for the sick there.  She returned to Denmark in 1976 and became relentlessly ill.  Her symptoms confounded her colleagues.  She died in December 1977.  Several years later in 1984, it was confirmed through testing she was HIV-positive.  During her time in Zaire, it was known she was directly exposed to blood – it is believed this was the source of her infection.

But, it doesn’t end there. 

The Road to Zero

Meanwhile, as a symbolic sign of the coming Armageddon, Studio 54 was forced to close its doors for liquor license violations and tax evasion; entrepreneurs Steve Rubell and his business partner were sentenced to short terms of imprisonment.  [Rubell later died of AIDS.]

By April of 1982, 248 cases of the disease were reported nationwide with many others too afraid or indifferent to see a doctor.  A virus was isolated in 1983 by French scientists (as Europeans were also recognizing and treating patients with “gay cancer”, many of whom were decidedly not gay). 

This good person also kindly corrected some of the misinformation about Rayford via a personal e-mail and was also kind enough to forward professional papers on the subject.  One such paper, in Lymphology from 1973, gives, perhaps, the best clinical synopsis of the case.  Another article, entitled Documentation of an AIDS Virus Infection in the United States in 1968 (by the same doctor and others), is also a “must read” for anyone interested in the earlier origins of AIDS in America. 

Good investigative work requires dogged determination.  Running an enigma to ground can take years. 

In conjunction with Studio 54, other bars for gay men to frequent thrived.  Another meeting place was the bath houses still found in many larger cities.  Once serving the utilitarian function for neighborhood residents to bathe (considering most homes up until the late 1920s did not have indoor plumbing) these quaint reminders of The Good Old Days were social gathering places for gay men.  They were prevalent in New York City and in San Francisco.  [Bette Midler, a great favorite among gay men, got her start singing in gay bath houses; her piano player in those days was songwriter/musician Barry Manilow).

As further incentive to not hire men as flight attendants, the death of a gay steward in 1954 became a scandal sufficiently great to lead to a rash of “fag bashings” (both gay men and lesbians were targeted) in Miami, Florida.  It was one of the nation’s worst anti-gay outbreaks in history. 

Molecular research shows the AIDS epidemic of the 1980s stemmed from a viral strain that had entered the US via Haiti about 1966.  Other strains have been isolated as well.  As in cases like Robert Rayford’s, the disease died with him (though he probably infected others, those people likely did not have access to the sheer number of sexual partners that, for example, Gaëtan Dugas had, and died before spreading it much). 

In 1979, before Dugas was infected, a bisexual German concert violinist, Herbert Heinrich, died.  In 1989, after testing of medical samples from his body, it was learned he was HIV-positive. 

AIDS now had a face.

Of a most enlightening nature was Rayford’s adamant refusal of any rectal exams.  It seemed that he may have been exposed to homosexual activity (assuming the submissive role in anal intercourse).  One of his attending physicians believed that he had been a victim of sexual abuse (a very likely scenario considering Rayford’s socio-economic background).  He could also have been “pimped out” against his will by someone who procured males to engage with him.  To date, this aspect of his life is unclear.

For one gay man, however, being a steward was all he’d needed to satisfy both his wanderlust and his physical lust. 

This makes little sense. 

Gaëtan Dugas was a French-Canadian born February 20, 1953.  His life was on a collision course with history.  In 1972, Dugas first became sexually active.  [He would later claim he had over 2,500 sexual partners in his lifetime, whether all male is unknown.  He may have been bisexual.] 

Current scientific research is clear: sometime in the 1930s, a simian form of immunodeficiency virus mutated sufficiently and made the leap across species to become a contagious disease of people. . . It was so unusual at the time . It existed as “slim disease”; the condition was universally ignored though many Africans died after mysteriously wasting away.  In 1959, about the time the Manhattan Jamaican shipping clerk died of his rare pneumonia, a blood sample from a Congolese man was taken and preserved.  Years later, this proved to be HIV-infected.  This Congolese man’s fate is unknown (whether he developed full-blown AIDS and died from it or not).  Similarly, a preserved lymph-node biopsy specimen taken from a Congolese woman in 1960 later proved to be HIV-positive.

The direct lineage of HIV-1 was traced to two groups of mutations that formed in the primates that carried the simian version.  One of the groups was dated to between 1847 and 1907; another subgroup dated to between 1606 and 1871.  HIV-2 made the leap most likely between the date range of 1856 and 1922.  Thus, it can be seen some prototypical version of the AIDS virus can be dated to the early 17th century.

In the end one can see there is no modern-day “Patient Zero”.

Dugas remained unrepentant.  He originally denied that whatever disease it was he had could be transmitted sexually.  His own words on the subject: “Of course I’m going to have sex.  Nobody’s proven to me that you can spread cancer.”  His depraved indifference to his sexual partners’ well-being was summarized with “It’s their duty to protect themselves.  They know what’s going on out there.  They’ve heard about this disease.”  The last element of his bitterness was voiced by his wish to take others with him: “I’ve got gay cancer.  I’m going to die and so are you.” 

One such mystery concerned the AIDS epidemic in America.  As long as the killer remained comfortably within the gay community not much was done to investigate.  As soon as AIDS found its way into the heterosexual population, though, suddenly America’s interest in ferreting out the cause was paramount.  Panic stricken virologists and other epidemiologists worked feverishly to isolate the source of this sexually transmitted disease first endemic among homosexual men. 

Finally, in 1968, the boy was admitted to St. Louis, Missouri.  His mother’s name was Constance Rayford, and he had a brother named George.  Rayford was described as slender.  His retardation left him relatively uncommunicative from shyness. 

In his wake, one of the unfortunate legacies he left was a renewed homophobia relative to male flight attendants.  They became a lightning rod for America’s fear and anger over AIDS and its links with homosexuality.  “Patient Zero”, Gaëtan Dugas, was reviled; in death he was even accused of bringing HIV to North America and spreading it around the country.

Ground Zero

Dr. Memory Elvin Lewis

Dr. Memory Elvin-Lewis was kind enough to respond to this piece in person.

Both his wife and daughter developed an illness that mimicked his symptoms, and they died in 1977. Louis, Missouri) was the earliest confirmed victim of AIDS in North America.

A strange disease lurked among the gay denizens and creepers of the bath houses, though.  Men began dying of pneumonia and other respiratory illnesses, but only after drastically losing weight and developing horrific skin lesions on their faces, necks, backs, and chests.  This disease became known in the gay community as “gay cancer”.  It was particularly volatile, and it progressed rapidly.  Dugas caught it early, possibly with his first encounter in the New York gay bathhouse on Halloween 1980.

This doctor handled, and talked with (though reported as largely uncommunicative), Robert Rayford personally for a period during Rayford’s confinement, and also attended Rayford’s autopsy, confirming the KS diagnosis and noting the preservation of tissue samples that later were shown to carry the variant of the HIV-1 virus.

Dugas may have personally, and directly, been responsible for dozens of AIDS cases (and no telling how many more indirectly), but he did not bring AIDS to the US, nor was he the first confirmed AIDS victim.  As noted, several California men and some Haitian immigrants were found later to have succumbed to the disease before Dugas.

His first months in the hospital were spent with his doctors cutting back on his water and salt intake, and they wrapped and raised his legs, all to cut down on his tissue’s swelling.  Despite this, the inflammation moved up his body and into his lungs.  Antibiotics were tried in varying dosages, but Rayford’s condition continued to deteriorate. 

And the real Patient Zero – the HIV-Adam or HIV-Eve – lived and most likely died there, somewhere in the Congo, unknown and unrecognized for the catastrophic role he or she would play in human history. 

Noe’s condition stabilized, but then flared up again in 1975 (coincidentally the same year a strange disorder called “slim disease” was reported in Africa for the first time, the beginnings of epidemic AIDS).  In addition to the respiratory condition and joint pains he developed motor skill problems and dementia before he died. 

He wrote myriad articles on the subject and penned a stage play, “A Normal Heart”, that did well.  In May 2014, this stage play was brought to the small screen.  It was presented as a movie on HBO starring Jim Parsons (of “Big Bang Theory” TV fame).  The story documented the earliest days of the AIDS epidemic in America told from the perspective of the New York City/Fire Island cohort.  It is engaging: it is what TV can do (but usually fails to do except in rare cases like this one).

The Greek letter “?” always refers to the end of an event or series, not its beginning.  Dugas was “Patient Zero”, not “Patient ?” – if the intent was to use such a Greek designation, he would have been named “Patient Alpha” (“?” or “?”)  for “the beginning”.  It is known that Dugas from the earliest investigations, based on diagrams the CDC (and others) created interlinking sexual contacts among those diagnosed with or dead from the mystery disease, was referred to from the start as Patient Zero (not Omega or “O”).

There is an apocryphal story that Patient Zero was really Patient “O” (as in the 15th letter of the English alphabet, first letter of the word “Omega” for the last letter of the Greek alphabet, ?).  Furthermore, it was alleged that a journalist misinterpreted the “O” (for “?”), and instead wrote up his report, referring to the AIDS’ source as “Patient 0″ [“zero”] instead.

The music scene was fueled by this gay celebration, none more blatantly than by a vocal group of disco hustlers calling themselves “The Village People”.  They dressed in favorite and stereotypical gay icon costumes – a policeman, a construction worker, a cowboy, a gay biker, and a Native American.  They were hugely successful for a short time with big sellers “In the Navy” and “YMCA”.  More subtly, Donna Summer performed her brand of dance music that was embraced by the gay community as was she.

First denying he was sick, he later willfully and maliciously spread the disease to unsuspecting partners.  After having casual sex in a darkened room once, a male interviewee later reported he had turned on a light in the room where Dugas lay naked on a bed.  This man spotted the lesions (Kaposi’s sarcoma) that were the classic earmarks of “gay cancer” on Dugas’ chest.  When he remarked upon it, Dugas replied sardonically, “It’s gay cancer.  Maybe you’ll get it.”

Almost any medical professional worth his or her license, whenever a patient dies of a strange ailment, takes the precaution of preserving tissue and blood samples for future research.  It is extremely fortunate that some doctors going all the way back to the late 1950s had been so far-sighted.  Working backward and re-examining suspicious or otherwise unresolved deaths from contagion globally proved enriching in piecing together the history of AIDS. 

A year earlier, a Portuguese man known only as Senhor José died under mysterious circumstances.  He was treated at the London Hospital for Tropical Diseases to no effect.  In later years, examination of preserved tissues verified he died of AIDS; the causative virus, HIV-2 was present, making him the first known confirmed victim.  Genetic research on the virus indicated he probably contracted the disease in 1966 in Guinea-Bissau (on the northwest coast of Africa).  Three gay men in California and six Haitian immigrants to the United States were later confirmed as AIDS victims from that same year.

Gateway to the West

He led doctors to believe any of his sexual activities were strictly heterosexual, even claiming at one point to having a girlfriend (who failed to surface at the time).  [This female was found some time later and was found to be in perfect health, relative to HIV and AIDS, from which one can only surmise she and Rayford had no intimate sexual intercourse or such activities were rare enough she was not exposed to critical levels by whatever ailed him.]

***

He had a chlamydia infection (a bacterial venereal disease), clearly indicating he was sexually active.  His doctors also uncovered evidence of the herpes simplex virus and the virus responsible for Epstein-Barr.  Robert Rayford was not terribly forthcoming with his doctors, partly due to his retardation leaving him mostly uncommunicative, but also because he was embarrassed by something.

The commercial airlines recognized the goldmine presented by hiring female “stewardesses”.  Certainly, they were paid less.  There was also marketability in women that men did not have – women could be hawked by an airline as possible sex partners for the discriminating male traveler choosing its service over another.

The music was disco, the dance beat adapted from gay men and their party scene.  The mock S&M dance moves, the sweaty bodies, the throb of the music, the drugs consumed, and the fact that not just anyone could get in heightened its allure.

He was admitted with multiple, and strange, symptoms (given his tender age).   The swelling in his legs was bothersome, his genitals and legs were covered in scrofulous skin, and his testicles were severely swollen.  He was also emaciated (having lost much weight suddenly), and even though he was an African-American male he was considered “pale”.  He also had shortness of breath.  His symptoms led his caregivers at Barnes Hospital to conclude that one of his problems was lymphedema (a swelling caused by lymphatic problems).  This was only a tiny part of his health issues, however.

The hedonism of the 1970s raged unchecked, and by the middle of the decade “gay” culture became pop culture.  Gay male partiers in the mid 1970s found an outlet on New York’s Fire Island.  Gay men rented time-share space in houses on the island and partied their summers away “in season”. 

Thus, by the late 1940s male flight attendants were not only undesirable, they were suspect as well.  Occupying a job with women that devoted itself to customer service, good manners, and fine grooming, the stewards garnered suspicions of being “queer”.

He started out as a hairdresser.  Wanting to travel, this French-speaking Canadian learned that flight attendants for Air Canada had to be bi-lingual.  He moved to Vancouver and learned English to qualify for the job.  He found work as a flight attendant on Air Canada.  This career choice allowed him the freedom to move around the world, visiting exotic locales, and meeting many strange men for anonymous sexual encounters.  In 1977, he was legally married in Los Angeles, California, in an illegal attempt to gain United States citizenship.

Years later, once medical science, and particularly genetics testing, had reached a greater level of technological advance, a revision of the “Patient Zero” findings of 1984 seemed necessary.  What was learned by later research was both fascinating and horrific simultaneously.  It turned out, HIV had not only been in the world for over a century, but it had been in the United States as early as 1966. 

Gaëtan Dugas, the narcissistic and embittered flight attendant, alternately feeling morose and spiteful about his condition, was given the code name “Patient Zero”, the source of the AIDS epidemic in North America. 

AIDS is what defined the decade of the 1980s, a decade that lived in fear beneath the penumbra of a certain and tortuous death from a highly communicable pathogen.

Make Bets That Assure You A Win

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By: Pedro Walker

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The Best Casinos for Blackjack in Las Vegas

With small decks, you’ll probably be seeing the better odds of 3:2, more and more, you’ll start to see rates of 6:5. This means if you hit a blackjack and your bet is $10 you’ll be paid $15 at a table with a 3:2 payout, but you’d win just $12 at a 6:5 paying table.

Player’s cards are cards offered at many casinos to gamblers who want to earn perks when they play. It has one of the highest concentrations of quality casinos and entertainment in the city. Many tourists never leave it during their stay.

The odds in blackjack vary as much by casino as they do by table. Some casinos use 8 decks and a shuffling machine to increase the house odds (or casino’s odds) and to make card counting almost impossible. What is the strip? It’s about a 4 mile stretch of a street on Las Vegas Boulevard South.

If you’ve heard of Las Vegas, then I’d bet you’ve heard of the strip. Depending on how much money you play with, you can earn quite a bit of complimentary gifts and discounts at restaurants, stores and theatres.. Other Las Vegas casinos play with just one deck with small bets to attract players

PGA golf betting odds for players to win the 2016 RBC Heritage

He has 21 PGA Tour wins including a shocker last year at the 2015 Wyndham Championship at age 51.

Notables

Carl Pettersson from Sweden won the RBC Heritage in 2012. Then a number of notable golfers are also listed with comments who have much higher odds this week to win the 2016 RBC Heritage.

After being the low amateur at the Masters and tying for 21st place overall, Bryson DeChambeau is turning pro for the 2016 RBC Heritage.Not many golfers win their pro debuts and this guy should be higher than 66 to 1 odds this week.

T-13. He missed the cut last week but improvement is expected this week.

Stewart Cink – 150 to 1 odds

Davis Love III – 250 to 1 odds

Brian Gay won this tournament in 2009. He has four career PGA Tour wins but his last win was in 2013. He does have 13 European Tour wins but his last win was in 2014.. Snedeker also won this tournament in 2011.

T-10. Brandt Snedeker – 20 to 1

The 2016 RBC Heritage golf tournament on the PGA Tour is taking place this week from April 14-17, 2016, at the Harbor Town Golf Links at the Sea Pines Resort on Hilton Head Island, South Carolina. Bill Haas, Justin Thomas – 33 to 1 odds each

Boo Weekley – 140 to 1 odds

Aaron Baddeley – 140 to 1 odds

Brandt Snedeker tied with Jason Day last week in 10th place at the Masters. The rest of these golfers at 50 to 1 odds each did not play last week in the major.

Kevin Kisner tied for 37th place at the Masters last week. Tony Finau won for the first time on tour on March 27, 2016 at the Puerto Rico Open, an alternate PGA Tour event. In his last start, Brian missed the cut at the Valspar Championship over a month ago.

Aaron Baddeley won the RBC Heritage in 2006. Fitzpatrick has a lot of talent and he won his first pro tournament last October at the 2015 British Masters on the European Tour. Prior to The Masters, Jason Day won the Arnold Palmer and the WGC Match play in back-to-back weeks but he took a week off before the Masters. Baddeley missed the cut at Houston two weeks ago in his last start. Snedeker has eight PGA Tour wins including his latest win which was at the 2016 Farmers Insurance Open in early February. That was the last of his five PGA Tour wins. He’s a tough bet here at only 25 to 1 odds.

Justin Leonard won this tournament in 2002. Boo Weekley won the RBC Heritage in back-to-back years in 2007 and 2008. Matt Kuchar, Zach Johnson – 22 to 1 odds each

Good luck to all the PGA golfers and especially the bettors this week at the 2016 RBC Heritage!

Graeme McDowell won the RBC Heritage in 2013. He’s 32 years old and his only PGA Tour win came last November in the RSM Classic. Branden Grace missed the cut at the Masters last week but the 27 year old has seven European Tour wins including the 2016 Qatar Masters in January. Paul Casey – 16 to 1

Paul Casey tied for 4th at Augusta last week and now he’s the second choice in the betting odds to win this week at 16 to 1. Jason Dufner, Charles Howell, Charley Hoffman, Tony Finau, Luke Donald, Graeme McDowell – 50 to 1 odds each

T-8. If Jason Day falters this week this kid could win.

Bill Haas tied for 24th last week at the Masters. He’s 44 years old and he has six wins on the PGA Tour with his last win coming in 2009 at The British Open for his only career major.

4. Kuchar has seven PGA Tour wins but his last win was in the RBC Heritage in 2014. Billy Horschel, Branden Grace, Kevin Na – 40 to 1 odds each

7. Kevin Kisner – 25 to 1

1. He’s a talented golfer but he never wins. Davis Love III (1987, 1991, 1992, 1998, 2003) holds the record for most wins in the tournament with five followed by Hale Irwin (1971, 1973, 1994) with three wins. He has 12 PGA Tour wins. Haas has six PGA Tour wins with his last win coming in January of 2015. Pettersson has missed the cut in his last two PGA tournaments.

3. Matthew Fitzpatrick – 30 to 1

Kevin Na has now played in 312 PGA events and he only has one win. Justin Leonard is 43 years old and he has 12 PGA Tour wins but his last win was in 2008.

Matt Kuchar tied for 24th at the Masters. Billy Horschel tied for 17th at the Masters last week which is not bad but Horschel only has three tour wins and his last win was at the Tour Championship in 2014.

Davis Love III holds the record for most wins in this tournament with five but his last win here was in 2005. Charles Howell has two wins on tour in 463 starts. Justin Thomas tied for 39th at the Masters. He’s got three PGA Tour wins but his last win was in 2011.

After a 10th place tie in the Masters last week, Jason Day is still ranked as the #1 golfer in the world and he’s the fairly heavy favorite to win the 2016 RBC Heritage at betting odds of 5.5 to 1. He’ll win this week if he’s back to his previous form but is 5.5 to 1 odds worth the risk?

Bryson DeChambeau – 66 to 1 odds

Listed below are all the PGA golfers with odds of 50 to 1 or less with comments. Boo made the cut in his last two tournaments but he was no threat to win either time.

Young 21 year old Matthew Fitzpatrick from England tied for 7th at the Masters earning himself a return trip next year. Jason Day – 5.5 to 1 odds

Luke Donald is a fomer #1 ranked golfer but he’s not won a tournament since 2012. Davis tied for 42nd last week at the Masters. Charley Hoffman tied for 29th at the Masters last week. The big news for the 2016 RBC Heritage is that Jason Day is in the field and he is easily the highest ranked golfer here this week.

Carl Pettersson – 225 to 1 odds

6. Zach Johnson has not won since capturing his second major at the 2015 British Open last July.

Justin Leonard – 175 to 1 odds

2. He missed the cut last week as did Jason Dufner. Here is a list of the betting odds for the PGA golfers to win the 2016 RBC Heritage golf tournament.

The RBC Heritage golf tournament dates back to 1969 when Arnold Palmer won the inaugural event. Paul Casey has only won once on the PGA Tour back in 2009. Thomas is 22 years old and he won for the first time on tour last November in the 2015 CIMB Classic.

Stewart Cink has wins in this tournament in both 2000 and 2004. Weekley also won at Colonial in 2013 for three career PGA Tour wins

Casinos 101- How to Avoid Being Ripped Off

The idea of cheating is likely as old as mankind, but some people/places have taken it to extremes. There are so many things going on behind the curtain that it would amaze you. Believe it or not, I once had a dealer tell me first hand that 50% of the people dealing at that establishment were card mechanics. The casinos have mastered this art of deception from what I have seen. Large corporations build these huge fortresses with one thing in mind, taking your money. If that doesn’t alert you, nothing will. However, take a walk inside that world, and you will know first hand that those public policies are crap. Their public policies for customer protection look great from a distance. So, for those who want to know, here is a list of things to watch out for when you are headed to any casino.

. Look carefully at the picture to your right for a perfect example of what some one once used

PGA golf betting odds for players to win the 2016 Dean & DeLuca Invitational

Don’t be fooled, though, as Kuchar also finished 3rd at the Players but that is not winning. Chappell is lower odds here because he finished alone in 2nd place at the Players in his last start. Players like Phil Mickelson, Lee Trevino and Zach Johnson are tied for the second most wins with two each.

T-13. At age 32, Kevin Kisner has one career win and he missed the cut in his last two starts. Nuff said. Matt Kuchar – 14 to 1

T-17. While the meltdown is not a good sign, Jordan Spieth did miss the cut the week before at the Players in his first start since the Masters so he is rounding into form and he did tie for 2nd place in this tournament last year.

T-19. Scott won this tournament in 2014 beating Jason Dufner in a playoff. Jordan Spieth – 6 to 1. Chris Kirk, Charl Schwartzel – 35 to 1 odds each

At odds of 6 to 1, Jordan Spieth is the betting favorite this week to win the 2016 Dean & DeLuca Invitational. On top of that, Bohn suffered a heart attack during the Honda Classic back in February. Colt Knost, Tony Finau, Marc Leishman, Kevin Kisner, Patton Kizzire – 50 to 1 odds each

Since winning the Texas Open for his 4th PGA Tour win on April 21st, Charley Hoffman finished 11th at the Zurich Classic, missed the cut at the Players and finished tied for 12th last week at the Byron Nelson. He’s a mild threat here to get his 6th PGA win here. Patrick Reed has finished alone in 2nd place three times this season but has not won a tournament since January of 2015.

T-11. Kevin Chappell – 28 to 1

Jason Dufner has a win in 2016 and he’s finished second in this tournament twice in the past (2012, 2014). Charl Schwartzel tied for 58th place last week but that was his first tournament since he missed the cut at the Masters. Ryan Palmer missed the cut last week. Kevin Na, Louis Oosthuizen, Patrick Reed, Jim Furyk – 33 to 1 odds each

Listed below are the betting odds and comments for each player who has odds of 50 to 1 or less to win this week. Zach Johnson – 22 to 1

Other than a 5th place finish at the Arnold Palmer in March, Zach Johnson has not played well enough to win in 2016. Kirk missed the cut in his last start at the Players. Schwartzel won the Valspar Championship in March and he could play well this week.

Bill Haas tied for 43rd place last week. That was the last of his three PGA Tour wins.

Matt Kuchar shot -14 under last week to finish alone in 3rd place at the Byron Nelson. Patton Kizzire is 30 and still looking for his first PGA Tour win.

Boo Weekley – 80 to 1 odds

David Toms won this tournament in 2011. Jordan Spieth was in position to win last week at the Byron Nelson playing with Brooks Koepka in the final pairing Sunday just two strokes back but Spieth shot a 74 and ended up tied for 18th place. Adam Scott has two wins in 2016 and 13 total wins on the PGA Tour. Toms has 13 career PGA Tour wins including a major but he’s not won a tournament since 2011.

6. He has three PGA Tour wins but his last win was in 2010.

4. Adam Scott – 11 to 1

5. He’s a big threat this week to win.

At age 29, Kevin Chappell is still looking for his first PGA Tour win. Zach Johnson does have two wins in this tournament (2010, 2012).

2. Matt Kuchar has not won a PGA Tour event in over two years now and he should be higher odds to win this week.

The Dean & DeLcua Invitational dates back to 1946. In his last four tournaments he’s failed to crack the top 25 and he finished last week tied for 66th. But Jason Bohn did finish tied for 2nd in this tournament last year just one stroke off the lead.

Good luck to all the PGA golfers and especially the bettors this week at the 2016 Dean & DeLuca Invitational at Colonial in Fort Worth, Texas!

Colt Knost is 30 and he’s yet to win on tour but he tied for 3rd at the Players and was 4th last week in his last two starts. Then a few notable golfers with much higher odds are listed along with comments why.

The 2016 Dean & DeLuca golf tournament on the PGA Tour is taking place this week from May 26-29, 2016, at the Colonial Country Club located in Fort Worth, Texas. Ben Hogan holds the record for most wins in the tournament with five. Marc Leishman has one career win in 188 starts. He won the Puerto Rico Open for his first career win at the end of March. Could he win again this year? Maybe, but who wants to bet on it?

Jason Bohn – 100 to 1 odds

T-7. Jimmy Walker, Brandt Sendeker, Danny Lee, Jason Dufner – 40 to 1 odds each

3. Charley Hoffman – 25 to 1

Adam Scott finished tied for 12th at the Players two weeks ago in his last start. Bill Haas, Ryan Palmer – 45 to 1 odds each

Notables

1. Louis Oosthuizen’s lone PGA win remains the 2010 British Open and he missed the cut last week.

Jason Bohn only has two career wins and his last win was in 2010 and he’s missed the cut in his last three PGA Tour starts. Tony Finau tied for 12th last week. Jim Furyk has one win on tour since 2010 and he’s making just his third start back after wrist surgery. Haas has six PGA Tour wins and he was second at the Valspar in March so he’s a mild threat to win this week. Brandt Snedeker has missed the cut in his last two starts and in three of his last four tournaments but he did tie for 2nd place here last year just one stroke off the lead.

Chris Kirk is the defending champion in this tournament but that was the last of his four PGA Tour wins. Chappell also finished alone in 2nd place at the RSM Classic and the Arnold Palmer this season so he’s been close to winning but he’s still a maiden on tour.

Boo Weekley won this tournament in 2013. Danny Lee has one win on tour and he finished tied for 18th last week. After missing the cut in his two previous starts, Jimmy Walker tied for 24th last week. Here is a list of the betting odds for the PGA golfers to win the 2016 Dean & DeLuca Invitational.

Kevin Na has one career win in 314 starts

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How the Sports Betting Line is Made by RJ Bell

What Is the Line Trying to Accomplish?

The opening line is the first line created by the oddsmakers, which is then sent out to sportsbooks.

There is a common misconception that point spreads represent the oddsmakers’ prediction of how many points the favorite will win by.

For example, if the pointspread on a game is 7 and most of the money is coming in on the underdog (taking the +7), sportsbooks will then move the number down to 6 ½ to try and attract money on the favorite.

“You either have a passion for it or you don’t,” Seba said. Stated another way, they want to create a line that half the people find appealing to bet one way while the other half find it appealing to bet the other way (known as ‘dividing the action’).

How the Opening Line Is Made

Oddsmakers at LVSC are professional sports junkies who love what they do and would probably do it for nothing if you asked them, but they do get paid for it. Reasons for such adjustments include:

Divided action means the sportsbook is guaranteed a profit on the game because of the fee charged to the bettor (called juice or vig – typically $11 bet to win $10). By necessity their approach is very research-oriented and concise, since with millions of dollars at risk there is little margin for error.

Since the oddsmaker’s ultimate goal is equally dividing the betting action, public perception and betting patterns must be taken into account. Of course there is an entire method to the madness on how the opening line is created. In our extended interview, Seba explained that there are 4-5 oddsmakers assigned to make lines for each of the major sports (pro & college football and basketball; MLB, NHL, boxing, golf). By moving the line, sportsbooks can influence how the public bets on a particular game. The power ratings are adjusted after each game a team plays.

“The #1 thing for us is to make a line for each game that creates good two-way action.

“The main objective is that our clients get equal action on both sides,” Seba said. Examples of non-game factors that would require an adjustment to a team’s power rating are key player injuries and player trades. Las Vegas Sports Consultants (LVSC) is the world’s premier oddsmaking company and the most respected authority on making the lines. Also, adjustments are made after reading each team’s local newspapers to get a sense of what the coaches & players are thinking going into the game.

A round-table discussion among the 4-5 oddsmakers involved in making the line for each sport is then conducted and a consensus line is decided upon by the Odds Director before it is released to the sportsbooks.

RJ Bell

©Pregame.com 2006

Website: http://www.Pregame.com

Once a game’s power rating based pointspread is determined, the oddsmaker will make adjustments to that line after considering each team’s most recent games played and previous games played against that opponent. Oddsmakers have to determine if any changes are necessary and send out an “adjusted line.”

Why the Line Changes

Contributed by:

Moving the line is the oddsmaker’s effort to balance betting action, and often times such moves can have a major impact on a bettor’s decision. If we’ve done that, we’ve done our job.”

Individual books having players who consistently bet with certain tendencies (such as an extreme bias toward favorites or toward a certain popular team like USC)

Once betting begins, sportsbooks can adjust the line at any time. Each of these oddsmakers bring unique opinions, strengths and weaknesses to the process.

Power ratings are the oddsmaker’s value of each team and are used as a guide to calculate a “preliminary” pointspread on an upcoming game.

Experts working for the individual books having a strong opinion on the game . Obviously, if the line comes out a week ahead of the event (which is the case in football), there is much that could happen during the week leading up to the event that could affect the line. We do this by drawing from past experiences and applying them to current situations. “We’re not trying to pick the team that covers the spread, we’re trying to make it a coin flip, a tough decision (for the bettor).

Oddsmakers can also change the line depending on various event-related factors such as player injuries or weather. People think it’s much more complicated, but it’s not.”

The last step in the line-making process for each oddsmaker is taking one final look to determine whether or not the line “feels right.” This is where common sense and past experience with how games are bet enters into the picture. That is not the case at all – their intent is NOT to evenly split the ATS result between the teams; rather, their goal is to attract equal betting action on both sides. In doing so they attempt to make more attractive the team that is getting less action. Of the 4-5 oddsmakers, generally the 2 most respected opinions are weighed more heavily by the Odds Director before he decides on the final line. This usually includes having up-to-date power ratings on each team. Seba explained that it all starts with each oddsmaker creating a line on each game based upon their own personal approach.

The purpose of these adjustments, like all line adjustments, is to more equally divide the betting action. For example, the public might have heavy betting interest week after week on a popular college football team such as USC. If an oddsmaker comes up with a preliminary line of USC -7, then an adjustment up to -7.5 or -8 would be made in response to the public’s expected USC bias.

Once the opening line is released by LVSC, the individual sportsbooks decide if they want to make any adjustments before offering it to the public. Mike Seba is a Senior Oddsmaker at LVSC and has been making lines for the last six years

The Best Casinos for Blackjack in Las Vegas

It has one of the highest concentrations of quality casinos and entertainment in the city. With small decks, you’ll probably be seeing the better odds of 3:2, more and more, you’ll start to see rates of 6:5. Other Las Vegas casinos play with just one deck with small bets to attract players. What is the strip? It’s about a 4 mile stretch of a street on Las Vegas Boulevard South.

Player’s cards are cards offered at many casinos to gamblers who want to earn perks when they play. Many tourists never leave it during their stay.. Some casinos use 8 decks and a shuffling machine to increase the house odds (or casino’s odds) and to make card counting almost impossible. This means if you hit a blackjack and your bet is $10 you’ll be paid $15 at a table with a 3:2 payout, but you’d win just $12 at a 6:5 paying table.

If you’ve heard of Las Vegas, then I’d bet you’ve heard of the strip. Depending on how much money you play with, you can earn quite a bit of complimentary gifts and discounts at restaurants, stores and theatres.

The odds in blackjack vary as much by casino as they do by table

AIDS Patient Zero – InfoBarrel

Kramer was a writer in New York and a part of the gay culture.  He, however, decided that merely watching his friends die quietly wasn’t enough. 

Dugas remained unrepentant.  He originally denied that whatever disease it was he had could be transmitted sexually.  His own words on the subject: “Of course I’m going to have sex.  Nobody’s proven to me that you can spread cancer.”  His depraved indifference to his sexual partners’ well-being was summarized with “It’s their duty to protect themselves.  They know what’s going on out there.  They’ve heard about this disease.”  The last element of his bitterness was voiced by his wish to take others with him: “I’ve got gay cancer.  I’m going to die and so are you.” 

In 1979, before Dugas was infected, a bisexual German concert violinist, Herbert Heinrich, died.  In 1989, after testing of medical samples from his body, it was learned he was HIV-positive. 

The dubious distinction of being America’s “Patient Zero” – the first documented and verifiable case of AIDS in the country – belongs not to Dugas but to a mildly mentally retarded black teenager named Robert Rayford (born ca. It existed as “slim disease”; the condition was universally ignored though many Africans died after mysteriously wasting away.  In 1959, about the time the Manhattan Jamaican shipping clerk died of his rare pneumonia, a blood sample from a Congolese man was taken and preserved.  Years later, this proved to be HIV-infected.  This Congolese man’s fate is unknown (whether he developed full-blown AIDS and died from it or not).  Similarly, a preserved lymph-node biopsy specimen taken from a Congolese woman in 1960 later proved to be HIV-positive.

Rayford lived in a brownstone in a poor neighborhood in St. many cases of AIDS have been autopsied that we didn’t even know had AIDS.”

Grethe Rask was a Danish surgeon who had traveled to Zaire in 1972 to lend medical aid for the sick there.  She returned to Denmark in 1976 and became relentlessly ill.  Her symptoms confounded her colleagues.  She died in December 1977.  Several years later in 1984, it was confirmed through testing she was HIV-positive.  During her time in Zaire, it was known she was directly exposed to blood – it is believed this was the source of her infection.

Air Canada

The airline industry developed glamour.  The titillation of a sexy stewardess in uniform, pandering to any business traveler’s ego, was priceless.  These were women without boundaries, women who went anywhere, anytime.  Therefore, they must be promiscuous.  The unspoken possibility of sex with a globe-trotting gal was also alluring.  Married women were aggressively discouraged from working as stewardesses.  The single women, all within a certain preferred range of body type, height, and attractiveness, were wanton women (in the minds of the average male of the day).  Although morbid obesity was not the problem in the 1940s it is today, there were no “big girls” on board.

Gaëtan Dugas was a French-Canadian born February 20, 1953.  His life was on a collision course with history.  In 1972, Dugas first became sexually active.  [He would later claim he had over 2,500 sexual partners in his lifetime, whether all male is unknown.  He may have been bisexual.] 

The term “velvet rope” came into existence then – a red velvet rope (as one might see in a museum keeping patrons at a safe distance from a particularly priceless exhibit) became the literal and symbolic barrier between the plebes on the street and the hipsters within.  Each night crowds gathered outside Studio 54’s doors; admission was granted whimsically by a group of door men and many times by Steve Rubell himself. 

From a front-line perspective

There is an apocryphal story that Patient Zero was really Patient “O” (as in the 15th letter of the English alphabet, first letter of the word “Omega” for the last letter of the Greek alphabet, ?).  Furthermore, it was alleged that a journalist misinterpreted the “O” (for “?”), and instead wrote up his report, referring to the AIDS’ source as “Patient 0″ [“zero”] instead.

The very first air flight attendants (in the 1920s) were men.  These positions were desirable; the men who did these jobs executed their duties more like up-scale, futuristic train porters and ship stewards than as menials.  As with many professions in that era (especially in service jobs such as telephone operators, bank tellers, et al) the sky porters known as “stewards” were exclusively male.  World War I saw the shift from male to female telephone operators and bank tellers; with a dearth of male workers during World War II, employers turned to the fairer sex to fill their employment needs in the airline industry, too. 

As early as his 13th year or sooner, he was sexually active.  Beginning in 1966, he started having some physical problems that seemed chronic.  His legs swelled, and he developed sores on his genitals and body. 

He wrote myriad articles on the subject and penned a stage play, “A Normal Heart”, that did well.  In May 2014, this stage play was brought to the small screen.  It was presented as a movie on HBO starring Jim Parsons (of “Big Bang Theory” TV fame).  The story documented the earliest days of the AIDS epidemic in America told from the perspective of the New York City/Fire Island cohort.  It is engaging: it is what TV can do (but usually fails to do except in rare cases like this one).

Good investigative work requires dogged determination.  Running an enigma to ground can take years. 

One such mystery concerned the AIDS epidemic in America.  As long as the killer remained comfortably within the gay community not much was done to investigate.  As soon as AIDS found its way into the heterosexual population, though, suddenly America’s interest in ferreting out the cause was paramount.  Panic stricken virologists and other epidemiologists worked feverishly to isolate the source of this sexually transmitted disease first endemic among homosexual men. 

Gaëtan Dugas fit right in with the gay community of the bath houses.  He was blond, voluble, and open.  Sex for him was a series of anonymous engagements, many times conducted hastily in bathroom stalls.  He took on whatever he felt like.  As well as many other men, he was developing what would become known as “The Clone Look”: close-cropped hair, largish but well-groomed mustache, muscle shirts, short shorts.  [The quintessential version of “The Clone Look” would be Freddie Mercury (rock band Queen’s lead vocalist who died of AIDS) after about 1981.] 

A strange disease lurked among the gay denizens and creepers of the bath houses, though.  Men began dying of pneumonia and other respiratory illnesses, but only after drastically losing weight and developing horrific skin lesions on their faces, necks, backs, and chests.  This disease became known in the gay community as “gay cancer”.  It was particularly volatile, and it progressed rapidly.  Dugas caught it early, possibly with his first encounter in the New York gay bathhouse on Halloween 1980.

Gaëtan Dugas died in Quebec City, Quebec, Canada, on March 30, 1984, at the age of 31.  His cause of death was kidney-failure brought on by his weakened condition from an onslaught of infections and ailments from AIDS.

The direct lineage of HIV-1 was traced to two groups of mutations that formed in the primates that carried the simian version.  One of the groups was dated to between 1847 and 1907; another subgroup dated to between 1606 and 1871.  HIV-2 made the leap most likely between the date range of 1856 and 1922.  Thus, it can be seen some prototypical version of the AIDS virus can be dated to the early 17th century.

In the end one can see there is no modern-day “Patient Zero”.

Mr. Louis, Missouri) was the earliest confirmed victim of AIDS in North America.

Meanwhile, as a symbolic sign of the coming Armageddon, Studio 54 was forced to close its doors for liquor license violations and tax evasion; entrepreneurs Steve Rubell and his business partner were sentenced to short terms of imprisonment.  [Rubell later died of AIDS.]

But, it doesn’t end there. 

Of a most enlightening nature was Rayford’s adamant refusal of any rectal exams.  It seemed that he may have been exposed to homosexual activity (assuming the submissive role in anal intercourse).  One of his attending physicians believed that he had been a victim of sexual abuse (a very likely scenario considering Rayford’s socio-economic background).  He could also have been “pimped out” against his will by someone who procured males to engage with him.  To date, this aspect of his life is unclear.

The music scene was fueled by this gay celebration, none more blatantly than by a vocal group of disco hustlers calling themselves “The Village People”.  They dressed in favorite and stereotypical gay icon costumes – a policeman, a construction worker, a cowboy, a gay biker, and a Native American.  They were hugely successful for a short time with big sellers “In the Navy” and “YMCA”.  More subtly, Donna Summer performed her brand of dance music that was embraced by the gay community as was she.

Occasionally, medical mysteries initially thought solved are found later to have very different truths at their cores.

Gay men realized the danger.  Many made the intuitive leap early that perhaps certain activities, such as anal intercourse, might be transmitting the causative agent.  Others flatly refused to believe that their lifestyles might be endangering the health of themselves and of others.  They felt it was a perceived backlash against gay men.  Higher-profile gay men (many closeted during their lifetimes) and activists within the gay community began dying as well as underground sub-culture members (the “Crisco, leather, and fisting” set).

A year earlier, a Portuguese man known only as Senhor José died under mysterious circumstances.  He was treated at the London Hospital for Tropical Diseases to no effect.  In later years, examination of preserved tissues verified he died of AIDS; the causative virus, HIV-2 was present, making him the first known confirmed victim.  Genetic research on the virus indicated he probably contracted the disease in 1966 in Guinea-Bissau (on the northwest coast of Africa).  Three gay men in California and six Haitian immigrants to the United States were later confirmed as AIDS victims from that same year.

By April of 1982, 248 cases of the disease were reported nationwide with many others too afraid or indifferent to see a doctor.  A virus was isolated in 1983 by French scientists (as Europeans were also recognizing and treating patients with “gay cancer”, many of whom were decidedly not gay). 

Certainly it was not Gaëtan Dugas (though, like Typhoid Mary over half a century before him, many deaths could be placed squarely on his doorstep). 

He was admitted with multiple, and strange, symptoms (given his tender age). Louis City Hospital, then transferred to Barnes Hospital (now Barnes-Jewish Hospital) in St. Memory Elvin Lewis

Dr. . Louis. 

The End of Days was seemingly at hand.

And the real Patient Zero – the HIV-Adam or HIV-Eve – lived and most likely died there, somewhere in the Congo, unknown and unrecognized for the catastrophic role he or she would play in human history. 

He led doctors to believe any of his sexual activities were strictly heterosexual, even claiming at one point to having a girlfriend (who failed to surface at the time).  [This female was found some time later and was found to be in perfect health, relative to HIV and AIDS, from which one can only surmise she and Rayford had no intimate sexual intercourse or such activities were rare enough she was not exposed to critical levels by whatever ailed him.]

Dugas, meanwhile, knew he was sick.  He didn’t know exactly what was wrong, but he had developed the skin lesions, associated with “gay cancer”.  But one can’t spread cancer, of course, because cancer isn’t contagious.  He indiscriminately continued having sex with men as his whims overtook him.  His “advantage” was his mobility – as a flight attendant, he might be in any part of the US, Canada, or the world on a moment’s notice.  His bitterness about having gay cancer crossed over into his lackadaisical attitude about possibly harming others.

This virus, after much international wrangling for recognition of discovery (with a particularly aggressive and bombastic US virologist lobbying for a claim that he had found it first–he did not) was later named Human Immunodeficiency Virus or HIV. 

AIDS is what defined the decade of the 1980s, a decade that lived in fear beneath the penumbra of a certain and tortuous death from a highly communicable pathogen. Louis, Missouri.  His mother’s name was Constance Rayford, and he had a brother named George.  Rayford was described as slender.  His retardation left him relatively uncommunicative from shyness. 

Concern for dying gay men was not paramount on America’s mind.  As more cases of the mysterious killer emerged, the name was changed from “gay cancer” to “gay-related immune deficiency” (GRID).  This, at least, was an open recognition that whatever was causing the disease was compromising a body’s immune system.  It didn’t explain, however, the rather esoteric choice of gay men (and soon discovered, IV drug users) by an unintelligent, non-sentient pathogen as victims.  It wasn’t until the first heterosexual cases of “gay cancer” emerged that the disease was examined more closely.

The Road to Zero

Molecular research shows the AIDS epidemic of the 1980s stemmed from a viral strain that had entered the US via Haiti about 1966.  Other strains have been isolated as well.  As in cases like Robert Rayford’s, the disease died with him (though he probably infected others, those people likely did not have access to the sheer number of sexual partners that, for example, Gaëtan Dugas had, and died before spreading it much). 

Without a precise diagnosis, Rayford’s cause of death was attributed to the catch-all vagary “loss of vitality”.  Intractable fluid imbalance and lung disease were listed as contributors.  An autopsy revealed a surprise – his body carried a very rare cancer called Kaposi’s sarcoma internally (though he had but one external lesion on his right thigh).  [Today, this cancer and its lesions are bellwethers of AIDS.] . It was so unusual at the time . Doctors, helpless to find the cause of death for the Noe family, preserved some tissue samples.  In 1988, further testing showed Noe, his wife, and his daughter had all been HIV-positive

Dr.  

In 1976, a Norwegian sailor, designated with the alias “Arvid Noe”, died; his wife and nine-year-old daughter died the next year of the same wasting disease.  In 1961, the 15-year-old Noe had sailed on his first voyage to Africa.  He worked a merchant vessel that plied along Africa’s west coast from mid-1961 to mid-1962; during this voyage he was treated for gonorrhea.  He sailed again to Africa in 1964, with a port of call in Kenya in eastern Africa.  In 1966, Noe started suffering from chronic joint pain and recurrent lung infections.  By 1968, he could no longer pass a physical to sail, so he worked as a long-haul truck driver. 

Update note:Dr. Memory Elvin-Lewis was kind enough to respond to this piece in person.

Years later, once medical science, and particularly genetics testing, had reached a greater level of technological advance, a revision of the “Patient Zero” findings of 1984 seemed necessary.  What was learned by later research was both fascinating and horrific simultaneously.  It turned out, HIV had not only been in the world for over a century, but it had been in the United States as early as 1966. 

This doctor handled, and talked with (though reported as largely uncommunicative), Robert Rayford personally for a period during Rayford’s confinement, and also attended Rayford’s autopsy, confirming the KS diagnosis and noting the preservation of tissue samples that later were shown to carry the variant of the HIV-1 virus.

***

Noe’s condition stabilized, but then flared up again in 1975 (coincidentally the same year a strange disorder called “slim disease” was reported in Africa for the first time, the beginnings of epidemic AIDS).  In addition to the respiratory condition and joint pains he developed motor skill problems and dementia before he died. 

Before Robert Rayford in the US, there was a possible case found in a dead Jamaican native named Ardouin Antonio.  He came to the US in 1927.  He was working as a shipping clerk for a clothier when he died at age 49 on June 28, 1959, in Manhattan.  He had developed a very rare kind of pneumonia, seemingly out of the blue.  Decades later the doctor who had performed Antonio’s autopsy was asked to re-evaluate the case.  Did he think Antonio possibly died of AIDS?  “You bet . In conjunction with Studio 54, other bars for gay men to frequent thrived.  Another meeting place was the bath houses still found in many larger cities.  Once serving the utilitarian function for neighborhood residents to bathe (considering most homes up until the late 1920s did not have indoor plumbing) these quaint reminders of The Good Old Days were social gathering places for gay men.  They were prevalent in New York City and in San Francisco.  [Bette Midler, a great favorite among gay men, got her start singing in gay bath houses; her piano player in those days was songwriter/musician Barry Manilow).

Ground Zero

Omega Man

“I’m Candy – Fly Me!”

AIDS in the United States was isolated in pockets of contagion until the promiscuity (homosexual or otherwise) of the 1970s gave the disease a clear path of propagation in humans.  IV drug use, on the rise in the 1970s and early 1980s, also provided another avenue of blood-exchange necessary for the virus to thrive. 

Both his wife and daughter developed an illness that mimicked his symptoms, and they died in 1977. . . 1952-1953).

The teen seemed stabilized by late 1968 (when he was around 15 years old).  He had been transferred to Deaconess Hospital by then, and in March 1969, however, all of his symptoms reappeared and rapidly worsened.  His breathing labored; his white blood cell count (as part of routine blood work) was noted to have dropped dramatically.  The only thing concurred at the time was that Rayford’s immune system had been somehow compromised.  He developed a fever and died either in the late hours of May 15, 1969, or the early hours of May 16 (sources differ).  His primary physician recalled, “Eventually his entire body constituted almost one wave of hard lumps and watery swellings.”

Current scientific research is clear: sometime in the 1930s, a simian form of immunodeficiency virus mutated sufficiently and made the leap across species to become a contagious disease of people. 

The disease it spawned was rechristened, in light of its indiscriminate virology, to Acquired Immune Deficiency Syndrome or AIDS.  That same year that 248 cases of the disease were reported, local health departments in conjunction with the Centers for Disease Control (CDC) in Atlanta began investigating.

Of the 248 cases known before the detection of the virus, interviewing led to the shocking revelation that at least 40 AIDS victims had one thing in common: all had either had sex with a certain male, blond, gregarious Air Canada flight attendant, or they had sex with someone who did.  This networking connection was made in 1984, and it was critical – it meant medical and public health officials investigating the source of AIDS might have finally gotten the breakthrough they needed. 

He started out as a hairdresser.  Wanting to travel, this French-speaking Canadian learned that flight attendants for Air Canada had to be bi-lingual.  He moved to Vancouver and learned English to qualify for the job.  He found work as a flight attendant on Air Canada.  This career choice allowed him the freedom to move around the world, visiting exotic locales, and meeting many strange men for anonymous sexual encounters.  In 1977, he was legally married in Los Angeles, California, in an illegal attempt to gain United States citizenship.

Gateway to the West

His first months in the hospital were spent with his doctors cutting back on his water and salt intake, and they wrapped and raised his legs, all to cut down on his tissue’s swelling.  Despite this, the inflammation moved up his body and into his lungs.  Antibiotics were tried in varying dosages, but Rayford’s condition continued to deteriorate. 

The hedonism of the 1970s raged unchecked, and by the middle of the decade “gay” culture became pop culture.  Gay male partiers in the mid 1970s found an outlet on New York’s Fire Island.  Gay men rented time-share space in houses on the island and partied their summers away “in season”. 

On October 31, 1980 – ominously enough, Halloween night – the French-Canadian gay male steward Gaëtan Dugas visited a gay bathhouse for the first time on a layover in New York City.

Author’s note

Larry Kramer was actively and aggressively involved with what was then known as “gay cancer” in the early 1980s when the disease first made its poisonous presence visibly known in the United States as “gay cancer”. 

This good person also kindly corrected some of the misinformation about Rayford via a personal e-mail and was also kind enough to forward professional papers on the subject.  One such paper, in Lymphology from 1973, gives, perhaps, the best clinical synopsis of the case.  Another article, entitled Documentation of an AIDS Virus Infection in the United States in 1968 (by the same doctor and others), is also a “must read” for anyone interested in the earlier origins of AIDS in America. 

As further incentive to not hire men as flight attendants, the death of a gay steward in 1954 became a scandal sufficiently great to lead to a rash of “fag bashings” (both gay men and lesbians were targeted) in Miami, Florida.  It was one of the nation’s worst anti-gay outbreaks in history. 

In America, the results of further research led to the conclusion that Gaëtan Dugas had not been the true “Patient Zero” after all.

This makes little sense. 

Gay and straight partiers alike finally found their Valhalla, however, in New York City in a crummy little club in the 1970s called Studio 54.  This rat hole was converted into a hot spot known all over the world.  Celebrities fell all over themselves to get in and be seen there.  Its allure was its faux air of exclusivity.  No club before or since carried the cachet of Studio 54.  Co-founded and owned by a cabaret-style, (almost a caricature) flamboyantly gay man, Steve Rubell, and a straight-laced heterosexual lawyer, this kitschy club defined hipsters in the Seventies. 

Homophobia was so great by the late 1950s almost no airlines in the United States would hire men as flight attendants – even Eastern and Pan Am stopped hiring stewards.  Stewardesses, however, were very desirable.  They were marketed as young, beautiful, and sexually available–this was hardly an acceptable career choice for any he-man.  In the same way that the sexual orientation of male nurses was suspect, only “pansies” wanted to be stewards.

The music was disco, the dance beat adapted from gay men and their party scene.  The mock S&M dance moves, the sweaty bodies, the throb of the music, the drugs consumed, and the fact that not just anyone could get in heightened its allure.

There is an interesting correlation between homosexuality and the airline industry.  At least, there is a publicly perceived correlation as it pertains to airline flight attendants.

The commercial airlines recognized the goldmine presented by hiring female “stewardesses”.  Certainly, they were paid less.  There was also marketability in women that men did not have – women could be hawked by an airline as possible sex partners for the discriminating male traveler choosing its service over another.

False Positive

The Greek letter “?” always refers to the end of an event or series, not its beginning.  Dugas was “Patient Zero”, not “Patient ?” – if the intent was to use such a Greek designation, he would have been named “Patient Alpha” (“?” or “?”)  for “the beginning”.  It is known that Dugas from the earliest investigations, based on diagrams the CDC (and others) created interlinking sexual contacts among those diagnosed with or dead from the mystery disease, was referred to from the start as Patient Zero (not Omega or “O”).

The criteria for entry were pure sadism: one night only women might be allowed in; other times, a sloppily dressed man might be sent away while another, looking exactly like that man but “famous”, would be let in.  Gay-themed parties were held there often, and casual sex in the bathrooms and the “exclusive” privacy lounge was common among attendees.

Running Dugas to ground, however, was pointless.  At the time, there were no criminal laws penalizing the willful spread of a known fatal disease (since then, law changes allow charges of attempted and pre-meditated murder to be brought in many states against anyone who is HIV-positive purposefully engaging in unprotected sexual intercourse with an unwitting partner).

Certainly, the African-American teenager Robert Rayford (who had never been outside the city of his birth) was not Patient Zero, either – somebody had to give it to him in the first place.

Diverting conversations occurred between Rayford and his primary care givers when questioned about his sexual activities.  His doctors had not considered homosexuality initially, and all conversations, such as they were, seemed to be taken as referring to female sexual contacts.

He had a chlamydia infection (a bacterial venereal disease), clearly indicating he was sexually active.  His doctors also uncovered evidence of the herpes simplex virus and the virus responsible for Epstein-Barr.  Robert Rayford was not terribly forthcoming with his doctors, partly due to his retardation leaving him mostly uncommunicative, but also because he was embarrassed by something.

Anal scarring also indicated repeated sexual penetration.

Tracing backward from Haiti (the source of the US strain in 1966) put the disease firmly in Central Africa. Somewhere, there was a Patient Zero, the epidemiological well-spring from which this plague spewed forth.

Dugas may have personally, and directly, been responsible for dozens of AIDS cases (and no telling how many more indirectly), but he did not bring AIDS to the US, nor was he the first confirmed AIDS victim.  As noted, several California men and some Haitian immigrants were found later to have succumbed to the disease before Dugas.

AIDS now had a face.

Gaëtan Dugas, the narcissistic and embittered flight attendant, alternately feeling morose and spiteful about his condition, was given the code name “Patient Zero”, the source of the AIDS epidemic in North America. 

For one gay man, however, being a steward was all he’d needed to satisfy both his wanderlust and his physical lust. 

In his wake, one of the unfortunate legacies he left was a renewed homophobia relative to male flight attendants.  They became a lightning rod for America’s fear and anger over AIDS and its links with homosexuality.  “Patient Zero”, Gaëtan Dugas, was reviled; in death he was even accused of bringing HIV to North America and spreading it around the country.

Because of the baffling nature of his case, doctors preserved several tissue and blood samples for later evaluation.  In 1987, eighteen years after his death, molecular biologists at New Orleans’ Tulane University tested specimens of Rayford’s preserved blood and tissues.  Their findings were stunning: a virus “closely related or identical to” HIV-1 was detected.  Further confirmation testing in 1989  proved Robert Rayford (African-American teenage male of St.   The swelling in his legs was bothersome, his genitals and legs were covered in scrofulous skin, and his testicles were severely swollen.  He was also emaciated (having lost much weight suddenly), and even though he was an African-American male he was considered “pale”.  He also had shortness of breath.  His symptoms led his caregivers at Barnes Hospital to conclude that one of his problems was lymphedema (a swelling caused by lymphatic problems).  This was only a tiny part of his health issues, however.

Less Than Zero

Dating America’s exposure to AIDS is irrelevant: AIDS is a global problem.  And continuing research has led to many more interesting facts about the spread of HIV.

First denying he was sick, he later willfully and maliciously spread the disease to unsuspecting partners.  After having casual sex in a darkened room once, a male interviewee later reported he had turned on a light in the room where Dugas lay naked on a bed.  This man spotted the lesions (Kaposi’s sarcoma) that were the classic earmarks of “gay cancer” on Dugas’ chest.  When he remarked upon it, Dugas replied sardonically, “It’s gay cancer.  Maybe you’ll get it.”

The discrimination in the labor market meant the United States Supreme Court had to step in and force airlines to hire male flight attendants.  This happened in 1971 after nearly 20 years of female-dominated service.  Even then, the Court’s decision forcing US airlines to hire men was greeted with derision in the press.  It also raised homophobic fears of placing men in such a servile and sexualized role. . Memory Elvin-Lewis, thank you so much for not only your contributions to science but to my humble efforts at disseminating it for general readership.  I truly appreciate it.

Almost any medical professional worth his or her license, whenever a patient dies of a strange ailment, takes the precaution of preserving tissue and blood samples for future research.  It is extremely fortunate that some doctors going all the way back to the late 1950s had been so far-sighted.  Working backward and re-examining suspicious or otherwise unresolved deaths from contagion globally proved enriching in piecing together the history of AIDS. 

Instead, about the only thing that can be said of HIV is that its “Ground Zero” location was almost certainly Central Africa.  

By the 1950s, this homophobia was rampant, and in the conservative times of Eisenhower and McCarthyism, men were slowly pushed out of the steward jobs.

Thus, by the late 1940s male flight attendants were not only undesirable, they were suspect as well.  Occupying a job with women that devoted itself to customer service, good manners, and fine grooming, the stewards garnered suspicions of being “queer”.

Finally, in 1968, the boy was admitted to St