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Seth Pincus, Elizabeth Fischer and Austin Athman, National Institute of Allergy and Infectious Diseases, National Institutes of Health // Public Domain
Seth Pincus, Elizabeth Fischer and Austin Athman, National Institute of Allergy and Infectious Diseases, National Institutes of Health // Public Domain

Scientists Pinpoint When and Where HIV Arrived in the U.S.

Seth Pincus, Elizabeth Fischer and Austin Athman, National Institute of Allergy and Infectious Diseases, National Institutes of Health // Public Domain
Seth Pincus, Elizabeth Fischer and Austin Athman, National Institute of Allergy and Infectious Diseases, National Institutes of Health // Public Domain
A human T cell (blue) under attack by HIV (yellow), the virus that causes AIDS. The virus specifically targets T cells, which play a critical role in the body's immune response against invaders like bacteria and viruses. Image credit: Seth Pincus, Elizabeth Fischer and Austin Athman, National Institute of Allergy and Infectious Diseases, National Institutes of Health

 

The global spread of AIDS was one of the greatest public health crises of the last century. While we’ve made tremendous advances in human immunodeficiency virus (HIV) prevention and treatment, the details of the virus’s global spread have been harder to pin down. A new report published this week in Nature sheds light on when and where HIV arrived in the United States: in New York City around 1970. It also removes blame from the man long known as "Patient Zero"—he was not, in fact, the first person in North America to contract the virus.

Because HIV attacks the immune system, limiting the body's ability to fight infections or infection-related cancers, the first patients presented with a range of symptoms, from enlarged lymph nodes and pneumonia to cancer. Physicians in California first recognized it as a single entity in 1981, but the disease didn’t get a name—acquired immunodeficiency syndrome (AIDS)—until a year later. By then, media reports of a “gay cancer” had begun to raise alarms and stigma across the country. The first drugs to treat HIV were not approved until 1987, by which time the disease had taken more than 40,000 lives.

Part of the problem lay in the limitations of medical and scientific technology. We didn’t have the capability to look inside the disease with the level of detail required to stop it. Blood tests could pick up on the presence of HIV in a sample, but they couldn’t spell out its genetic code. To do that, said study co-author and virus evolution expert Michael Worobey of the University of Arizona, researchers would need a sample of RNA from the virus itself—a serious challenge, as the virus’s RNA is super delicate and breaks down at the slightest provocation.

But we’ve come a long way since then. Worobey and his colleagues in Arizona and at the University of Cambridge have created a vividly named new technique called RNA jackhammering that allows them to break down the human genes in a blood sample and extract and examine the virus RNA hiding within them.

To rewind the clock to HIV’s early days in the States, the researchers applied their jackhammers to blood samples taken from more than 2000 men in New York and San Francisco in 1978 and 1979. The nearly 40-year-old samples had degraded since their collection, but Worobey and his colleagues were still able to extract eight near-complete HIV RNA sequences, creating the oldest-known record of North American HIV genetics.

By comparing these sequences with those collected from other parts of the globe, the researchers were able to trace the virus’s evolution and devastating spread. They found that HIV had crossed from Africa to the Caribbean, and from there jumped to New York City and then San Francisco, where the first patients were identified. These findings run counter to earlier theories, which pinpointed the virus’s U.S. landfall to San Francisco.

The density of vulnerable populations in New York City were like “dry tinder” for HIV, Worobey said in a press statement, "causing the epidemic to burn hotter and faster and infecting enough people that it grabs the world's attention for the first time.”

By the time the blood samples were collected, the authors say, the virus had already evolved into the form it bears today.

Their analysis also upends another well-known element of the AIDS story: the identity of “Patient Zero.” For nearly three decades, scientists have traced the virus’s entry to the U.S. back to one man: Gaëtan Dugas. But Worobey and his colleagues tested a sample of Dugas's blood from 1983 and found that the virus RNA in his blood was no less evolved—and therefore no older—than the viral genes in his peers. He wasn't Patient Zero.

That the weight of the AIDS pandemic ever came to be placed on Dugas's shoulders at all may itself have been a simple typographical error, the authors write. The man’s original file identified him as a patient from Outside of California, or Patient O. Somewhere along the way, the letter O became a zero, a mistake that would be perpetuated for decades—long after Dugas himself had died.

The authors are hopeful that their findings and their new technique will help accelerate scientific unraveling of the virus.

"Earlier detection and better alignment of the various options we have to make it harder for the virus to move from one person to the next," Worobey said, "are key to driving HIV out of business."
 

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Medicine
Bill Gates is Spending $100 Million to Find a Cure for Alzheimer's
Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation
Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation

Not everyone who's blessed with a long life will remember it. Individuals who live into their mid-80s have a nearly 50 percent chance of developing Alzheimer's, and scientists still haven't discovered any groundbreaking treatments for the neurodegenerative disease [PDF]. To pave the way for a cure, Microsoft co-founder and philanthropist Bill Gates has announced that he's donating $100 million to dementia research, according to Newsweek.

On his blog, Gates explained that Alzheimer's disease places a financial burden on both families and healthcare systems alike. "This is something that governments all over the world need to be thinking about," he wrote, "including in low- and middle-income countries where life expectancies are catching up to the global average and the number of people with dementia is on the rise."

Gates's interest in Alzheimer's is both pragmatic and personal. "This is something I know a lot about, because men in my family have suffered from Alzheimer’s," he said. "I know how awful it is to watch people you love struggle as the disease robs them of their mental capacity, and there is nothing you can do about it. It feels a lot like you're experiencing a gradual death of the person that you knew."

Experts still haven't figured out quite what causes Alzheimer's, how it progresses, and why certain people are more prone to it than others. Gates believes that important breakthroughs will occur if scientists can understand the condition's etiology (or cause), create better drugs, develop techniques for early detection and diagnosis, and make it easier for patients to enroll in clinical trials, he said.

Gates plans to donate $50 million to the Dementia Discovery Fund, a venture capital fund that supports Alzheimer's research and treatment developments. The rest will go to research startups, Reuters reports.

[h/t Newsweek]

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science
A New Analysis of Chopin's Heart Reveals the Cause of His Death

For years, experts and music lovers alike have speculated over what caused celebrated composer Frederic Chopin to die at the tragically young age of 39. Following a recent examination of his heart, Polish scientists have concluded that Chopin succumbed to tuberculosis, just as his death certificate states, according to The New York Times.

When Chopin died in 1849, his body was buried in Paris, where he had lived, while his heart was transported to his home city of Warsaw, Poland. Chopin—who appeared to have been ill with tuberculosis (TB)—was terrified of the prospect of being buried alive, and nostalgic for his national roots. He asked for his heart to be cut out, and his sister later smuggled it past foreign guards and into what is now Poland.

Preserved in alcohol—likely cognac—and stored in a crystal jar, Chopin's heart was laid to rest inside Holy Cross Church in Warsaw. (It was removed by the Germans in 1944 during the Warsaw Uprising, and later returned.) But rumors began to swirl, as the same doctor tasked with removing the heart had also conducted an autopsy on the composer's body, according to the BBC.

The physician's original notes have been lost, but it's said he concluded that Chopin had died not from TB but from "a disease not previously encountered." This triggered some scholars to theorize that Chopin had died from cystic fibrosis, or even a form of emphysema, as the sickly musician suffered from chronic respiratory issues. Another suspected condition was mitral stenosis, or a narrowing of the heart valves.

Adhering to the wishes of a living relative, the Polish church and government have refused to let scientists conduct genetic tests on Chopin's heart. But over the years, teams have periodically checked up on the organ to ensure it remains in good condition, including once in 1945.

In 2014, a group of Chopin enthusiasts—including Polish scientists, religious officials, and members of the Chopin Institute, which researches and promotes Chopin's legacy—were given the go-ahead to hold a clandestine evening meeting at Holy Cross Church. There, they removed Chopin's heart from its perch inside a stone pillar to inspect it for the first time in nearly 70 years.

Fearing the jar's alcohol would evaporate, the group added hot wax to its seal and took more than 1000 photos of its contents. Pictures of the surreptitious evening procedure weren't publicly released, but were shown to the AP, which described Chopin's preserved heart as "an enlarged white lump."

It's unclear what prompted a follow-up investigation on Chopin's heart, or who allowed it, but an early version of an article in the American Journal of Medicine states that experts—who did not open the jar—have newly observed that the famed organ is "massively enlarged and floppy," with lesions and a white, frosted appearance. These observations have prompted them to diagnose the musician's cause of death as pericarditis, which is an inflammation of tissue around the heart. This likely stemmed from his tuberculosis, they said.

Some scientists might still clamor at the prospect of testing tissue samples of Chopin's heart. But Michael Witt of the Polish Academy of Sciences—who was involved in this latest examination—told The Guardian that it was unnecessary to disturb what many consider to be a symbol of national pride.

"Some people still want to open it in order to take tissue samples to do DNA tests to support their ideas that Chopin had some kind of genetic condition," Witt said. "That would be absolutely wrong. It could destroy the heart, and in any case, I am quite sure we now know what killed Chopin."

[h/t The New York Times]

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