In a study published Wednesday in the journal Nature, researchers used newly available genetic evidence to show that Gaetan Dugas — who has been dubbed “Patient Zero” — could not have been the first person in the United States to have the virus that causes AIDS. And they pinpointed that the AIDS virus appeared to have been circulating in our borders for much longer than was previously known, and made the jump in or around 1970 - about a decade before it was officially recognized to be in the United States in 1981. The work, led by Michael Worobey from the University of Arizona and Richard McKay from the University of Cambridge, confirms the controversial theory that the virus crossed over from the Caribbean (rather than going from the United States to the Caribbean, as some have argued). (Serum is blood with the red and white blood cells removed.) So his group’s next step was to scour the serum samples for fragments of HIV RNA that may have been circulating in these men’s bloodstreams. The researchers found that the HIV virus first jumped from the Caribbean to New York City around 1970, triggering the North American epidemic. The researchers also found that it was New York City, not San Francisco, that was the location of the initial outbreak. “How the virus moved from the Caribbean to the US and New York City in the 1970s is an open question - it could have been a person of any nationality, it could have even been blood products.”

The mistaken emphasis placed on Dugas that saw him placed as a key link between the spread of HIV/Aids between the east and west coasts of the US in the 1984 study, he said, was likely down to Dugas’s efforts to help researchers. “New York City acts as a hub from which the virus moved to the West Coast — and eventually to Western Europe, Australia, Japan, South America and other places.”

Dr. Beatrice Hahn, a professor of medicine at the University of Pennsylvania who studies the origin and evolution of immunodeficiency diseases, said she was impressed by the lengths the authors went to in order to find actual virus samples from so long ago. Researchers separately sequenced the virus found in Patient Zero and found that his HIV-1 genome appeared “typical” of U.S. strains of the time and that there was extensive genetic diversity around the time he appears to have been infected, indicating that the virus had likely been in the country and evolving several years earlier. Worobey, whose expertise is in virus evolution, and McKay, a science historian, wrote that their work shows there is “neither biological nor historical evidence for the widely held belief that he was the primary cause of the HIV epidemic in North America”

“This individual was simply one of thousands infected before HIV/AIDS was recognized,” McKay said. They explained that public health investigators at the time had dubbed him “Patient ‘O’” meaning the letter O and not the number zero because he came from ‘Out(side)-of-California’,” but that the letter became confused with the number in the medical literature and popular media and over time became part of the mythology of AIDS despite numerous attempts by some scientists to clarify his role in the epidemic. The team used the same approach to extract the full HIV genetic code from “Patient Zero,” an Air Canada flight attendant identified as Gaetan Dugas in the Randy Shilts 1987 bestseller “And the Band Played On.”

Shilts, who wrote his book after Dugas had died, identified him as playing a key role in spreading the virus; media accounts painted him as a villain. The research, conducted by an international team of scientists, was published this week in the journal Nature

"No one should be blamed for the spread of a virus that no one even knew about, and how the virus moved from the Caribbean to the US in New York City in the 1970s is an open question," co-author of the research, Dr. Michael Worobey, a professor and head of the ecology and evolutionary biology department at the University of Arizona, said at a news conference Tuesday.
A research team led by an evolutionary biologist at the University of Arizona publishes a paper in Nature on the genetic history of HIV proving that Gaëtan Dugas, the Canadian flight attendant who had been identified for years as "Patient Zero" of the AIDS epidemic in the U.S., did not spread the virus to the country. The study indicates that HIV first spread to the U.S. from the Caribbean around 1970.