AMA News Release For Release Friday, May 6, 1983 EVIDENCE SUGGESTS HOUSEHOLD CONTACT MAY TRANSMIT AIDS Chicago—Evidence suggesting that Acquired Immune Deficiency Syndrome (AIDS) can be transmitted by routine household contact is presented in this week’s Journal of the American Medical Association. James Oleske, MD, MPH, and colleagues report eight cases of otherwise unexplained immune deficiency syndrome among children from the Newark, N.J., metropolitan area born into families with recognized risks for AIDS.“Four of these children have died,” the authors report. “Our experience suggests that children living in high-risk households are susceptible to AIDS and that sexual contact, drug abuse or exposure to blood products is not necessary for disease transmission.” Commenting on the study in an accompanying editorial, Anthony S. Fauci, MD, of the National Institutes of Health, points out, “We are witnessing at the present time the evolution of a new disease process of unknown etiology with a mortality of at least 50 percent and possibly as high as 75 percent to 100 percent with a doubling of the number of patients afflicted every six months.” At first the disease appeared to be confined only to male homosexuals, he adds. Then it became clear that IV drug users also were susceptible, and after that the disease was found among Haitians and hemophiliacs, the latter apparently exposed through transfusion of blood products. The finding of AIDS in infants and children who are household contacts of patients with AIDS or persons with risks for AIDS has enormous implications with regard to ultimate transmissibility of this syndrome,” Fauci says. “If routine close contact can spread the disease, AIDS takes on an entirely new dimension,” he adds. “Given the fact that incubation period for adults is believed to be longer than one year, the full impact of the syndrome among sexual contacts and recipients of potentially infective transfusions is uncertain at present. If we add to this the possibility that nonsexual, non-blood-borne transmission is possible, the scope of the syndrome may be enormous.”
The author continues:
Arye Rubinstein was astounded that Anthony Fauci could be
so stupid as to say that household contact might have anything to do with
spreading AIDS. Rubinstein had never been a great admirer of New Jersey’s Dr.
Oleske; they had antithetical views of AIDS in children. To Rubinstein, the
mode of transmission was fairly obvious and fit quite well with existing
epidemiological data on AIDS. The mother obviously infected the child in her
womb. The fetus and parent shared blood as surely as an intravenous drug user,
hemophiliac, or blood transfusion recipient. The fact that none of the infants
in Oleske’s study were over one year old reinforced this notion. In order to
interpret this data to mean that “routine household contact” might spread AIDS,
an entirely new paradigm for AIDS transmission was needed. Rubinstein’s paper
explained it all very easily, though the Journal of the American Medical
Association seemed more enamored with Oleske’s specious analysis. In fact, the
journal editor at first returned Rubinstein’s paper with the section on
intrauterine transmission crossed out. The paragraphs had only appeared because
Rubinstein had insisted that they be retained. What was Fauci’s
problem? Upon
investigation, Rubinstein learned that Anthony Fauci had not bothered to read
his paper [I presume Shilts means Rubinstein’s paper] before writing the
editorial. Instead, he just read Oleske’s conclusions and started running off
at the mouth.
One finds this rather interesting. We see a great deal of this again today. When we hear politicians state they want to have a "playbook" so what is currently happening does not happen again, one wonders if anyone remembers the AIDS epidemic.
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