Editing Gaëtan Dugas

{{Short description|Canadian flight attendant, long misidentified as the index case of the North American AIDS crisis}}
{{Use Canadian English|date=September 2020}}
{{Use mdy dates|date=March 2014}}
{{Infobox person
| name        = Gaëtan Dugas
| image       = Gaëtan Dugas.jpg
| alt         = 
| caption     = 
| birth_date  = {{birth date|1953|02|20}}
| birth_place = [[Quebec City]], [[Quebec]], Canada
| death_date  = {{death date and age|1984|03|30|1953|02|20}}
| death_place = [[Quebec City]], [[Quebec]], Canada
| death_cause = [[Kidney failure]] due to AIDS-related infections
| other_names = 
| known_for   = "[[Index case|Patient Zero]]" of the [[HIV/AIDS in the United States|North American AIDS epidemic]]<ref name="Macleans">{{cite magazine |last1=Johnson |first1=Brian D. |title=How a typo created a scapegoat for the AIDS epidemic |url=https://www.macleans.ca/culture/movies/how-a-typo-created-a-scapegoat-for-the-aids-epidemic/ |access-date=20 April 2019 |magazine=Maclean's |date=17 April 2019}}</ref>
| occupation  = [[Flight attendant]]
}}

'''Gaëtan Dugas''' ({{IPA|fr|ɡaetɑ̃ dyɡa|lang}}; February 20, 1953 – March 30, 1984) was a Canadian flight attendant incorrectly identified as "patient zero" during the AIDS epidemic. This narrative, popularized notably by [[Randy Shilts]]' 1987 book ''[[And the Band Played On]]'', has been refuted through subsequent scientific scrutiny. Genetic analysis later determined that several thousand gay men already had [[HIV]] in the United States prior to Dugas' own infection.<ref name="Macleans"/><ref>{{cite journal |last1=McKay |first1=Richard A. |title='Patient Zero': the absence of a patient's view of the early North American AIDS epidemic |journal=Bull Hist Med |volume=88 |issue=1 |year=2014 |pages=161–194 |doi=10.1353/bhm.2014.0005 |pmid=24769806 |pmc=4046389 }}</ref><ref name="NYT 2016-10-27">{{cite web |url= https://www.nytimes.com/2016/10/27/health/hiv-patient-zero-genetic-analysis.html |title=H.I.V. Arrived in the U.S. Long Before 'Patient Zero' |work=[[The New York Times]] |date=26 October 2016 |access-date=26 October 2016 |last=McNeil |first=Donald G |author-link=Donald McNeil Jr.}}</ref><ref name="BBC-October-26-2016">{{cite web|last=Gallagher|first=James|date=26 October 2016|title=HIV Patient Zero cleared by science|url=https://www.bbc.com/news/health-37767179|access-date=26 October 2016|work=[[BBC News Online]]}}</ref>

Dugas worked as a flight attendant for [[Air Canada]] and died in [[Quebec City]] in March 1984 as a result of [[kidney failure]] caused by AIDS-related [[Opportunistic infection|infections]]. In March 1984, a study tracked Dugas, along with other [[Gay men|gay]] and [[bisexual]] men, to indicate his role in a particular cluster of 40 AIDS cases in the United States. He was named "Patient O" with "O" standing for "Out-of-California", however ''And the Band Played On'' later used the term "Patient 0" standing for "zero" and put significant media focus on Dugas. A 2016 study confirmed that Dugas did not bring HIV to the United States, and he was not Patient Zero, via [[genetic analysis]] of stored blood samples, supported by historical detective work.<ref>{{cite news |title=New research clears Gaétan Dugas as 'patient zero' in AIDS epidemic |url=https://www.cbc.ca/radio/thecurrent/the-current-for-november-1-2016-1.3829419/new-research-clears-ga%C3%A9tan-dugas-as-patient-zero-in-aids-epidemic-1.3829454 |author=Anna Maria Tremonti |publisher=CBC News |date=November 1, 2016}}</ref><ref>{{Cite AV media |title=New research clears Gaétan Dugas as 'patient zero' in AIDS epidemic |url=https://www.cbc.ca/player/play/audio/1.3830714 |host=[[Anna Maria Tremonti]] |publisher=CBC Radio |contribution=Richard McKay |series=[[The Current (radio program)|The Current]] |format=audio |date=November 1, 2016}}</ref><ref>{{cite web |title=Full Episode Transcript: New research clears Gaétan Dugas as 'patient zero' in AIDS epidemic |url=https://www.cbc.ca/radio/thecurrent/the-current-for-november-1-2016-1.3829419/november-1-2016-full-episode-transcript-1.3831506 |series=The Current |website=CBC Radio |date=November 1, 2016 |access-date=15 April 2024}}</ref><ref name="Auerbach1984">{{cite journal |last1=Auerbach |first1=David M. |first2 =William W.|last2= Darrow |author2-link=William Darrow |first3=Harold W. |last3=Jaffe |first4=James W. |last4=Curran |author4-link=James W. Curran |title=Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact |journal=The American Journal of Medicine |volume=76 |issue=3 |pages=487–92 |year=1984 |doi=10.1016/0002-9343(84)90668-5 |pmid=6608269 |url=https://www.amjmed.com/article/0002-9343(84)90668-5/abstract |access-date=March 3, 2014}}</ref><ref name="npr.org">{{cite news |last=Doucleff|first=Michaeleen|date=October 26, 2016|title=Researchers Clear 'Patient Zero' From AIDS Origin Story|url=https://www.npr.org/sections/health-shots/2016/10/26/498876985/mystery-solved-how-hiv-came-to-the-u-s|website=NPR.com}}</ref><ref>{{Cite news|last=McNeil|first=Donald G. Jr.|date=2016-10-26|title=H.I.V. Arrived in the U.S. Long Before 'Patient Zero'|language=en-US |work=The New York Times|url=https://www.nytimes.com/2016/10/27/health/hiv-patient-zero-genetic-analysis.html|access-date=2021-08-19|issn=0362-4331}}</ref><ref>{{cite news |url=http://archives.cbc.ca/IDC-0-13-400-2251/desastres_tragedies/sida/clip1 |title=La découverte de la maladie&nbsp;— Sida, les premières années |trans-title=Discovering the illness&nbsp;— AIDS, the first years | language=fr | work=[[Canadian Broadcasting Corporation|Radio-Canada]] |date=17 January 1992 |archive-date=August 18, 2004 |archive-url=https://web.archive.org/web/20040818070955/http://archives.cbc.ca/IDC-0-13-400-2251/desastres_tragedies/sida/clip1 }}</ref>

==1984 cluster study==
[[File:AIDS index case graph.svg|upright=1.5|thumb|A 1984 paper<ref name="Auerbach1984"/> linked 40 AIDS patients by sexual contact. Of those patients, Dugas was the first to experience an onset of symptoms of AIDS.  In the above graph, Dugas is represented by the number 0. Because Dugas was very forthcoming in helping researchers, Michael Worobey concludes there may be [[sampling bias|ascertainment bias]] in the study.<ref name="npr.org"/>]]
A [[Centers for Disease Control and Prevention]] (CDC) study published in ''[[The American Journal of Medicine]]'' in 1984 titled ''Cluster of Cases of the Acquired Immune Deficiency Syndrome'' examined the sexual contacts of gay men infected with AIDS to determine if their histories were consistent with the hypothesis that AIDS was caused by an infectious agent. A graph included with the paper traced the sequence of infection among 40 men and labelled one of the nodes as "Patient 0" (with other nodes including the place of residence and a number indicating the sequence in which they developed AIDS symptoms, such as "NY 14").<ref name="Auerbach1984"/> The paper later stated:
{{blockquote|If the infectious-agent hypothesis is true, Patient 0 may be an example of a "carrier" of such an agent. He had had sexual contact with eight other AIDS patients and was the possible source of AIDS for at least three of them. Two of these three men had been his partners before he had overt signs of Kaposi's sarcoma.}}

The researchers later stated they had originally intended to designate Dugas as "Patient O", with "O" standing for "Out-of-California" but at some point it was changed to a "0".<ref name="Macleans" />

=="Patient Zero" designation==
Dugas is featured prominently in [[Randy Shilts]]' 1987 book ''[[And the Band Played On: Politics, People, and the AIDS Epidemic]]'' (1987), which documents the outbreak of the [[HIV/AIDS in the United States|AIDS epidemic in the United States]]. Shilts refers to Dugas as "Patient Zero" and portrays him as having almost sociopathic behaviour by allegedly intentionally infecting, or at least recklessly endangering, others with the virus. Shilts interviewed epidemiologist [[Selma Dritz]] who reported that in 1982 she informed Dugas that he was infecting other people, but he refused to cease having casual sex in spite of this.<ref>{{cite news |title=How One Young, Gay Man Was Wrongfully Blamed for Bringing AIDS to the US |url=https://www.vice.com/en/article/how-one-young-gay-man-was-wrongfully-blamed-for-bringing-aids-to-the-us/ |author=Bethy Squires |publisher=Vice |date=December 1, 2016}}</ref> Dugas is described as being a charming, handsome sexual athlete who, according to his own estimation, averaged hundreds of sex partners per year.<ref name="Macleans"/> He claimed to have had over 2,500 sexual partners across North America since becoming sexually active in 1972.<ref>{{cite book |last=Shilts |first=Randy |author-link=Randy Shilts |title=And The Band Played On |url= https://archive.org/details/andbandplayedon00shil |url-access=registration |publisher=[[Penguin Books|Penguin]] |year=1988 |pages=[https://archive.org/details/andbandplayedon00shil/page/439 439] |isbn=978-0-14-011130-9}}</ref><ref>{{cite book |last=Gladwell |first=Malcolm |author-link=Malcolm Gladwell |title=The Tipping Point |publisher=[[Little, Brown and Company]] |year=2000 |pages=[https://archive.org/details/tippingpointhowl00glad/page/21 21] |isbn=978-0-316-34662-7 |title-link=The Tipping Point }}</ref> In [[David France (writer)|David France]]'s 2016 book ''[[How to Survive a Plague]]'', Shilts' editor expressed his regret for having "made a conscious decision to vilify Dugas in the book and publicity campaign in order to spur sales."<ref>{{cite book |url=https://books.google.com/books?id=I31ODAAAQBAJ&q=gaëtan%20dugas&pg=PT79 |title=How to Survive a Plague: The Story of How Activists and Scientists Tamed AIDS |first=David |last=France |author-link= David France (writer) |publisher=[[Macmillan Publishers|Pan Macmillan]] |date=December 1, 2016 |isbn=978-1-5098-3941-4 |page=PT79 |access-date=December 28, 2016 }}</ref>

==Re-examination==
{{see also|History of HIV/AIDS}}
A number of authorities have since voiced reservations about the implications of the CDC's Patient Zero study and characterizations of Dugas as being responsible for bringing HIV to cities such as Los Angeles and San Francisco.<ref name="Macleans"/> In the Patient Zero study, the average length of time between sexual contact and the onset of symptoms was {{Fraction|10|1|2}} months.<ref name="Auerbach1984" /> While Shilts' book does not make such an allegation, the rumour that Dugas was the principal disseminator of the virus became widespread.<ref name="lrb">{{cite magazine |last1=Crewe |first1=Tom |title=Here was a plague |url=https://www.lrb.co.uk/v40/n18/tom-crewe/here-was-a-plague |access-date=29 September 2018 |magazine=London Review of Books |date=27 September 2018}}</ref> In 1988, Andrew R. Moss published an opposing view in ''[[The New York Review of Books]]''.<ref>{{cite news |last=Moss |first=Andrew R. |url=http://www.nybooks.com/articles/4227 |title=AIDS Without End |work=[[The New York Review of Books]] |date=December 8, 1988 |access-date=December 2, 2006 }}</ref>

In 2016, a group of researchers led by [[evolutionary biology|evolutionary biologist]] Michael Worobey conducted a genetic study that looked at blood samples taken from gay and bisexual men in 1978 and 1979 as part of a [[hepatitis B]] study, and based on the results of the data, concluded that Dugas was not the source of the virus in the United States. "On the family tree of the virus, Dugas fell in the middle, not at the beginning."<ref name="Straube 2016-05-16">{{cite web |url=https://www.poz.com/article/mapping-early-aids-us |title=Mapping Out Early AIDS in the U.S. |first=Trenton |last=Straube |date=May 16, 2016 |work=[[POZ (magazine)|POZ]] }}</ref> "Beliefs about Patient Zero," Worobey concludes, "are unsupported by scientific data."<ref name="Straube 2016-05-16"/> Worobey's paper, published in ''[[Nature (journal)|Nature]]'' in October 2016, finds "neither biological nor historical evidence that he was the primary case in the United States or for [[subtypes of HIV|subtype]] B as a whole."<ref name="BBC-October-26-2016"/><ref name="NYT 2016-10-27"/><ref name="Nature Journal study 2016">{{cite journal|last1=Worobey|first1=Michael|author2=Thomas D. Watts|author3=Richard A. McKay|author4=Marc A. Suchard|author5=Timothy Granade|author6=Dirk E. Teuwen|author7=Beryl A. Koblin|author8=Walid Heneine|author9=Philippe Lemey|author10=Harold W. Jaffe|display-authors=2|date=October 26, 2016|title=1970s and 'Patient 0' HIV-1 genomes illuminate early HIV/AIDS history in North America|journal=[[Nature (journal)|Nature]]|volume=539|issue=7627|pages=98–101|bibcode=2016Natur.539...98W|doi=10.1038/nature19827|pmc=5257289|pmid=27783600}}</ref> While Dugas was not the source of HIV infection in the U.S., he was the source of infection for a large number of men, by his own admission. 

A study by historian Richard McKay of Cambridge and others identified several causes for the Patient Zero myth. During early CDC analysis of cases in California, patient 057 (Dugas) was nicknamed patient "O" for "Out-of-California", but this was interpreted by others as Patient Zero.<ref name="Macleans"/> Dugas was particularly helpful in tracing his network of partners, providing names and addresses for many of them, which was further expanded because others remembered his distinctive name.<ref name="lrb"/> Although many of the patients analysed reported in excess of 1,000 sexual partners, most remembered "only a handful" of names, making their contacts to other cases more difficult to trace.<ref>{{cite web |url=https://www.eurekalert.org/pub_releases/2016-10/uoc-nr102416.php |title=New research reveals accidental making of 'Patient Zero' myth during 1980s AIDS crisis |publisher=[[University of Cambridge]] |date=October 26, 2016 }}</ref><ref name="Nature Journal study 2016"/> Richard McKay later extended this study into a book, ''Patient Zero and the Making of the AIDS Epidemic''.<ref>{{Cite book |last1=McKay |first1=Richard A. |url=https://press.uchicago.edu/ucp/books/book/chicago/P/bo16463356.html|title=Patient Zero and the Making of the AIDS Epidemic|date=2017|publisher=University of Chicago Press |language=en}}</ref> This book also contains the most definitive biography of Dugas' life, constructed through numerous interviews with friends, family, and lovers. Robert M. Grant, an AIDS researcher at the [[University of California]], has stated: "No one wants to be the Patient Zero of their village. But this may be helpful because it says, 'Just because you are the first to be diagnosed doesn't mean you started the epidemic.'"<ref name="NYT 2016-10-27" />

Gay activist [[Larry Kramer]] argued that Dugas' promiscuous lifestyle was nonetheless "irresponsible", and that the finding did not change his opinion of Dugas.<ref>{{Cite web |date=2016-11-02 |title=Longtime AIDS activist Larry Kramer on ‘Patient Zero’ myth, HIV stigma |url=https://www.nbcnews.com/feature/nbc-out/aids-activist-larry-kramer-stigma-patient-zero-myth-n676841 |access-date=2025-04-25 |website=NBC News |language=en}}</ref>

Two films, [[John Greyson]]'s musical comedy film ''[[Zero Patience]]'' (1993)<ref>{{cite news | last =Baumgarten | first =Marjorie | title =Zero Patience | work =[[Austin Chronicle]] | date =April 1, 1994 | url =http://www.austinchronicle.com/gyrobase/Calendar/Film?Film=oid%3a138869}}</ref> and [[Laurie Lynd]]'s documentary ''[[Killing Patient Zero]]'' (2019),<ref>{{cite web |first=Victoria |last= Ahearn |url=https://www.thestar.com/entertainment/movies/2019/04/25/documentary-killing-patient-zero-seeks-to-restore-reputation-of-quebec-man-unfairly-targeted-in-aids-epidemic.html |title=Documentary Killing Patient Zero seeks to restore reputation of Quebec man unfairly targeted in AIDS epidemic |publisher= [[Toronto Star]] |date=April 25, 2019}}</ref> have discussed the Patient Zero myth around Dugas.<ref name="cbc">{{cite news |last1=Knegt |first1=Peter |title=Killing Patient Zero: How a Quebec flight attendant was falsely accused of bringing AIDS to America |url=https://www.cbc.ca/arts/killing-patient-zero-how-a-quebec-flight-attendant-was-falsely-accused-of-bringing-aids-to-america-1.5224906 |access-date=21 March 2022 |publisher=CBC Arts |date=25 July 2019}}</ref>

==Portrayal in film==
Dugas was played by [[Jeffrey Nordling]] in the 1993 [[HBO]] [[And the Band Played On|adaptation]] of ''And the Band Played On.''

==See also==
* [[Timeline of early HIV/AIDS cases]]
* [[Timeline of HIV/AIDS]]
* [[Mary Mallon]], better known as "Typhoid Mary", an Irish-American cook widely blamed for the spread of [[typhoid fever]] in 1900s New York

==References==
{{Reflist}}

==External links==
* [http://gay.hfxns.org/GaetanDugas Halifax Rainbow Encyclopedia page for Dugas]—he lived in Halifax for several years.
* {{Find a Grave|9905570}}
* The 30 30 Campaign https://the3030campaign.com/year/1983 archive footage of Gaetan Dugas speaking at an [[AIDS Vancouver]] forum (beginning at ~5:45)
* [https://www.science.org/doi/10.1126/science.351.6277.1013 'Patient Zero' no more] - study reported in Science Magazine (Vol. 351, Issue 6277, pp.&nbsp;1013), American Association for the Advancement of Science (AAAS) (Article)

{{Portal bar|Biography|Canada|LGBTQ}}
{{Authority control}}

{{DEFAULTSORT:Dugas, Gaetan}}
[[Category:1952 births]]
[[Category:1984 deaths]]
[[Category:Canadian gay men]]
[[Category:AIDS-related deaths in Canada]]
[[Category:Flight attendants]]
[[Category:History of HIV/AIDS]]
[[Category:Index cases]]
[[Category:Canadian people of French descent]]
[[Category:People from Quebec City]]
[[Category:20th-century Canadian people]]
[[Category:Air Canada people]]
[[Category:Deaths from kidney failure in Canada]]
[[Category:People with HIV/AIDS]]
[[Category:20th-century Canadian LGBTQ people]]