Study Proves 'Patient Zero' of the AIDS Epidemic Was No Such Thing

A group advocating AIDS research marches down Fifth Avenue during the 14th annual Lesbian and Gay Pride parade in New York, June 27, 1983. Photo via AP Images.
A group advocating AIDS research marches down Fifth Avenue during the 14th annual Lesbian and Gay Pride parade in New York, June 27, 1983. Photo via AP Images.

Early coverage of the AIDS epidemic labeled flight attendant Gaëtan Dugas as “Patient Zero,” painting him as a sort of hyper-sexual boogeyman, creating a popular perception that he singlehandedly introduced HIV to America. A new study of blood samples from the late ‘70s confirms that he did not—the virus’s presence in America predates him.

The New York Times reports on the study, just published in Nature. Researchers looked at blood samples collected in New York and San Francisco in 1978 and 1979 for hep B research, a number of which turned out to have been taken from men with HIV. That allowed genome sequencing tracing the progress of various strains of the disease, a brain-meltingly impressive scientific achievement; “Looking at these archival samples allowed us to step back in time,” Michael Worobey, the study’s lead author, explained to BuzzFeed News.

What they found, according to the Times:

The strain of H.I.V. responsible for almost all AIDS cases in the United States, which was carried from Zaire to Haiti around 1967, spread from there to New York City around 1971, researchers concluded in the journal Nature. From New York, it spread to San Francisco around 1976.

The new analysis shows that Mr. Dugas’s own blood, sampled in 1983, contained a viral strain already infecting men in New York before he began visiting gay bars here after being hired by Air Canada in 1974.


If Dugas had in fact introduced the disease, his strain would have been more distinctive. It’s not clear how HIV did, in fact, get to the U.S. Via Buzzfeed News:

“There’s many plausible routes that the virus could have taken,” Worobey said. “It could be a person of any nationality moving from one region to the next. It could have been a contaminated blood product, since until the mid-1970s a lot of commercial blood products were imported to the US from Haiti. We simply don’t know.”

“I think for any infectious disease—whether it’s Zika or Ebola or SARS or flu or HIV—there is value in trying to understand what it takes to make a successful outbreak,” Worobey told Buzzfeed News, but “the idea of blaming people for a pathogen that infected thousands of people before anyone knew about it is absurd.”

The study also clarifies that “Patient Zero” was essentially a typo; in early studies, Dugas was actually “Patient O,” meaning “outside Southern California.” But the phrase stuck thanks to publicity around Randy Shilts’s 1987 bestseller And the Band Played On, and further coverage turned Dugas—who died in 1984—into a villainous stereotype in the popular narrative of the disease. (In fact, this was what made “Patient Zero” into an epidemiological term.) Various researchers and advocates have worked for years to unravel the perception of Dugas, and the study provides them with still more ammunition.


The study points out another yet irony: Dugas probably stuck out so much because he kept a diary he handed over to investigators, which was particularly helpful in tracing the outbreak. No good deed, as they say.

Senior Editor, Attic Haunter, Jezebel

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The book Spillover dedicates a large section to the spread of HIV and talks this, plus the myth of Patient 0. I’m glad they’re finally officially debunking it. It gives a good background of the possible route of the early infections (plural) with bushmeat hunters, and how it got going, facilitated by a plasma trade that’s rather sketchy. Really kind of highlights how it’s a BLOODBORNE pathogen, of which sex is one entry route, rather than the sexual scourge it turned into.

The book covers all kinds of zoonotic transmission events and how some go BOOM and others don’t (the Next Big One will be a zoonosis), for anyone interested in that who doesn’t want to dive into medical literature, it’s a great read.