Resources

Grade Levels

Colleges and universities

Academic Topics

• History of Public Health
• History of Medicine

Learning Outcomes

After completing this class resource, students are expected to:

• Demonstrate a historically-grounded understanding of the emergence and recognition of HIV/AIDS in North America in the late 20th century.
• Interpret scientific and popular attempts to understand the origins of HIV/AIDS, as well as several other historical epidemics which were accompanied by efforts to lay blame for the arrival and spread of disease.
• Articulate the strengths and weaknesses of infectious disease epidemiology as a discipline.
• Summarize the objectives and conclusions of the Centers for Disease Control’s Los Angeles cluster study.
• Explain the origins of the term “patient 0” and the popular misconceptions surrounding its meanings.
• Use primary source documents, images, and video to contextualize the creation and reception of Randy Shilts's history, And the Band Played On.
• Provide examples of how the idea of “Patient Zero” was incorporated into political debates about HIV/AIDS in the late 1980s.
• Give examples of the continuing storytelling power offered by the idea of “Patient Zero” and the consequences of these stories.

Evaluate the process of scientific discovery and the respective roles biomedical research and epidemiology play in promoting health and preventing disease.

Overview

The search for a “Patient Zero”—popularly understood to be the first infected case of an epidemic—has been an important feature of the news media’s coverage of disease outbreaks from the late 20th century onward, including HIV/AIDS, Ebola, SARS, and H1N1. Yet despite its widespread use, the term is a recent invention, drawing its origins from epidemiological studies investigating the etiology of AIDS in the United States in 1982. How did the idea of an epidemic's “Patient Zero” so swiftly come to exert a strong grip on the scientific, media, and popular consciousness?

Read More

Patient Zero and the Early North American HIV/AIDS Epidemic, developed by Richard A. McKay, PhD, explores the historical precedents and emergence of this phenomenon. It also traces the closely interlinked development of one enduring popular origin tale for the North American HIV/AIDS epidemic: namely, that AIDS could be traced to a single, gay, French-Canadian flight attendant named Gaétan Dugas. What factors gave rise to the widely disseminated and disturbing depiction of this individual as the original “Patient Zero” of the American AIDS epidemic? Upon what historical precedents did this tale draw? How did this tale affect how people understood HIV/AIDS and subsequent disease epidemics? Students will have the opportunity to discover the answers to these questions and reflect on the historical and present-day challenges raised by outbreaks of infectious disease.

There are six one-hour lessons in this resource. Lessons 1 and 2 on historical precedents encourage students to draw comparisons between the challenges faced by earlier Western societies dealing with epidemics and responses to HIV/AIDS in the late twentieth century. Lessons 3 and 4 on infectious disease epidemiology and narrative focus on the role of epidemiology in the first years of the recognized American epidemic, and on one investigation in particular that coined the term “patient 0” and shaped the way journalist Randy Shilts wrote his best-selling history, And the Band Played On. Lessons 5 and 6 on social, cultural, and medical responses to epidemics explore the varied responses to Shilts’s book and its promotional focus on the role of the flight attendant, Gaétan Dugas, whom it identified as “Patient Zero.” It also considers the impact of these responses on both media coverage and scientific investigations of subsequent disease outbreaks.

Information about this resource's author, suggested use, and academic objectives is also available online at About the Author. Close