Index case

The index case or primary case is the initial patient in the population of an epidemiological investigation. The index case may indicate the source of the disease, the possible spread, and what reservoir holds the disease in between outbreaks. The index case is the first patient that indicates the existence of an outbreak. Earlier cases may be found and are labeled primary, secondary, tertiary, etc. "Patient Zero" was used to refer to the index case in the spread of HIV in North America.

Gaëtan Dugas case (Patient Zero)

In the early years of the AIDS epidemic, there was controversy about a so-called Patient Zero, who was the basis of a complex transmission scenario compiled by Dr. William Darrow and colleagues at the U.S. Centers for Disease Control (CDC).

Journalist Randy Shilts subsequently wrote about Patient Zero, based on Darrow's findings, in his 1987 book And the Band Played On, which identified Patient Zero as Gaëtan Dugas. Dugas was a flight attendant who was sexually promiscuous in several North American cities, according to Shilts' book. He was vilified for several years as a "mass spreader" of HIV, and seen as the original source of the HIV epidemic among homosexual men. Four years later, Darrow repudiated the study methodology and how Shilts had represented its conclusions. probably through a single immigrant.

The term "Patient Zero" is now used in the media to refer to the index case for infectious disease outbreaks, as well as for computer virus outbreaks, and, more broadly, as the source of ideas or actions that have far-reaching consequences.

Other index patients

Mary Mallon (a.k.a. Typhoid Mary) was an index case of a typhoid outbreak. An apparently healthy carrier, she infected 47 people while working as a cook. She eventually was quarantined to prevent her from spreading the disease to others. The first recorded victim of the Ebola virus was a 44-year-old schoolteacher named Mabalo Lokela, who died 8 September 1976, 14 days after symptom onset. 64-year-old Liu Jianlun, a Guangdong doctor, transmitted SARS during a stay in the Hong Kong Metropole Hotel in 2003. A baby in the Lewis House at 40 Broad Street is considered the index patient in the 1854 cholera outbreak in the Soho neighborhood of London. (The Ghost Map, Steven Johnson, 2005) Édgar Enrique Hernández may be patient zero of the 2009 swine flu outbreak. He recovered, and a bronze statue may be erected in his honor. Maria Adela Gutierrez, who contracted the virus about the same time as Hernández, became the first officially confirmed fatality.

See also

Proband

Misconceptions about HIV and AIDS

Mayinga N'Seka

Notes

References

Auerbach DM, Darrow WW, Jaffe HW, Curran JW. (1984) Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact. Am J Med. 76, 487–492 PMID 6608269

External links

Letter to the New York Review of Books (vol. 35, no. 19, December 8, 1988) by Dr. Andrew Moss, Dept. of Epidemiology and International Health, San Francisco, regarding the Patient Zero myth.

Category:HIV/AIDS Category:Epidemiology