September 30, 1985

The New York City school system has decided to permit youngsters with Acquired Immune Deficiency Syndrome (AIDS) to attend school. This prompted thousands of parents to keep their own youngsters at home. Hard to blame them. AIDS has itself acquired a deadly reputation, but is it communicable? No one knows precisely.

People with AIDS die of an assortment of diseases, such as unbridled hepatitis, rampant mononucleosis, malignancies (probably caused by via virus) called Kaposi’s sarcoma, as well as a formerly arcane disease known as Pneumocystis Carinii.

It is thought that AIDS (resulting from HIV infection) is caused by a virus of the Human T Cell Leukemia (HTLV3) virus class. However, instead of causing HTLV Leukemia, (maybe that’s the Kaposi’s Sarcoma virus) it causes, a T Cell Lymphoma). We have a virus in AIDS that destroys the human host indirectly by suppressing his or her immune system to allow other germs to flourish. Sneaky! The measles virus attacks directly; pneumococci may hide in the lungs, but present themselves dressed in shiny capsules to any decent microscopist. Staph causes right up front. Everybody recognizes a boil. Staph makes no secret of its presence as a sore throat. But AIDS masquerades as a battalion of infectious agents killing those infected, and scaring the rest of us to death.

AIDS is quite distinct from other diseases, first surfaced in the homosexual community among promiscuous males. Initial news releases suggested anal intercourse played a role in mediation of the disease, and this led some to conclude that the virus resided in feces. But actually it seems to concentrate in sperm, and one mode of transmission is thought to be from sperm to the host through abrasions in the rectal mucosa. To date, according to Dr. James R. Allen of the Center for Disease Control in Atlanta, GA., The virus has been cultured from sperm and never from feces.

Currently there are about thirteen thousand cases of AIDS clustered in Los Angeles, Chicago and New York City. Only 1% can be traced to blood transfusions. At greatest risk were hemophiliacs who required factor VIII for bleeding tendencies. Factor VIII is derived from pools of blood taken from numerous donors increasing the chances of including a donor with AIDS. Immune Globulin is another example of pooled blood derivative. Thus the introduction in April of a test that screens for AIDS proved welcome. 25% of blood donors screened for AIUDS were positive, and of this small number, 60% were false positives. Of course, this percentage of true positives is much higher in the homosexual population. 60% of those with confirmed positive blood will yield cultures positive to the causative virus.

All donors and all pooled blood samples drawn after April have been screened for AIDS. According to Dr. James W. Curran, AIDS is no longer considered a transfusion risk.

The diagnostic blood test that detects antibodies against AIDS has been used to screen homosexual populations. Surprisingly, only about 5% of that group seems to be afflicted. More interesting is the fact that only 10% of those with demonstrable antibodies to AIDS have clinical evidence of the disease. This implies either that 90% develop immunity after exposure or that because of the long incubation period measured in years, the worst is yet to come for that 90%.

This low incidence of AIDS antibodies in the general population is a surprise and implies that AIDS is brand new. Had it been around for a long time, the antibody would be more promiscuous. Thus it appears that it takes quite a bit of intimate contact to transit AIDS. But that may not always be true, and a street-smart attitude of parents who want to take their kids out of school may be well justified.

Furthermore, since schools transmit diseases more efficiently than they transmit education a youngster with AIDS, his or her immune system already compromised, would be a singular target for the germ pool of any city school.

New York appears to have erred. It would have been eminently more sensible to keep AIDS kids out of school and send tutors to their homes. The scientific community is not certain about the communicability of AIDS, but doctors who know about AIDS feel that it is not “catching” by less than intimate contact. However, they would not introduce children with AIDS into Day Care Centers because, they say, the surveillance is not as good as in the schools, and the chances of transmission are greater. But AIDS, although not easily communicated, is only loophole safe. Certainly youngsters with less imposing diseases are asked to stay home.

Early on, patients treated with chemotherapy for cancer have died of what was then called by some Acquired Immuno Deficiency. They died of the same cluster of diseases that kill in AIDS. I have been assured that the population of chemotherapy recipients does not display AIDS antibodies. I suspect that chemotherapy created a soil for organisms that are lethal to patients with SS and that a link between the two will surface. It would be nice to see a published report of the incidence of AIDS antibodies in the populations of Chemotherapy recipients who have AIDS.

One thing is certain, AIDS will give research in immunity a jolting shot in the arm. In the long run we may gain more than we will lose from the appearance of this fascinating disease in our midst.