The First Five Years of AIDS

AID's First 5 Years and a Look at It's Future

By Cristine Russell
Washington Post Staff Writer
Thursday, June 5, 1986

On June 5, 1981, with characteristic scientific understatement, the federal Centers for Disease Control reported five "unusual" cases of a mysterious deadly disease afflicting young homosexual men in Los Angeles.

Five years to the day later, the "unusual" cluster has grown to an epidemic of more than 21,000 victims of acquired immune deficiency syndrome across the united States, more than half of whom have already died. And there is growing concern that more than 10 times as many Americans could have AIDS five years from now.

While it is difficult to predict the course of the epidemic, several AIDS experts said this week that given current trends, the cumulative number of U.S. AIDS cases could possibly rise to 250,000 over the next five years.

New estimates were prepared by the CDC for discussion yesterday at a private Public Health Service workshop of some 80 AIDS specialists who gathered in Berkeley Springs, W. Va., to draw up a new five-year government plan for dealing with AIDS.

A five-year projection of 250,000 cases by the end of 1991 -- with roughly 60,000 to 80,000 new cases that year -- is "in the ballpark of what we're considering," said one government official attending yesterday's meeting. "This is based in large part on the people we believe are already infected . . . The number one message is going to be to try to prevent more infections from occuring."

Government estimates suggest that about 1 million Americans may now be infected with the virus that can cause AIDS and that at least 15 to 20 percent of them may come down with the disease within five years after infection.

The best hope for such individuals would be the development of drugs to control the virus responsible for the slow destruction of the immune system that makes AIDS victims vulnerable to life-threatening infections and cancer. Should an AIDS vaccine be developed successfully in coming years, it would not help those infected but would prevent the disease in others.

In interviews this week, specialists in the field stressed that major scientific advances have been made since the disease was first noticed five years ago, but the disease is far more complicated and the epidemic far worse than was anticipated at the start.

Not only is there more widespread infection, but there has been growing recognition that the virus responsible for the disease may incubate in the body and not cause health problems for five years or more -- or perhaps a lifetime.

"In June of 1981, all of us realized that there was something very important happening . . . From the very beginning, it was a very unusual and very serious disease in young men. Few if any of us recognized the numbers of people that would ultimately be affected and the profound impact of the disease on our international society," said Dr. James Curran, head of the CDC's AIDS effort for the past five years.

"We've really learned a tremendous amount about this disease in the past five years, but a lot of what we've learned has not been reassuring. The mortality (R) is close to 100 percent, a very large number are already infected and inevitably many of them will become ill," said Curran's deputy, Dr. Harold Jaffe.

Although the first cases were in homosexual men -- who continue to account for three-fourths of the cases -- AIDS has spread through other segments of the population, largely through sexual contact or exposure to blood.

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© 1986 The Washington Post Company