Aids surfaced in Haiti. West Coast homosexuals brought it back to San Francisco. Cheap transatlantic travel flew it in to England. And next year the handful of known cases will become hundreds as the four-year incubation period comes to an end for gays, and maybe even for their heterosexual partners. Andrew Veitch our medical correspondent, reports on the disease, the stark choices, and the search for an antidote.
Aids flew in on Skytrain. That much seems certain. Freddie Laker╒s cheap fares gave thousands of homosexuals the chance to go to San Francisco. For many, the disease is the permanent souvenir of days of free and plentiful sex in the city╒s bathhouses.
The virus ╤ assuming it is a virus ╤ can work away in the body for years before the symptoms show. That suggests that for Britain the trouble has only just begun. People who were in the danger zone two or three years ago are now developing the disease.
Each of those initial carriers may by now have passed on the disease to more than 100 others. The most sexually active gay man might have up to 300 different partners in a single year. This is the worst-case scenario, but it is the one that some of the most senior specialists now believe. The figures tend to bear it out. In midsummer the number of cases reported to the Communicable Disease Surveillance Centre was holding steady at around 12. By October the number had jumped to 24, 10 of whom have died. The numbers include two heterosexual haemophiliacs and one woman. Doctors are not compelled to inform the CDSC of cases, and there may be a long delay in diagnosis.
In the US the number of cases was more than doubled since January to 2,374 last month. New cases have been reported at the rate of over 50 a month. It has been predicted that the numbers would double every six months, though the latest figures suggest that the rate of increase is slowing. Surveys in the States have shown that gays are reducing the number of people they sleep with.
In retrospect Aids is seen to be endemic to Haiti and Zaire. Some five or six years ago Haiti became a popular holiday resort for West Coast gays. The theory is that the US epidemic began when they brought it home with them.
╥That suggests a four-year time lag,╙ said a senior specialist. ╥It is logical to assume that the next move will take a similar number of years.╙
If he is right, the number of UK cases should start rising sharply early next year. A survey earlier this year by doctors at St Mary╒s Hospital, Paddington, showed that 12 per cent of apparently healthy homosexuals had the first signs of the disease. Four had all the signs of Aids. Three of those had been to US cities in the past three years.
Apart from ordinarily promiscuous gays, said the specialist, the high risk groups are those who saved up their money for a sexual binge in cities like San Francisco, Los Angeles and New York, and affluent travellers who pick up boys abroad.
The specialist╒s advice is: ╥Stop being promiscuous, settle down with one partner, and don╒t go to bed with people from the danger areas ╤ even if they are nice and sensible, you won╒t know if they╒re infectious.╙
Aids is transmitted in blood, which suggests that oral/genital sex, anal intercourse, and particularly violent forms of gay sex may be the most risky. Avoiding danger areas is becoming more difficult. The disease is spreading through Europe. France is worst affected with 94 cases mainly due to its traditional links with Haiti and Zaire. Belgium, with its Zaire connection, has 38 cases. Denmark has 12. Germany, Holland, and Austria have about seven each.
Many gays insist there is less danger of an epidemic in Britain because they do not indulge in violent communal sex on the American scale. A gay in a San Francisco bathhouse or a New York club might be exposed to blood and faeces from more than a dozen men in one session.
Since blood is the main vector, drug addicts have been infected by contaminated needles. Some 17 per cent of the US cases are drug addicts.
The disease has spread to women, presumably through bisexuals. One woman has died in Liverpool. About 150 have caught the disease in the States. Paris doctors have reported the case of a woman who was thought to have caught Aids from her Haitian lover in New York. Both she and the lover died. Her husband also developed the disease. He too died.
A child of an infected mother has been born with the disease. Another child has contracted it from a contaminated blood transfusion. Gays in Britain who think they may have been in contact with the disease have been asked not to donate blood.
The threat to haemophiliacs through contaminated Factor VIII was first identified in the US in July last year. To date about 1 per cent of the US cases have been haemophiliacs. A haemophiliac from Bristol has died, another in Cardiff is suffering from Aids. Dr John Craske, in Manchester, is tracking down haemophiliacs who received Factor VIII from a batch given to the two men which was imported from the States.
Blood from up to 2,500 donors may go into the making of a single injection of Factor VIII ╤ the blood clotting agent. In one year a haemophiliac may be exposed to blood from over 25,000 donors. About half of the 70 million units of Factor VIII used each year by Britain╒s 4,500 haemophiliacs comes from the States.
