“For years, several successive editions of a top-selling medical dictionary [Mosby’s Medical Dictionary] – a type of publication frequently considered to bear the ultimate imprimatus of authority – contained an entry for ‘Patient Zero’ which read: “an individual identified by the Centers for Disease Control and Prevention (CDC) as the person who introduced the human immunodeficiency virus in the United States”…The entry…remained unchanged until the tenth edition (2017)”.

The above quote, from Richard McKay’s book Patient Zero and the Making of the AIDS Epidemic, indicates just how deeply the myth of Patient Zero became embedded in AIDS history.

‘Patient Zero’ was, if the media was to be believed, the man who almost singlehandedly introduced, then spread AIDS across America.

Of course, we know that when it came to the media’s reporting of AIDS, truth and facts were frequently absent (see, for example, my post on AIDS in the British Press). But what is particularly sad about this case is the fact that this all came about because of errors and serious misjudgements within the AIDS community; specifically the Centers for Disease Control and author and activist Randy Shilts.

In consequence, one man was demonised and portrayed as some kind of psychopathic monster bent on infecting as many people as he could. Thankfully, he was already dead by the time his name was sullied in this way, but his surviving family members were left to deal with this vilification for some years.

Step One – The Man From Outside of California

The episode began in 1982 when researchers were trying to identify possible links between AIDS cases in Southern California. It has to be remembered that, this early on in the AIDS crisis, no definitive cause had been established. So these researchers were exploring the possibility that an infectious agent was involved. To do this they asked a number of gay men with AIDS if they could remember their previous sexual contacts. Their investigation showed that there had been sexual contact between a number of the men in their study. And one man in particular appeared to have significantly more connections than any other in the group.

This image from the BBC documentary “Killer in the Village” shows an early graph charting the links between people with AIDS in California – and one from “Out-of-California”

The links were drawn up on a diagram, with each man being given a number to preserve their anonymity. But the man who had the most connections was from outside the state. So he was recorded initially as “Out-of-California” which, over time was shortened to the letter O. And so the stage was set for the creation of Patient Zero.

At some point in time the letter O was misread, and subsequently mis-recorded, as 0 (zero). From there it was only a matter of time before this new designation and his connection to the largest number of other people with AIDS created Patient Zero – the man who had started the AIDS crisis.