Search Salon

- - - - - - - - - - - -

Recently in Salon Health & Body

Column
The dressing room
A suburban dad makes himself into the girl of his dreams.
By Virginia Vitzthum
[10/05/99]

Sexpert Opinion
When did you stop abandoning your child? and other FAQs from the road
Why is it no one ever asks John Updike where hiskid is while he's on book tour?
By Susie Bright
[10/02/99]

Books
Separated by curtains, united by grief
In a recovery room, a woman realizes the loss she has experienced, only after hearing another woman's cries.
By Pamela Post
[10/01/99]

Jonesing for my Coke high
Why can't I make it through a day without my diet soda fix?
By Liz Krieger
[09/30/99]

Urge
Great expectations
Nancy learns Jasmine's true motives for going 12-stepping.
By Tracy Quan
[09/30/99]

Complete archives for Health & Body

- - - - - - - - - - - -

- - - - - - - - - - - -

EXCERPT
- - - - - - - - - - - -

"THE RIVER"

An exhaustive history of HIV and AIDS offers a bold new theory about its origins

- - - - - - - - - - - -
By Edward Hooper

Oct. 6, 1999 | Frozen in time: 1959 Let us take a moment in time. Let us freeze it. Let us watch as the crystals form, as it becomes translucent. Let us mount it on a slide and lift it carefully to the microscope stand. Using strong light and mirrors, adjusting the focus, let us see what can be seen.

Truth, like beauty, resides in the eye in the beholder. Whatever the material on that glass slide -- be it a moment in history or a cluster of cells -- it is inevitable that what you see and what I see will be different. I may see colors, a myriad of dots, a divine impressionistic sweep of light and shade. You, the historian, may see a pattern, a grand design, the beginning of a chain of cause and effect. Now let us change the eyepiece, increase the magnification. This time I may see a meaningless smudge with specks of darkness within, while you, the biologist, may see a nucleus and mitochondria, the beauty of simplicity, the pulsating potential of a cell ready to divide.

How will we describe our truths, you and I, for the blind man, for the child without a microscope? And whose description will be more accurate? While I pack away the lenses, and you put the glass rectangle into its slot in the velvet-upholstered case, remember this. Empirically, the image that you see and that which I see are the same. What differs is our relative clarity of vision, level of understanding, power of analysis -- and the language we choose to describe what lies beneath the lens.

The River: A Journey to the Source of HIV and AIDS By Edward Hooper Little, Brown Nonfiction 1,070 pages   Buy The River: A Journey to the Source of HIV and AIDS by Edward Hooper

It is the February of 1959. It is a particular moment in the history of the world. The old order is breaking up; the barriers of time and space are tumbling. The first jet planes are taking off, heading for destinations -- Hong Kong, Nairobi, Sydney -- that once were days away, but are now just hours. There is a new type of global language too, as people talk of atom bombs, the cold war, of international power blocs, and the arms race. It is also a particular time in the history of Africa. The wind of change is blowing hard: in the last two years Ghana and Guinea have attained independence, and across the continent the clamor is rising. The old colonial powers -- the British, the French, the Belgians -- are, each in their own time, recognizing the inevitability of the process, acknowledging that these are the final days of the Raj; only the Portuguese are still defiantly opposed. Here, in the Belgian Congo, amidst the wide, gracious, tree-lined avenues of the capital, Leopoldville, the first round of riots has just ended, with more than fifteen hundred Africans arrested. The Belgians are bewildered. People returning to Brussels tell the man from the London Times that "something untoward is brewing at Stanleyville," the town a thousand miles upstream at the great bend in the river.

Meanwhile two doctors, one American and one Belgian, are traveling around the capital immersed in their own world, which is one of scientific inquiry. The American, funded by grants from the U.S. Public Health Service and the Rockefeller Foundation, arrived in Leopoldville just after the end of the unrest, and neither saw evidence of its impact nor, one suspects, would have had much appreciation of its significance had he done so. The Belgian, for his part, has just been appointed chair of microbiology at the newly built university of Lovanium, eight miles from the city center on the banks of the Congo River -- but for all that, he is happy for the chance to collaborate with such a rising star in the firmament of human genetics. These are impassioned men operating in an era that reveres their activities, in an era when science is the new religion, and the men in white coats its prophets and priests.

Over the next few weeks the American, Arno Motulsky, and the Belgian, Jean Vandepitte, with the help of other local doctors, start collecting blood samples from medical staff, hospital patients, and police recruits in Leopoldville, and from a large group of villagers living to the south, near the Angolan border. Motulsky is keen to investigate the relative incidence of two genetic traits in different ethnic groups in sub-Saharan Africa, and their possible relationship to malaria. Later, he visits several other regions of the Belgian Congo and the neighboring territory of Ruanda-Urundi, administered by the Belgians as a trusteeship since Germany was dispossessed of its African colonies after the First World War. At the end of three months, he and his Belgian colleagues have collected nearly eighteen hundred blood samples from eight different population groups, including pygmies from the Ituri Forest, hospital patients from Stanleyville, and schoolchildren from the two principal ethnic groups in Ruanda-Urundi, the Tutsi and the Hutu. Most of these samples are finger-prick specimens mounted on glass slides and examined in local laboratories the same day, but more than seven hundred are samples of whole blood, which are then refrigerated and flown back to Motulsky's department at the University of Washington in Seattle.

As Jean Vandepitte bids farewell to Arno Motulsky at the airport, neither man has any inkling of the additional significance which one of these 5-milliliter blood samples will assume just over a quarter of a century later. Independence arrives, and the countries where Motulsky obtained his specimens subsequently become known as the Republic of the Congo, Rwanda, and Burundi. Over the next few years, all three experience tragic events, as ethnic tensions and the meddling of foreign powers combine to promote upheavals, violence, and bloodshed. Meanwhile, back at the University of Washington, various tests are conducted on the blood samples, and a series of papers published in journals of genetics.

Several years later, Moses Schanfield, a professor from Emory University, contacts Motulsky to ask if he can undertake further genetic studies on the Congo cohort, and the remaining 672 frozen plasmas are flown to Atlanta. Finally, in 1985, they change hands once more, and are given to another Emory professor, André Nahmias, who has an entirely different interest. He wants to test them for the presence of antibodies to a virus that has suddenly entered the medical limelight -- the virus that causes AIDS. He examines not only the Motulsky samples, but a further 500 plasmas originating from South Africa, Mozambique, and Congo-Brazzaville, and collected at various times between 1959 and 1982.

Over the next few months, the specimens are examined exhaustively, first at Emory and then at Harvard; the results are then confirmed at two other laboratories, by a total of four different testing procedures. Of all the plasma samples, just one comes out strongly positive on all the tests. Its code number is L70, and it comes from a group of 99 specimens taken in 1959, somewhere in or around Leopoldville.

In the mid-eighties, scientists are just awakening to the possibility that HIV (as it will soon become known) may have been present in sub-Saharan Africa for some years before the recognized start of the AIDS epidemic in North America and Europe in 1981, and the Nahmias investigation provides the first really dramatic evidence in support of this hypothesis. No further details appear to be available, however, about the source of the L70 sample. In the 1986 letter to The Lancet in which he reports the results of his investigations, Nahmias comments simply: "The identity of the donor is no longer known."

Nearly four decades have passed since his trip to Africa, but Arno Motulsky, now professor emeritus, still lives in Seattle and is still a man of spiky brilliance. And his papers do reveal a little more about the identity of the L70 donor. They record that the blood was taken from a Bantu male, one of 78 men in the group of 99 designated as "Leo." Unfortunately, of all the 12 groups tested by Motulsky, there is less documentation about the "Leo" series than any of the others. Motulsky says that most of them were normal members of the population, and that around 20 percent were hospital patients. The identity of the hospital is not recorded, although Jean Vandepitte, now professor emeritus at the University of Leuven and the Institute of Tropical Medicine in Antwerp, believes that it was probably that at Lovanium, the great campus the Belgians constructed on the outskirts of Leopoldville, and which many consider to have been their parting gift to the country they ruled for 75 years.

Whatever, it appears that this tiny amount of blood, taken in 1959 from an unknown man living in the city now known as Kinshasa, the bustling capital of the Congo, represents the oldest specimen of the human immunodeficiency virus in existence. We shall return to it later in the story. As with the early course of a river, where water may seep unnoticed through sphagnum bogs, or plunge underground through limestone, so with the early course of a new disease. It is, of course, entirely possible that the first traces of an unusual and hitherto unseen condition (especially a disease syndrome with a diverse range of presentations and a long latency period, like AIDS) will pass by unremarked. There again, perhaps because of serendipity, or an especially conscientious team of doctors, it can also happen that the crucial clues are noticed and recorded for posterity.

Next page | A working-class Englishman becomes part of the mysterious history of the AIDS epidemic