DR. JAMES CURRAN/CDC

DR. JAMES CURRAN THE CENTERS FOR DISEASE CONTROL

The Centers for Disease Control in Atlanta, Georgia, house the government's public health monitoring services. When a cluster of deaths indicates the outbreak of disease, the CDC is our front line of investigation. Rapid CDC response led to the identification and control of Toxic Shock Syndrome and Legionnaire's Disease.

In 1981 Dr. James Curran headed the CDC's Venereal Disease Division, so it was to him that Dr. Michael Gottlieb of the University of California at Los Angeles and Dr. Wayne Shandera of the Los Angeles Department of Public health reported that Gottlieb had discovered a new complex of infections, centering on pneumocystis pneumonia, among gay men whose immune systems lacked T-cells.

The CDC published that report, and soon doctors in New York, Los Angeles, and San Francisco confirmed the existence of a new syndrome-Gay-Related Immune Deficiency (GRID)-in which opportunistic infections (Ols; see card 72) killed homosexual men. But almost as soon as GRID was announced to the world, doctors in Africa and Haiti reported so many heterosexual cases that a new name, Acquired Immune Deficiency Syndrome (AIDS) was coined. AIDS is a collection of symptoms, not one disease, so as scientists learn more about how HIV leads to AIDS (see card 58), the CDC periodically revises its definitions of AIDS. On January 1, 1993, the number of people in the U.S. with AIDS doubled overnight when a broader definition went into effect. Under the new CDC rules, all HIV-positive people with T-cell counts below 200 (about 1/5 of the normal count) have AIDS. The new definition also adds three more Ols to the list of those that affect people with AIDS. Next Card 93: DIANA: Princess of Wales, AIDS Activist

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