Richard A. McKay. Patient Zero and the Making of the Aids Epidemic

The outbreak of HIV in the early 1980s led to both an epidemiological and an epistemological crisis. Doctors, public health officials, scientists, politicians and, most of all, LGBTQ people struggled to understand HIV, to classify its pathology, to define its causes, and to treat it. In a slip of a pen, CDC epidemiologists wrote the letter “O” to identify one of the subjects as “Out(side)-of-California” but it got misread as the number zero, which then gave way to the use of the now infamous and ubiquitous term “Patient Zero.” The emergence of Patient Zero immediately provided a logic to an epidemic that otherwise confounded scientists, doctors, and the public. It, as Richard McKay brilliantly explains in his tour de force of the origins of the HIV/AIDS epidemic, Patient Zero and the Making of the AIDS Epidemic, evoked age-old narratives that traced the epidemic to a particular cause. As McKay explains, in earlier periods, people blamed a divine wrath or a human carrier in order to rationalize the spread of an epidemic. Identifying Patient Zero as the starting point of the epidemic, in turn, illustrates how the HIV epidemic is, as Charles Rosenberg explains, a “social phenomenon” that has a “dramaturgic form” (“What is an Epidemic? AIDS in Historical Perspective,” Daedalus 118 (1989): 2).

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