It is learned that epidemiologists can be thought of as medical detectives who determine the origins of disease by examining the earliest known human who was infected and the agent causing the infection. Consider the case of Gaetan Dugas, “Patient Zero” who was identified as a key figure initiating the spread of the HIV virus in the gay community in the US. In 1982, the CDC tracked down Dugas, who was a French-Canadian flight attendant. His travel patterns and multiple partners allowed him to spread the virus to a large number of people very quickly. By the time he learned he was contagious, he had been carrying the HIV virus for two years. After interviewing Dugas and obtaining the names of his sexual partners, CDC researchers were able to track the spread of a large number of cases of HIV in the San Francisco and New York City gay communities. Dugas died in 1984, after having AIDS for 4 years. He did not stop having sex, even after knowing he was contagious with a deadly disease.
(Source: Shiltz, R. (1987) And the band played on: Politics, people, and the AIDS epidemic. NY: St. Martin’s Press.)
Once an individual is identified as carrying an infectious disease that seems to be rapidly spreading and life-threatening, how does one balance individual freedom with the protection of the community? Compare this example to other recent outbreaks, such as the H1N1 virus (“swine flu”) and the case of Andrew Speaker who had drug-resistant tuberculosis and traveled internationally by plane in 2007 before being detained. Consider also how during the 19th and 20th centuries, outbreaks of tuberculosis led to many states and communities in the US requiring people to be quarantined in sanatoriums. When it is unclear how dangerous an illness may be, how quickly should health officials step in with preventive measures (e.g., mandatory vaccines, quarantines)?
