Timeline of early HIV/AIDS cases

Human blood samples from 1959 and 1960 from Kinshasa, the capital and the largest city of the Democratic Republic of the Congo on the Congo River, led scientists to extrapolate the virus back to the early 1900s, likely around 1908 in Africa.[1] Around that time the virus may have been transmitted from another species.[1] Paralleling the HIV discoveries, primate researchers found Simian immunodeficiency virus (SIV), which was widespread among many populations of chimpanzees.[1]

In 2006, scientists reported the origin of HIV came from a population of chimpanzees that were "penned in" a 260-square-kilometre (100 sq mi) section of Cameroon bracketed by the Boumba River to the west, the Sangha River to the east, "this patch of tropical forest is sealed into an inland peninsula to the south by the Ngoko River."[1] One hypothesis is that a Bantu hunter became infected while processing a chimpanzee.[1][2] In the early 1900s the area was experiencing an upheaval as the German Empire took over the land in 1884, naming the colony Kamerun.[1] The hypothesis follows that the infected hunter would have visited or moved to a more densely populated area and passed the infection on via sexual contact.[1]

Using the same virus tracing technologies, scientists extrapolate about a "chimp patient zero" that existed within a million years ago, although it is likely impossible to further limit the time frame.[1] This chimp would have had to have eaten SIV-infected monkeys from two distinct species, a red-capped mangabey, and a spot-nosed guenon.[1] Normally these viruses would have been defeated separately, or never interacted.[1] But in "chimp zero", a relatively rare occurrence of pieces of the two viruses combined and thrived, leading to the virus that later was introduced to humans and became one virus.[1] Scientists have found a dozen HIV strains spread from chimps, monkeys, and gorillas, but one is responsible for the majority of the human infections causing a high percentage of the almost 36 million people who have died as of 2014.[1] The research is being used to study the prevention of other "patient zero" events with other viruses.[1]

The strain of HIV viruses most closely related to the lineage of HIV-1 subgroup M (responsible for the global pandemic) may have first emerged in the 1920s in Kinshasa, then part of the Belgian Congo. A team of scientists from the universities of Oxford and Leuven concluded this "estimated location of pandemic origin" in 2014 by applying computational methods of evolutionary analysis to archived samples of HIV's genetic code.[3][4]

Earlier, it had been estimated from the genetic differences of the ZR59 and DRC60 samples that HIV-1 subgroup M had jumped to humans in 1908 ± 10 years.[5]

A series of small scale pneumocystis pneumonia epidemics occurred in northern and central European countries between the 1930s and 1950s,[6] affecting children who were prematurely born. The epidemics spread likely due to infected glass syringes and needles. Malnutrition was not considered a cause, especially because the epidemics were at their height in the 1950s. At that time war torn Europe had already recovered from devastation. Researchers state that the most likely cause was a retrovirus closely related to HIV (or a mild version of HIV) brought to Europe and originating from Cameroon, a former German colony. The epidemic started in the Free City of Danzig in 1939 and then spread to nearby countries in the 1940s and 1950s, like Switzerland and The Netherlands.

Sadayo Fujisawa, a sixty-year-old Japanese-Canadian mid-wife, died in Montreal on 28 June 1945 of pneumocystis pneumonia with Human cytomegalovirus (CMV), diarrhea, and wasting,[7][8] a group of symptoms which some authors conclude would have led to an automatic diagnosis of AIDS in the early 1980s.

Richard Edwin Graves Jr., a 28-year-old World War II veteran who had been stationed in the Solomon Islands, died on 26 July 1952 in Memphis, Tennessee with pneumocystis pneumonia and CMV, what some authors suggest are a sufficient number of opportunistic infections for a clinical course suggestive of an AIDS diagnosis.[9][10]

Until 2008, the earliest known sample of HIV-1 was from Kinshasa, Democratic Republic of the Congo (DRC) (formerly Zaire, formerly the Belgian Congo). The sample, named ZR59, was isolated from tissues collected from "a Bantu male" in 1959 and was found with retrospective genetic analysis to be most closely related to subtype D strains. In 2008, partial HIV viral sequences were identified from a specimen of lymph node collected from an adult female in Kinshasa, DRC in 1960. This specimen, named DRC60, was around 88% similar to ZR59, but was found to be most closely related to subtype A HIV-1 strains. These specimens are significant not only because they are the oldest specimens of the virus known to cause AIDS, but because they show that the virus already had an extensive amount of genetic diversity in 1960.[11] This suggests the virus had either undergone recombination or been circulating for years or perhaps decades in the Kinshasa population.

Notable potential individual cases of AIDS from this period include:

David Carr: (Contested, see below.) A Manchester printer (sometimes mistakenly referred to as a sailor) who died on 31 August 1959 following the failure of his immune system; he succumbed to pneumonia. Baffled by what he had died from, doctors preserved 50 of his tissue samples for inspection. In 1990, the tissues were found to be HIV-positive. However, in 1992, a second test by AIDS researcher David Ho found that the strain of HIV which was present in the tissues was similar to the strain of HIV which was found in tissue samples which were collected and analyzed in the late 1980s rather than an earlier strain of HIV (which would have mutated considerably over the course of 30 years). Ho's discovery has cast doubt on the theory that David Carr's death was caused by AIDS.[12]

Ardouin Antonio, a 49-year-old Jamaican-born Haitian,[13][14] has been suggested as a possible early AIDS case. Antonio had emigrated to the United States in 1927, and at the time of his death, he was working as a shipping clerk for a garment manufacturer in Manhattan. He developed symptoms which were similar to the symptoms which David Carr developed, and he died on 28 June 1959, apparently of the same very rare kind of pneumonia that killed Carr. Many years later, Dr. Gordon R. Hennigar, who had performed the autopsy on Antonio's body, was asked whether or not he thought his patient had died of AIDS; he replied "You bet ... It was so unusual at the time. Lord knows how many cases of AIDS have been autopsied that we didn't even know had AIDS. I think it's such a strong possibility that I've often thought about getting them to send me the tissue samples."[14]

Robert Rayford: A 16-year-old boy who died in 1969, described as the first case of AIDS in the United States.[15][16]

Researchers drew blood from 75 children in Uganda to serve as controls for a study of Burkitt's lymphoma. In 1985, retroactive testing of the frozen blood serum indicated that 50 of the children had antibodies to a virus related to HIV.[17]

Arvid Noe: Arvid Darre Noe (an anagram of his birth name Arne Vidar Røed) was a Norwegian sailor and truck driver who was probably infected in Cameroon some time between 1962 and 1965, and died on 24 April 1976, three months after his daughter. Tissues of Røed, his wife and daughter all tested positive for HIV 1 type O, in an epidemiology study in 1988.[18][19]

Grethe Rask: A Danish surgeon who traveled to Zaïre in 1964 then again in 1972 to aid the sick. She was likely directly exposed to blood from many Congolese patients, one of whom infected her. She became unwell from 1974, then returned to Denmark in late 1976, with her colleagues baffled by her symptoms. She died of pneumocystis pneumonia in December 1977. Her tissues were examined and tested by her colleagues and found positive in 1987.

Senhor José (English: Mr. Joseph): A Portuguese man who is the first confirmed case of HIV-2. He was believed to have been exposed to the disease in Guinea-Bissau in 1966. He was treated at the London Hospital for Tropical Diseases by Professor Anthony Bryceson until he died of the disease in 1978.[20]

Herbert Heinrich: German concert violinist who died in 1979. Tests in 1989 found that he was HIV-positive, and there has been speculation that he was infected by a prostitute who was infected by Noe, but as of 1997, this had not been proven.[19]

• List of HIV-positive people
• History of HIV/AIDS
• Timeline of HIV/AIDS

• Cribb, Julian, The White Death, Sydney: Angus & Robertson, 1996