Index case
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The index case or patient zero is the initial patient in the population sample of an epidemiological investigation. Patient zero is a somewhat less specific term than index case and is sometimes used to refer to the central patient in an epidemiological investigation rather than the first patient. When used in general to refer to such patients in epidemiological investigations, the term is not capitalized. When the term is used to refer to a specific person in place of that person's name within a report on a specific investigation, the term is capitalized as Patient Zero. Often scientists search for the index case to determine how the disease spread and what reservoir holds the disease in between outbreaks.
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The origin of the term "Patient Zero"
In the early years of the AIDS epidemic, there was a lot of controversy about a so-called Patient Zero who was the basis of a complex transmission scenario compiled by Dr. William Darrow and colleagues at the Center for Disease Control (CDC) in the US. This epidemiological study showed how 'Patient O' (mistakenly identified in the press as 'Patient Zero') had given HIV to multiple partners, who then in turn transmitted it to others and rapidly spread the virus to locations all over the world (Auerbach et al., 1984). In all, at least 40 of the 248 people diagnosed with AIDS by April 1982 were thought to have had sex either with him or with someone who had.
A journalist, Randy Shilts, subsequently wrote an article based on Darrow's findings in his 1987 book And The Band Played On, in which it named Patient Zero as a gay Canadian flight attendant named Gaëtan Dugas (February 20, 1953—March 30, 1984 [1]). For several years, Dugas was vilified as a "mass spreader" of HIV and the original source of the HIV epidemic among gay men. However, four years after the publication of Shilts's article, Dr. Darrow repudiated his study, admitting that its methods were flawed and that Shilts had misrepresented the study's conclusions.
Other Patient Zeros
- Patient Zero was a character in the Canadian film Zero Patience.
- In the third Sliders episode, "Fever", Quinn's double is alleged to be Patient Zero of a global plague.
- The movie Outbreak dealt with government officials charged with finding the index case of an outbreak of an Ebola-like virus .
See also
References
- Auerbach DM, Darrow WW, Jaffe HW, Curran JW. (1984) Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact. Am J Med. 76, 487-492 PMID 6608269