Staying healthy in Japan

Features Health - July 19th, 1985

by Elyse M. Rogers

AIDS

Two years ago I wrote about AIDS (Acquired Im­mune Deficiency Syndrome) which at the time was a new, very serious, frightening disease. It was first re­ported in the US. in 1981. The Center for Disease Control (CDC) in Atlanta reports that as of Feb. 25, 1985, 8,597 cases of AIDS had been reported in the U.S. (600 in Europe); during that same period deaths from AIDS ran over 50% (4,145 deaths in the U.S.).

In a February issue of the New England Journal of Medicine, three physicians who specialize in AIDS (Sheldon H. Landesman, Stanley H. Weiss and Harold M. Ginzburg) reported that an estimated 400,000 Ame­ricans may have been exposed to the virus that can cause AIDS and gave an ominous prediction of 8,000 new cases of AIDS in 1985 in the U.S. In addition to the suffering the disease brings to its victims, the actual fiscal cost lo society is great as well. For ex­ample, 8.000 new cases would cost about U.S. $12,000 each in hospital care, for a total hospital bill of $336 million.

So, unfortunately, although the disease is no longer new, it remains a frightening one. However, it’s good to remember that AIDS is a relatively rare disease. To keep it in perspective, compare the approximately 4,000 deaths from AIDS that have occurred since 1981 in the U.S. (that would be approximately 1,000 per year) with the over 50,000 deaths that occur annually as a result of automobile accidents! So, we are all far more in danger of being run over by a car than we are of perishing from the AIDS virus.

The disease itself is one that damages the immune system. In some way the “helper cells” (called “T-cells”) are crippled, and the AIDS victims become vulnerable to infections and diseases that would not usu­ally be serious. T-cells prime the immune system to destroy foreign organisms. The two resulting diseases that cause most of the fatalities in AIDS are a rare form of parasitic pneumonia and Kaposi’s sarcoma, a rare form of skin cancer. Even fungal infections and routine viruses that a person with a normal immune system could handle cause serious and sometimes fatal illness in the AIDS patient.

WHO IS MOST AT RISK?

Almost all the AIDS cases have occurred in belonging to one of the following six groups:

  1. Sexually active homosexual and bisexual men who have multiple sex partners. (This is by far the largest group, accounting for over 70% of the cases.)
  2. Intravenous drug users or abusers. (17%)
  3. Haitian persons in the U.S. (4%)
  4. Patients  who have received blood transfusions (1%)
  5. On-going sexual partners of persons with AIDS or of persons at high risk for developing aids (1%)
  6. Hemophiliacs (patients who have a blood-clotting problem from birth) (0.7%)

Today, AIDS remains the number one priority of the U.S. Public Health Service, and much new research has been done and is being done. Millions of dollars are being poured into research projects, and the National Institute of Health in Maryland re­ports that “six of the 11 research components have been involved in multidisciplinary studies on AIDS in NIH laboratories and clinics.” These studies have yielded the cause of AIDS and have been directed also at the pathogenesis of AIDS; that is, how it progresses in the body once infection occurs and establishing the disease in animal models.

As if often true, luck played a role in the research laboratory. In 1976 encouraged the growth of human T-cells was isolated. This substance, now known as “interleukin-2,” enabled researchers to grow T-cells in the laboratory and study the diseases that affect such cells. A type of leukemia was the first disease studied and it appeared to be caused by a human “retrovirus.” (Retroviruses are an unusual kind of virus that had previously been found only in animals, not humans.)

Through a complicated process of cell and genetic research, in 1980 scientists finally confirmed that this leukemia retrovirus (known now as HTLV) did indeed exist. And in 1982, the guess that HTLV was possibly the cause of AIDS proved right, and soon after it was confirmed that AIDS patients had a retrovirus in their blood. This retrovirus (which scientists feel is a mutant version of HTLV-1) has been labeled HTLV-3. It is important to realize that of those people found to have HTLV-3 in their blood, only an estimated 25% will get some symptoms (such as lymph node problems and weight loss) and only about 10% will develop the severe form of AIDS which destroys the body’s immune system.

A NEW BLOOD TEST

As a result of this breakthrough in identifying the AIDS virus, a commercial blood test has been developed that can be used to test blood for HTLV-3 and thereby determine if blood given in blood banks is safe. This will be a relief to the approximately three million Ame­ricans who get blood transfusions each year, as any contaminated blood will be discarded. Margaret M. Heckler, Secretary of the United States Department of Health and Human Services, called the new blood test “an additional insurance policy” for preventing the trans­mission of AIDS through the nation’s blood supply.

This commercial blood test (produced by Abbott Lab­oratories of Chicago) was just approved by the Federal Drug Administration (FDA) in the United States in March of this year and is already being used in blood banks across America. The testing kits are also being exported to other countries (such as England and Aust­ralia) for use in their blood bank programs but, un­fortunately, the kits have not been approved for import into Japan as yet.

There has been some concern, particularly among the homosexual community, that the test would be used for “discriminatory purposes,” even though the blood test docs not confirm that the donor has AIDS, but merely that the blood contains antibodies to the AIDS virus. To avoid any such discrimination, the U.S. government has required labeling on the blood-test kit stating lb “it is inappropriate to use this test as a screen for AIDS or as a screen for members of groups at increased risk for AIDS in the general population.” And in an FDA letter sent to health-care providers, an official urged that the test results be kept confidential “because disclosure could lead lo serious social and employment consequences.”

CAN AIDS BE PREVENTED?

Although scientists are hopeful that a vaccine against AIDS will be available within two or three years, no such definite preventive tool is available today. How­ever, the U.S. Public Health Service recommends that everyone follow the following steps to prevent the spread of AIDS:

  • Avoid sexual contact with persons known or sus­pected of having AIDS.
  • Avoid having sex with multiple partners, particularly those in the high-risk groups.
  • Members of high-risk groups should refrain from donating blood.
  • Physicians should order blood transfusions only in serious medical emergencies.
  • Health workers should use caution when handling used hypodermic needles.
  • Don’t use intravenous drugs unless ordered by your physician. If you use intravenous drugs, don’t share needles and syringes (boiling does not necessarily de­stroy all germs). Don’t have sexual relations with people who abuse intravenous drugs.

For most people not in the high-risk groups, which includes most foreigners in Japan, AIDS will not be a problem. Still, since there is evidence that the AIDS virus is beginning to spread to the non-high-risk pop­ulation and, since AIDS is certainly a frightening disease that we’d all like to see eradicated, I’ll keep you posted on any new developments. A free 16-page cartoon-type booklet discussing AIDS in simple terms (that might be useful for curious teenagers) can be obtained by writing to:

AIDS Information
U.S. Public Health Service
Room 721-H, HHH Building
200 Independence Avenue, S.W.
Washington D. C. 20201

For those of you going to the U.S. on home leave or a business trip, there’s a toll-free hotline in America which provides a recorded message on AIDS and a recent developments of major importance. If interested, dial (800) 342-AIDS.