BIOL 191 Microbiology Laboratory
And the Band Played On Worksheet Key
01/05/11
1. In the early stages of the epidemic, how did the CDC (Centers for Disease Control)
react?
Many in the CDC, seeing the early stages of a pandemic virus, worked diligently to
determine the cause of the disease. They struggled along on little money for
research—and little interest from some bureaucrats within their own organization.
They also were often hampered by ‘politics’- If ‘voters/contributers’ became
‘offended’, their funding and efforts were impeded.
There is a scene in this film where the CDC is meeting with other government health
agencies at a round table discussion in an attempt to determine how to curb the
spread of the disease. As a few high-level bureaucrats allow their discussion to
become more shallow and financially driven, Francis’ frustration overcomes his
civility and he stands to deliver a passionate and emotional speech. He lets loose a
rant at these officials, essentially asking them ‘how many people must die before a
cure becomes cost effective?’
2. How did the media initially react to the AIDS problem?
At first, it was ignored in the straight press. The media, in the exercise of its First
Amendment guarantee, made AIDS seem an entirely gay problem for years (calling
it GRID-Gay related immune deficiency). Though it slightly reported about
Haitians, hæmophiliacs, other blood transfusion recipients, and drug addicts, it
centered its coverage squarely on the gay community. With this sharp focus on
homosexuals, the CDC got little money for research, the religious right was able to
denounce the disease and anyone who had it, and the gay community closed ranks
against what it saw as an attack on its hard-won civil liberties. As And the Band
Played On shows, more probably than any other of the group, how the media
brought on full-fledged horror with its slanted coverage; a shift of a few degrees
toward caring and understanding in reporting would have given the public a
different perception of AIDS than it got—and there might well have been more
funding earlier to fight the spread of the disease.
3. How did elected officials and the U.S. government initially react to the AIDS problem?
Many governmental officials, such as the surgeon general at the time, denied that
there was a significant problem. Many rarely spoke of it or did little so that they
would not offend voters.
-Public health officials and the U.S. Administration shortchanged AIDS research
until it was perceived as a national, and not just a homosexual and drug addict
problem.
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4. Who is Dr. Gallo (played by Alan Alda)?
Gallo spent 30 years at the National Institutes of Health's National Cancer Institute,
where he was head of its Laboratory of Tumor Cell Biology (at Bethesda, MD). He
discovered the first retrovirus (HTLV). He was contacted by the CDC and told the
outbreak was probably a retrovirus. He agreed to work on it. His work did make
great strides in AIDS research.
Note: Gallo left the NIH in 1996 to found and direct the Institute of Human
Virology (IHV).
5. Do you find any of Dr. Gallo's actions unethical? If so, which ones?
Although Dr. Gallo’s contributions were considerable, his behavior in many ways
hampered the search to discover the cause of AIDS and, then, a diagnostic blood test
after the virus was identified. For a significant period of time and despite much
evidence to the contrary, he stubbornly insisted the disease was caused by the
HTLV virus (which he really did discover) so that he could be the first to publish.
His behavior was boorish, at best, when the CDC sent France (a frequent research
collaborator) tissue samples from patients. Seeing it as a competition rather than
as a human health issue, he bullied those at the CDC and declined to assist their
future efforts. Gallo was willing to tie up the efforts of the CDC and the French
government’s scientists with enough red tape to stifle any serious progress for
decades. Common sense on the part of the French and the CDC prevailed as they
made a bargain with Gallo, who turned around and announced to the world (in a
press conference with U.S. health and human services secretary Margaret Heckler)
that he was the one (ignoring the French contributions) who discovered the virus,
thus cheating everyone for the sake of his ego. When it came out that the French
had actually discovered the virus from the lymph nodes of an AIDS patient a year
earlier (the French initially called the virus LAV), and that he'd used a strain of the
French virus -- the result, Gallo insists, of laboratory contamination -- in developing
his breakthrough blood test, Gallo found himself in a situation where his fellow
scientists didn't just brand him a boor; they sued him and called him a cheat. After
years of legal wrangling, it is still uncertain if he isolated the virus on his own or not.
Because of his behavior, he was snubbed by the Nobel committee for the Nobel Prize
in medicine due to his actions.
6. What was the primary motivation for Gallo's conduct?
Ego, professional reputation, and money. He basically was a bully that wanted to
get the glory of discovering and naming the virus and the money that these
accolades would bring from future investor and from patents.
Note: Gallo was well-known for his poor behavior even before the AIDS incident.
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7. Describe the initial reaction of members of the gay community to the outbreak.
A rift develops within the gay community as the CDC pushes to close down the
bathhouses, which is seen by many gay men in the film as a symbol of their sexual
freedom (early 80s, rise in gay rights movement). The community is typically
divided between those who do not wish to give up their sexual independence and
attendant identity, and those who recognize the threat to their health.
Even when it began to be understood what was causing AIDS (originally called
GRID—Gay Related Immune Deficiency), the gay community, at first, did very
little to change their often promiscuous sexual habits. Fresh from their humanrights victories in the seventies and early eighties, many gays saw AIDS as a farce, a
means for the government to control them through fear. Some also had the fatalistic
view that if there was a disease, they'd probably already been exposed, so why
should they change their habits now? [Note: Shilts was infected in 1987.]
8. How did some religious leaders/organizations react to the AIDS problem?
Some religious organizations, seeing AIDS as a rightful scourge upon immoral
homosexuals, lobbied to make sure there was no funding available for research
dealing with a disease that they considered just punishment. Their lobbying efforts
were so successful that Ronald Reagan never said the word “AIDS” in public.
9. What health care organizations were discussed in the movie? How did these health
care organizations react to the AIDS problem?
The San Francisco Health Department delayed putting restrictions on the
bathhouses for several years so as to not offend the homosexual lobby. It wasn't
until 1987 that the last bathhouse closed its doors.
Like the bathhouse owners, blood bank operators faced the AIDS problem by
ignoring it. By late 1981 there was reason to believe that AIDS was a bloodborne
virus like hepatitis B and that it would turn up in blood transfusions by mid-1982
the CDC had reported that hemophiliacs had contracted AIDS through clotting
factor. Yet in December 1982 an officer of the American Association of Blood Banks
went on network television to say flatly that there still was no evidence that
transfusions spread AIDS. It's not that there was no way to screen blood. One
method, rejected as too expensive, was to test for antibodies to the core of the
hepatitis B virus, antibodies very common in the blood of AIDS patients. Another
method was to ask members of high risk groups to exclude themselves voluntarily.
But at a meeting of all the major blood banking organizations it was announced that
no such screening would be tolerated. "Direct or indirect questions about a donor's
sexual preference are inappropriate," read the official statement. Dr. Roger Enlow,
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a New York homosexual physician and a leader of the American Association of
Physicians for Human Rights, praised the policy. "We've preserved not just gay
rights," he said, "but the human right to privacy and individual choice." -Except, of
course, for those who chose not to die of a horrible disease simply because they
needed blood products. In his epilogue Shilts writes, "An estimated 12,000
Americans were infected from transfusions largely administered after the CDC had
futilely begged the blood industry for action to prevent the spread of the disease."
This holds true for the FDA also. For many years the FDA did not require that
blood banks follow the above regulations.
Some hospitals didn’t want AIDS patients. Morgan MacDonald was a Florida AIDS
patient who was “dumped” by his hospital and shipped to San Francisco to die. He
died of AIDS in 1983.
10. Describe the following list of (real) people (this information may be found online).
Write your answers on a separate page(s).

Randy Shilts: (August 8, 1951 – February 17, 1994) was a pioneering gay
American journalist and author. He worked as a freelance reporter for both The
Advocate and the San Francisco Chronicle, as well as for San Francisco Bay Area
television stations. Shilts's second book, And the Band Played On: Politics,
People, and the AIDS Epidemic (1980–85), published in 1987, won the Stonewall
Book Award and brought him nationwide literary fame. And the Band Played On
is an extensively researched account of the early days of the AIDS epidemic in the
United States. The book was translated into seven languages,[3] and in 1993 was
made into an HBO film with many big-name actors in starring or supporting roles,
including Matthew Modine, Richard Gere, Anjelica Huston, Phil Collins, Lily
Tomlin, Ian McKellen Steve Martin and Alan Alda, among others. The film
earned 20 nominations and 9 awards, including the 1994 Emmy Award for
Outstanding Made for Television Movie.[4]

Don Francis (Matthew Modine): CDC doctor, AIDS research activist

Bill Kraus (Ian McKellen): Public liason between San Fransisco’s gay
community and politicians Congressional aide and gay political leader from
San Francisco. Died of AIDS in 1986.

Jim Curran: Director of CDC infectious disease section

Mary Guinan: Assistant to Curran, physician

William Darrow: CDC intelligence officer, sociologist and epidemiologist;
performed contact tracing.
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
Roger Gail Lyon: San Francisco AIDS patient who testified at Congressional
hearing on AIDS in 1983. Died of AIDS in 1984.

Dr. Grethe Rask: Danish surgeon in Zaire, one of the first AIDS victims in the
world. Died of AIDS in 1977.

Dr. Luc Montagnier (Patrick Bauchau): Head of the Pasteur Institute in Paris.
Montagnier and his colleagues at the Pasteur Institute had isolated a virus
(which they named LAV) from the lymph nodes of an AIDS patient -- a fact
that was lost in the tumult of the Heckler press conference stating that Gallo
has first isolated the virus.

Dr. Francoise Barre (Nthalie Baye): Researcher with the Pasteur Institute in
Paris First person to isolate the AIDS virus.

Dr. Selma Dritz (Lily Tomlin): Asst. Director of the Bureau of Communicable
Disease Control, San Francisco Department of Public Health.; liason with the
gay community.

Michael Bennett (Richard Gere): Choreographer and director (including “A
Chorus Line”). Died of AIDS in 1987.

Gaetan Dugas: French-Canadian airline steward identified by Shilts (author
of And The Band Played On) as “Patient Zero.” Died of AIDS in 1984.
FYI instructors: And the Band Played On Rough Timeline/Notes:
World AIDS Clock: http://www.unfpa.org/aids_clock/
Don Francis: researcher working the 1976 Ebola outbreak.
1977: First documented case (Copenhagen)
1978: Another case in Paris
1980: UCLA Medical Center, another case (first U.S. cases?)
1981: Reagan elected.
LA outbreak (similar cases in New York, San Francisco)
CDC is now aware there is a problem. They think it is in semen, sexually transmitted
and probably a virus.
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5-152 cases in seven months -100% mortality.
No money for research and poor facilities.
1982
Contacted Bob Gallo (HTLV retrovirus discoverer) after making a connection between
the feline leukemia retrovirus and hepatitis B.
March 285 US cases, 119 deaths
Patient Zero: evidence sexually transmitted with variable incubation period.
But the CDC was not absolutely exlicit about the sexual transmission. Afraid of losing
funding if say things about the sexual transmission (only ‘gays’) and, in SF, will lose
political support from the gay community is close the bath houses.
Gay community split. Controversy: at SF public forum someone says “it’s a Reagan trick
to put down the gays. Bath houses not closed down.
Problem (on-going): Can’t PROVE anything yet without a ‘test’.
June
405 US cases 272 deaths
1983
France taking tissue sample from lymph of AIDS patient. Trying to isolate virus-looking
for a retrovirus. Gallo now working full-force on it.
The disease is now called GRID (gay-related immune deficiency).
Gallo and French have problems keeping the cells alive to grow the virus.
Now in blood supply: hemophiliacs, IV drug users?
Found that 88% of those with GRID also carry Hepatitis B virus-so could test for Hep B
to screen blood.
To PROVE it is in the blood supply-have to find someone that could not get it any other
way but blood transfusions.
An Rh baby with AIDS received blood from 13 donors at Irwin Memorial Hospital.
Need a list of donors. One donor that died was from a socially prominent, rich family-he
died of AIDS. Found his ‘other’ doctor that took care of his ‘hidden’ ailments. He had
GRID symptoms.
Jan. 4
951 US cases 640 deaths
CDC/blood suppliers meeting: CDC suggests the Hep. B test to blood banks, but they
don’t want to spend the money.
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It is now the second leading cause of hemophiliac deaths.
The name is now changed to AIDS from GRID (not just a ‘gay’ disease anymore).
Looking for infected rich people to cause a stink- After they do, the blood banks agree to
test for Hep. B.? NO.
FDA denied the regulation saying it would cost too much.
France began feeding the cells continuously to keep them alive-they got retrovirus, but
not Gallo’s HTLV.
Gallo asks French to send him samples of their virus.
October 1983:
2640 US cases 1092 US deaths
Gallo can’t find any now HTLV cases with AIDS. He is very upset that Don Francis sent
samples to the French (against his ‘own’ side). He cuts off the CDC from materials.
CDC realizes the incubation period is years long and can be passed during that time..
Mass panic begins against AIDS patients: People fired, CPR classes cancelled, funeral
directors refuse to embalm AIDS patients.
Gallo has a test, wants a patent. French (had virus 1. 5 years before Gallo) will sue-tie up
work for years.
1984
April 1984
4123 US cases
2937 deaths
Paris: Gallo at the Pasteur Institute kicks Don Francis out of the meeting. They reach a
deal: 3 papers publ. (CDC, Gallo, Pasteur Institute) and a joint announcement and share
credit for finding the virus.
But at a press announcement with Margaret Heckler (US Secretary of Health?)announces Gallo as the discoverer
Nov. 1984
Reagan re-elected
Phase II (education, etc.) proposal turned down
Don Francis transferred to SF
1985
Feb.
7
8408 US cases
6305 US deaths
It comes out that the virus Gallo found was the same as the French virus (from the same
patient).
Candlelight vigil
28,000 blood borne cases
Blood banks bagan testing
Bath houses closed
1987
Settlement Gallo/French co-discoverers
1992: Don Francis retired from the CDC
Dec. 2005
40 million worldwide cases
1 million in US
May 2, 2006 12:16pm
42,689,478 worldwide cases
How many are there now? What does that say about the infection rate overall? What
happened to the people that were living with AIDS then but are not now?
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