HEALTH

An epidemic of fear

September 23 1985
HEALTH

An epidemic of fear

September 23 1985

An epidemic of fear

HEALTH

To the experts the reaction was unjustified and hysterical. But it was not mere ignorance that led parents to keep about 12,000 New York City students out of school last week when they learned that one seven-yearold with Acquired Immune Deficiency Syndrome was attending Grade 2 somewhere in the city.

In meetings and in the media, health officials and doctors informed parents repeatedly that the presence of the child was no threat to his or her schoolmates. Their message was clear, but it failed to placate the protesting parents. Like many of them, Samuel Granirer, president of one of the two school boards where the boycotts took place, knew that there were no known cases of AIDS being transmitted by casual contact. But he also appreciated the true horror of the advancing plague and decided that the admittedly tiny risk of his children con-

Fear of AIDS in schools last week proved more potent than assurances to anxious parents in New York and Montreal

tracting the disease in school was still too high. Said Granirer: “If they keep kids out of school with chicken pox, why not with AIDS? It doesn’t make sense.”

Those same concerns led the Protestant School Board of Greater Montreal to send an unidentified girl home recently after her mother died of AIDS. And although the board readmitted the child after receiving doctors’ assurances that her presence posed no risk, at least one other local public school is trying to expel a student AIDS sufferer, according to Dr. Normand Lapointe, head of immunology at Ste-Justine Children’s Hospital. Lapointe, who refused to identify the school, added that the child’s case should be brought before the provincial human rights commission if the school persists in trying to force the child out.

Such a case would establish a precedent in Canada. In the United States several legislatures, committees and professional associations have already made laws and rules designed to defuse fear and end discrimination against AIDS victims. But the American experience has proven that the fear of the disease is far more potent than any

measures yet taken to contain it.

Ever since AIDS sufferer Ryan White, 13, was refused admission to school in Kokomo, Ind., last year, doctors have insisted that the disease, which is spread by intimate sexual contact and blood transfusions, cannot spread in elementary schools. They point out that no

health care workers have become infected while treating AIDS patients, except for one English nurse who inadvertently pricked herself with an infected syringe. Nor has the virus attacked any family members living in close contact with AIDS sufferers, even though few take special precautions. Said Dr. Thomas Peterman, an AIDS researcher with the Centers for Disease Control (CDC) in Atlanta: “If you are not getting transmission in families, it is extremely unlikely to occur in schools.” Added Harvard University AIDS authority William A. Haseltine: “Nobody says the risk is

zero. But it is absolutely an extremely remote possibility. That is rock solid. There is no controversy on that point.”

That medical consensus does not convince parents like Granirer. He said that the CDC guidelines on which the New York committee based its decision are “full of vacillating words.” Indeed, CDC spokesmen have admitted that certain types of contact between infected and healthy schoolchildren—a bloody fight, a bite or classroom incontinence—“would arouse some concern about transmission of the virus.”

At least one U.S. AIDS researcher agrees that the rush to protect the rights of sufferers is premature. Writing in The Washington Post last week, Dr. Richard Restak, a Washington neurologist and author of The Brain, cautioned against “efforts by medically unsophisticated politicians and attorneys to dictate policy in regard to an illness that has the potential for wreaking a devastation such as has not been encountered on this planet in hundreds of years.” He added, “In the presence of considerable ignorance about the causes and effects of the syndrome, the benefit of the doubt should not be given to the victim of AIDS.”

Few other physicians admit that in cases of casual contact doubt exists. But Restak argued that “the incubation period is sufficiently lengthy to cast doubt on any proclamations, no matter how seemingly authoritative, in regard to the transmissibility of the illness.” Restak, who declined to elaborate on his remarks in an interview, stands almost alone against the entire medical establishment. But even among doctors who agree that AIDS is almost impossible to transmit except through intimate sexual contact, there are significant differences of opinion about precisely how easy the disease is to catch.

One such difference emerged after the Vancouver Province reported that Dr. John Blatherwick, the city’s chief medical officer, had allowed “five to 10” AIDS sufferers to continue working as waiters in local restaurants. After the news report appeared, Blatherwick called a press conference and denounced the story as “irresponsible” because it created unnecessary alarm. Expressing accepted medical opinion, Blatherwick said that the chance of a waiter transmitting the disease through food in a restaurant was extremely remote. Later, he told Maclean’s that AIDS is most often transmitted sexually during anal intercourse that causes bleeding. But in fact no leading researcher has publicly said that is true. Haseltine, for one, called it “a myth” and added that “the frequency of transmission from men to women is thought to be the same as from men to men.” Added Peterman: “You do not have to do anything unusual, you just

have to have sex with an infected person.”

Similarly, Dr. Alastair Clayton, director general of the Laboratory Centre for Disease Control inOttawa, told Maclean’s that “the essence is that AIDS is passed on from person to person by multiple contact and you need to get a lot of the virus.” But Peterman said that the infection can be transmitted during just one episode, although he added that “the more often you do it, the more likely it is that infection will occur.”

In part, such differences reflect the rapid pace of AIDS research, which pro-

duces new insights almost every week. And medical doubts about the basic issue are rare. Still, many researchers now say that one in 10 North Americans —including 20 to 30 per cent of collegeage women—will eventually become infected through sexual transmission. By that time, many of the children now thought to be in danger will have reached sexual maturity, and no authorities will be able to offer definite assurances about their safety.

—JOHN BARBER in Toronto with DIANE LUCKOW in Vancouver

DIANE LUCKOW