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Kimberly Ann Bergalis (January 9, 1968 – December 8, 1991) was an American woman who was one of six patients purportedly infected with HIV by dentist David J. Acer who had the disease AIDS.[1] This incident is the first known case of clinical transmission of HIV.
Background
The eldest of three daughters, Bergalis was born in Tamaqua, Pennsylvania in 1968, where her family lived until moving to Florida in 1978. In 1985, she enrolled at the University of Florida and majored in business.
In December 1987, dentist Dr. David Acer removed two of Bergalis's molars. Acer was HIV-positive at the time, having been diagnosed that fall. In March 1989 Bergalis began to show symptoms of AIDS and was diagnosed with the disease in January 1990.[2] The Centers for Disease Control and Prevention(CDC) initial report[3] that she had likely acquired her infection from her dentist prompted Acer to write anopen letter requesting that his patients be tested for HIV infection. The Florida Department of Health and Rehabilitative Services tested over 1000 patients, discovering two additional HIV-positive patients.[4] The CDC would eventually identify a total of ten HIV-positive former Acer patients, and link the infections of six to their dentist.[5]
CDC investigation
The CDC conducted a phylogenetic analysis of the DNA sequences of the viral envelope gene. The analysis revealed that the viral sequences from five patients, including Bergalis, were more closely related to the dentist's viral sequences than to those from local controls.[6] Later analyses identified another HIV-positive patient with a viral sequence closely related to Acer's.[7][8] Independent review of the CDC tests strengthened the case that Bergalis's HIV infection was linked to Acer.[5]
Political reaction
During the last months of her life, Bergalis' case was cited by some politicians and journalists as an example of a 'blameless' HIV infection that had been allowed to happen due to the CDC and the healthcare industry being overly responsive to the concerns of AIDS activists and the gay community. In an obituary, the National Review wrote that Bergalis
"...came to feel she had a special calling...to bring a glimmer of truth, however forlorn, into a debate characterized by confusion, denial, smugness, and suicidal self-indulgence... 'No sexual history' is how the jaded describe a chaste woman of 23 who, as Miss Bergalis explained to disbelieving interviewers, 'wanted to wait for marriage.' Marriage and its joys will never come for Kimberly Bergalis, but in her integrity and courage she affirmed that other things were also precious."[9]
Bergalis actively participated in several actions by congressmen to pass legislation restricting the activities of persons infected with HIV. Shortly before Bergalis's 1991 death, despite failing health, she testified before the Congress in support of a bill sponsored by Representative William Dannemeyermandating HIV tests for healthcare workers, and permitting doctors to test patients without their consent.[10]
Posthumous controversy
The time between Bergalis' dental procedure and the development of AIDS (24 months)[11] was short; 1% of infected homosexual/bisexual men[12] and 5% of infected transfusion recipients[13] develop AIDS within two years of infection.
In June 1994, CBS' 60 Minutes aired a program reporting that Bergalis was treated for genital warts, a sexually transmitted disease, and had shown her on videotape allegedly claiming to have had sex with two different men during her life. However, none of Bergalis' former boyfriends tested positive for HIV. In addition, the 60 Minutes anchors argued that the CDC may have botched the genetic tests that proved that Bergalis had the same strain of HIV as her dentist. The television broadcast was dismissed by CDC scientists as misleading and inaccurate.[14] Stephen Barr, a journalist who contributed to the show, rebutted this dismissal.[15][16] Shortly after her death, a small park on Hutchinson Island South, Florida was renamed Kimberly Bergalis Park in her memory.
References
1. Lambert, Bruce (December 9, 1991). Kimberly Bergalis Is Dead at 23; Symbol of Debate Over AIDS Tests. New York Times
2. Johnson, Bonnie (1990-10-22). "A Life Stolen Early". People. Retrieved 2008-12-24.
3. CDC (1990). Morbid. Mortal. Wkly. Rep. 39: 489. Missing or empty |title= (help)
4. "2 New AIDS Infections Deepen Florida Mystery". The New York Times. 1990-09-22. Retrieved2010-12-13.
5. ^ Jump up to:a b Hillis DM, Huelsenbeck JP (1994). Nature 369:24-5
6. Ou, Chin-Yih; et al. (1992). "Molecular epidemiology of HIV transmission in a dental practice". Science 256(5060): 1165–1171. doi:10.1126/science.256.5060.1165. JSTOR 2877255. PMID 1589796.
7. CDC (1991-01-18). "Epidemiologic Notes and Reports Update: Transmission of HIV Infection during an Invasive Dental Procedure -- Florida". Retrieved 2007-02-28.
8. CDC (1991-06-14). "Epidemiologic Notes and Reports Update: Transmission of HIV Infection During Invasive Dental Procedures --- Florida". Retrieved 2007-02-28.
9. Editorial staff (December 30, 1991). Kimberly Bergalis, R I P National Review
10. Hilts, Philip J. [1], The New York Times, September 27, 1991, accessed December 13, 2010.
11. CDC (1990-07-27). "Possible Transmission of Human Immunodeficiency Virus to a Patient during an Invasive Dental Procedure". Retrieved 2007-02-28.
12. Lifson, A.R.; Hessol N., Rutherford G.; et al. (June 20–24, 1990). "Natural history of HIV infection in a cohort of homosexual and bisexual men: clinical and immunologic outcome". Vol. 1 VI International Conference on AIDS. San Francisco. p. 142.
13. Ward, J.R.; Bush T.J., Perkins, H.A.; et al. (1989). "The natural history of transfusion-associated infection with human immunodeficiency virus: factors influencing the rate of progression to disease". N Engl J Med321 (14): 947–52. doi:10.1056/NEJM198910053211406. PMID 2779617.
14. Ciesielski, C. A.; et al. (1994). "The 1990 Florida dental investigation, The press and the science". Ann Intern Med 121 (11): 886–88. doi:10.7326/0003-4819-121-11-199412010-00011. PMID 7978703.
15. Barr, Stephen (1996-01-15). "The 1990 Florida Dental Investigation: Is the Case Really Closed?". Annals of Internal Medicine 124 (2): 250–254. doi:10.7326/0003-4819-124-2-199601150-00009. ISSN 0003-4819. PMID 8534001. Retrieved 2007-02-28.
16. Brown, David (1996-01-15). "The 1990 Florida Dental Investigation: Theory and Fact". Annals of Internal Medicine 124 (2): 255–256. doi:10.7326/0003-4819-124-2-199601150-00010. ISSN 0003-4819.PMID 8534002. Retrieved 2007-02-28.