From: tuff@ellis.uchicago.edu (Geoff Tuffli)
Subject: Re: AIDS & Epidemics
Reply-To: tuff@midway.uchicago.edu
Organization: University of Chicago Computing Organizations
Date: Thu, 12 Nov 1992 03:18:12 GMT

In article carroll@cs.uiuc.edu (Alan M. Carroll) writes:
>
>> e)  The amount of research money geared for AIDS is IN NO WAY adequate for
>> the magnitude of the problem.  There have been only three diseases to fit
>> the definition of "plague" in the modern (recorded history) era:  Plague
>> itself (agent: Yersinia pestis), Smallpox, and AIDS.  Of the three, AIDS
>> will undoubtably kill many more humans.
>
>Perhaps in absolute numbers, but I think you might find that influenza
>is a contender. In terms of percentages (last I heard, up to 10% of
>population) AIDS is still not up to the level of the Black Death
>(25%-33% in Europe). Has the total number of AIDS deaths in the U.S.
>passed the _yearly_ heart disease total (~300K)?
>
>AIDS is clearly a problem, but we are best served by accuracy rather
>than denial or hysteria.
>

	Agreed. While in no way devaluing the severity of the problem,
calling AIDS an epidemic is in actuality inaccurate. While it could
conceivably become such, the percentages involved, as well as very
limited methods for infection of the disease, simply do not classify it
as an epidemic.

	AIDS has infected -- mind you, INFECTED, not actually fallen sick --
with somewhere around 1 million people in the United States. A bit over a
tenth of this (130,000 people) are actually sick from it. The population of
the U.S. is well over 300 million people. That comes down to approximately
0.3% of the population is infected with the disease.
 
	Worldwide the number of people infected is guessed to be possibly
as high as 10 million, with approximately 1 million actually stricken with
the disease. The population of the world is over 5 billion. That comes down
to, worldwide, approximately, about 0.2% of the population is infected with
the disease.
 
	Some of this is deceptive, however, especially the worldwide
figures. It needs to be pointed out that the greatest part of the punch AIDS
has delivered to the world has gone to sub-Saharan Africa. While I don't
have the exact numbers for there, I do know that the percentages there are
higher than in the U.S., though no higher than a factor of ten higher
(i.e., 3% of the population infected, 0.3% sick, and even that is probably
on the high side of the estimate.)
 
	In comparison, the Black Death killed overall some 25 million people
in the outbreak around 1346, taking Europe from a population of about
100 million to 75 million, an epidemic that took the lives of 25% of the
population. The mortality rate of those people infected was around 75% -
which means in comparison to the worldwide AIDS infection rate of 0.2%,
the Black Death (the Bubonic Plague) infected some 33 million people,
resulting in an infection rate of _33%_ as opposed to 0.2%.
 
	In many areas, the mortality rate went even higher, for example,
in the outbreak in the early part of the 18th century in France, some
50% of the population of Marseilles died, 60% of Toulon, and 44% in Aix
and Avignon.
 
	All this is to merely put some perspective on the situation: AIDS
is, NO question about it, an extremely deadly disease, and should certainly
be dealt a significant portion of our resources in finding ways to halt
its relentless spread. However, calling it an epidemic is to put a cast on
it that simply doesn't fit. It is a disease, but there are MANY more diseases
that are as or even more virulent or widespread than it, and if we are to
deal effectively with the disease and others like it, it is imperative that
we see it as it is.
 
	Geoff Tuffli