Chicago Tribune (CT) - Tuesday September 1, 1987
Ronald Kotulak, Science Writer

The expected increase in cases will not mean that the deadly disease is spreading more rapidly or that it is affecting new groups.

The new cases will represent patients who were presumed to have acquired immune deficiency syndrome in the past but who did not meet the existing strict definition of the disease.

"We feel that the new definition will be more sensitive because it will pick up a larger proportion of AIDS cases and yet it will remain quite specific," said Dr. Timothy Dondero, chief of the surveillance and evaluation branch of the Centers for Disease Control's AIDS program.

The new CDC definition, which was approved by the Council of State and Territorial Epidemiologists, is designed to track more accurately the course of the disease, which destroys a person's ability to fight infections, Dondero said.

As of Aug. 31, 41,366 AIDS cases had been reported to the CDC. Of these, 23,844 have resulted in death.

CDC officials expect an immediate increase in cases as states go through their backlog of suspected cases and report those that meet the new definition, Dondero said.

"There will be a surge in the first month or two of old AIDS cases which are now reportable," he said. "But once that stabilizes, there should be a 10 to 15 percent increase in the number of reported AIDS cases overall."

The broadened definition probably will lead to an especially large increase in the number of AIDS cases reported among infants, because the previous definition prevented many pediatric cases from being reported, he said.

The AIDS virus is primarily transmitted by sexual activity and sharing contaminated hypodermic needles. It also is passed from infected mothers to their newborns.

The original definition was devised in 1981 when AIDS was first recognized as a new disease but before the virus that causes the disease was discovered.

This definition was designed to be strict to make sure that only people with AIDS were included. Basically it required that patients be diagnosed with an immune deficiency problem of unknown origin accompanied by some rare opportunistic diseases such as Kaposi's sarcoma or Pneumocystis carinii pneumonia.

The discovery of the AIDS virus (HIV or human immunodeficiency virus) almost four years ago led to a blood test to detect antibodies to the virus. The antibody test was then included in the definition.

As the epidemic grew, however, researchers found that people infected with the AIDS virus could have other disorders and infections, such as dementia, emaciation and tuberculosis.

Under the new definition, a person is considered to have AIDS if he or she has a wide variety of infections and disorders and has tested positive for AIDS antibodies.

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