The New York Times - July 9, 1982

The Haitian cases represent a new development in the outbreak of the immune disorder, which leads to one or more of several unusual infections by so-called opportunistic organisms and often to a rare form of cancer called Kaposi's sarcoma. Both the infections and the cancer are often fatal. The cause of the underlying immune disorder, which came to public attention a year ago, has not been determined.

It had been reported earlier that the disorder affected primarily male homosexuals and people who use drugs intravenously. These patterns were not apparent in the cases of the Haitian immigrants.

All but Four Were Men

Of the 34 cases among Haitian immigrants, all but four were men, and all 34 were 20 to 45 years old. However, 23 of the men were questioned about homosexual activity and all 23 denied it. Of 26 men questioned about intravenous drug use, all but one denied it.

Of the 34 cases, 21 were reported in Florida; 10 in Brooklyn; and one each in California, Georgia and New Jersey. Among the opportunistic infections that afflicted the Haitians were tuberculosis that had spread widely throughout the body, toxoplasmosis, Pneumocystis carinii, cryptococcal meningitis and cytomegalovirus.

The Haitian cases bring to 452 the total number of cases of the immune deficiency disorder reported to the national Centers for Disease Control since June 1981.

Some Said They Took Drugs

Of that total, 113 victims said they were not homosexual. Twentythree of the cases were in women. Sixty percent of the non-Haitian patients said they had repeatedly taken drugs intravenously.

The outbreak has baffled the Federal epidemiologists from the disease control facility in Atlanta. Dr. James W. Curran, who heads the center's team of epidemiologists investigating the cases, said in an interview that no answers had been found to the many questions they had been asking about the Haitian cases.

"Is this the same thing that is going on in homosexual men and intravenous drug abusers?." he said. "If so, what does that mean? What is the unifying hypothesis or cause? The answer is we do not know."

However, Dr. Curran said the Haitian and other outbreaks appeared similar on the basis of clinical and laboratory tests. The Atlanta epidemiologists learned of the Haitian cases several months ago as a result of the diagnoses of toxoplasmosis at postmortem examinations in Florida. At that time, Dr. Curran said, it had not yet become clear that a high proportion of the victims were Haitians who had recently moved to this country. Initially, questions were raised about links of the illnesses to dietary habits.

Diagnoses and Clarification

Dr. Curran said that "it wasn't until there were a number of living patients that the team was able to perform immunologic studies," observe the cases, determine that other unusual infections were involved, and that the cases were "very similar" to the immune deficiency disorder previously reported.

Further clarification came from the diagnosis of cases in Brooklyn, which showed more clearly that a population of Haitian immigrants were afflicted, Dr. Curran said. At least one of the 10 victims in Brooklyn had been ill before leaving Haiti for the United States. Five of the 10 patients have died.

Upon further investigation, the Federal epidemiologists said they learned that 11 cases of Kaposi's sarcoma had been diagnosed in Portau-Prince, where they had been treated by a single dermatologist. The diagnoses were confirmed by pathologists at the National Cancer Institute in Bethesda, Md., Dr. Curran said
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