The Medical CIA
(Published in drastically rewritten, condensed form as
Membership by special approval only. Six-week training sessions. Two years of active duty. Assignments to health departments anywhere in the country. On call around the clock, bags packed for immediate travel. Covert disease surveillance. A secret emblem. Lifelong reserve status, permanently available for future actions.
Few people have ever heard of the Epidemic Intelligence Service (EIS), yet its agents have infiltrated hospitals, universities, government agencies, health departments, corporations, foundations, and even the communications media. It has existed for more than forty years as a semi-secret, internal division of the Centers for Disease Control (CDC), exerting its hidden influence on our society. It has magnified our fear of flu epidemics, scared us half to death about Legionnaires disease, and turned small clusters of mildly sick fast-food patrons into nationwide panics. It has revived the fear of contagious epidemics decades after heart disease and cancer displaced them as the major killers.
The CDC has developed a remarkable track record for weathering public relations disasters, even managing to come out ahead, and audaciously demanding expanded emergency powers. Its most potent weapon has been the EIS, born in the Cold War as a quasi-military unit designed to counter biological warfare. This clandestine wing of the CDC has proven its ability to detect and choose the most useful disease outbreaks for political purposes, blowing them out of proportion or manipulating public fear by falsely blaming such clusters on infectious germs.
The EIS certainly had its work cut out after the CDCs swine flu disaster in 1976-77 no flu epidemic had ever appeared, while the CDCs vaccine did take dozens of lives and injured thousands more. Only a brand new epidemic, particularly a contagious one, could justify new public health control measures.
Opportunity struck in April, 1981. EIS officer Wayne Shandera, on active assignment in the Los Angeles health department, received a call from Michael Gottlieb, a young immunologist at the UCLA Medical Center. Four patients had Pneumocystis carinii pneumonia and serious immune deficiencies. Shandera had already heard a report of a fifth such case. One or two cases usually meant nothing; five seemed more plausible as an outbreak. And all five men were young, male homosexuals, which could be interpreted to fit the hypothesis of a sexually-transmitted infectious agent. These five cases were the official start of what later came to be known as the Acquired Immune Deficiency Syndrome (AIDS) epidemic.
Shandera excitedly forwarded the data to his unofficial bosses at the CDC. According to Randy Shilts, in his book And the Band Played On, the CDC official who saw the report, James Curran, wrote Hot Stuff. Hot Stuff across the top and rushed it into publication. New reports were trickling in of dying male homosexuals, most of whom also suffered the blood vessel cancer known as Kaposis sarcoma. CDC leaders decided there was no time to waste, and formed the Kaposis Sarcoma and Opportunistic Infections (KSOI) Task Force to manage the investigation. Loaded with such EIS members as Harold Jaffe and Mary Guinan, the Task Force set about in a frenzy to prove the new epidemic infectious.
Virtually all of the first fifty cases admitted using poppers, the liquid nitrite drug wildly popular among homosexual men for its aphrodisiac properties. Scientists had not studied the long-term effects of this inhaled drug, but its chemical structure was known for its severe toxicity and ability to cause cancer. The CDC was not interested, of course, in a toxin-induced disease. So the Task Force loaded the deck by offering two possible explanations: Either the syndrome was caused by a single bad batch of poppers, or it was infectious. Never did they seriously consider the possibility that years of popper use might itself cause immune deficiency. It would be something like looking for a batch of bad cigarettes to blame for lung cancer. Failing to find such a bad lot of poppers, the Task Force threw out the drug hypothesis altogether.
To make AIDS seem convincingly infectious, the Task Force mobilized the EIS network to define sexually-linked clusters of cases, and to prove the syndrome had spread beyond homosexual men. Clusters were not hard to find, since the AIDS cases were extremely promiscuous men with hundreds or thousands of sexual contacts each; odds were that each man was connected through a chain of sexual encounters with one or more other AIDS cases. EIS officers such as David Auerbach, assigned to the Los Angeles County Department of Public Health, interviewed these men and confirmed the prediction. Meanwhile, following the model of hepatitis B transmission, EIS agents hunted down every heroin addict and blood transfusion recipient, including hemophiliacs, who might have conditions vaguely resembling the immune deficiencies in homosexuals. EIS personnel scoured hospitals and monitored local health departments for patients, and within months found a small handful of heroin users with opportunistic infections. EIS members Bruce Evatt and Dale Lawrence tracked down a hemophiliac in Colorado, dying primarily of internal bleeding, who also happened to have a pneumonia. EIS agent Harry Haverkos traveled to Florida and Haiti to find impoverished Haitians with opportunistic tuberculosis. Instantly the heroin addicts, the hemophiliac, and the Haitians were all relabeled as AIDS cases, and the CDC trumpeted the news that AIDS had spread outside of the homosexual community.
The biomedical research establishment bought the line, and scrambled to find a virus. Scientists first turned to their familiar microbes. Epstein-Barr virus and cytomegalovirus, both known for many years through herpes virus research, were each blamed by different factions.
But the fate of AIDS research was sealed almost from the beginning. Donald Francis, the EIS member since 1971 who had gained notoriety for his heavy-handed public health tactics, had by 1981 risen to a high position within the CDCs Hepatitis Laboratories Division. He had also earned a graduate degree studying feline retroviruses, a type of virus known for being harmless to its host. This background, however, biased Francis in favor of blaming a retrovirus for AIDS. Within just eleven days after the first report of AIDS cases appeared in June, 1981, Francis placed a telephone call to Myron (Max) Essex, his former research supervisor. On the basis of no evidence whatsoever, Francis insisted that the new syndrome must be caused by a retrovirus with a long latent period between infection and disease. Only five patients officially existed, yet Francis had already mapped out the entire future of AIDS.
For as soon as Francis had made his decision, he transformed himself into a relentless champion of the retrovirus-AIDS hypothesis. He doggedly pushed this view whenever anyone would lend him an ear, and even when no one would. Within a year, KSOI Task Force head James Curran was echoing the Francis hypothesis, as were other key CDC staffers. Working with Essex, Francis lobbied their close colleague Robert Gallo, a well-funded retrovirus scientist at the National Institutes of Health (NIH), to search for an AIDS virus. Robert Biggar, another EIS member at the NIH, helped mobilize the huge Federal institute behind the retrovirus hunt.
After many months of arm-twisting, Gallo finally joined the new crusade. First he tried to offer another retrovirus he had already discovered, HTLV-I, which he previously blamed for causing leukemia. But other scientists did not wish to lose their favorite leukemia virus to AIDS, and Gallo had to search further. In 1983, the French scientist Luc Montagnier found a new retrovirus, since named the Human Immunodeficiency Virus (HIV), and Gallo claimed co-discovery one year later. When Gallo held a media press conference to announce the virus, the event set the HIV hypothesis in stone as official Federal dogma. Donald Francis and his fellow EIS agents had triumphed, though remaining out of the spotlight.
With the EIS network operating behind the scenes, the CDC has been able to manipulate public opinion, either to provoke hysteria over an imminent AIDS pandemic or to cover up embarrassing scientific data. AIDS alarmism has been promoted by such highly-placed officials as EIS member Jonathan Mann, former head of the World Health Organizations Global AIDS Program, who predicted 100 million HIV infections by the year 2000. HIV, however, has not spread with time; roughly 12 million people worldwide are infected today, the numbers remaining constant wherever widespread testing is performed. Thus the current head of the WHO AIDS program, EIS member Michael Merson, was forced to revise the prediction to a smaller, but still frightening, 40 million HIV infections by the end of the decade. Both men continue to paint AIDS as an imminent crisis.
One of the biggest publicity coups for the CDCs war on AIDS was in the myth of the Florida woman who supposedly caught AIDS from her dentist. The story began in late 1986 with David Acer, a Florida dentist who discovered he was HIV-positive. He apparently frequented the homosexual bathhouse scene, including the poppers and other drugs so pervasive in that environment. Within another year, Acer had developed Kaposis sarcoma, his health slowly degenerating.
Meanwhile, Acer had pulled two teeth from college student Kimberly Bergalis, a business major. By 1989, more than a year later, Bergalis developed a mild yeast infection, a condition common to many women. A few months later she contracted a brief pneumonia, in the wake of emotional stress in studying for the state actuarial exam. Neither of these symptoms was serious or permanent, and both affect large numbers of people. But Bergalis was nevertheless tested for HIV, and turned out to be positive.
She denied any intravenous drug use or blood transfusions, and insisted she was a virgin. Because she seemed not to have caught HIV through any of the standard risks, her case attracted CDC attention within three months. The EIS network may have played a role, since several of its members worked in the Florida health department. Eager to find an excuse for imposing strict new regulations on the medical profession, the CDC sent in a team of investigators to find a plausible source of her infection. They soon came across David Acer, her dentist. Although Acer appeared to be conscientious and no route of HIV transmission could be found, the CDC investigators jumped to the conclusion that Bergalis must have caught the virus from the dentist. To reinforce this idea, a group of CDC researchers that included EIS members Harold Jaffe, Ruth Berkelman, and Carol Ciesielski compared the genetic sequences of HIV from dentist and patient, pronouncing them the same. The CDC experts even tested over a thousand of Acers clients, finding four others with HIV but no obvious risk factors.
The insurance company saw things differently, insisting that its own analysis showed that Bergalis received HIV from some other source. But the CDC ignored this evidence, rushing to publicize its own conclusions. The news leapt straight to the front pages and prime time television news broadcasts, terrifying the nation and swinging public opinion behind Congressional legislation to impose new CDC controls on medical workers. Ultimately the bill failed, though only after intense pressure from the medical profession.
In the meantime, an independent study out of Florida State University has concluded that Bergalis did not get HIV from her dentist after all. Other scientists have now pointed out that among Acers patients, five HIV positives add up to the same percentage as HIV positives in the general population implying that these patients also caught the virus elsewhere. Where could Bergalis have contracted HIV? Apparently her mother has never been tested, opening the possibility that Kimberly may have carried the virus from birth for twenty-three years before she died.
Bergalis, moreover, did not die of HIV infection. She and her dentist suffered radically different diseases; he had Kaposis sarcoma, a cancer, while she first had a temporary yeast infection. Then Bergalis was prescribed the toxic and controversial AIDS drug AZT, a failed cancer chemotherapy that causes anemia, bone marrow loss, muscle wasting and destruction of the immune system. Months of AZT treatment ravaged her body, leaving her open to opportunistic infections and forcing her into a wheelchair until her death.
But to this day, the CDC propaganda story formulated by EIS agents remains popular myth, keeping alive the fear of AIDS as a supposedly infectious disease.
The CDC has also learned how to squelch embarrassing news stories before much damage is done, with help from EIS agents in the media. In July of 1992, during the Eighth International AIDS Conference in Amsterdam, Newsweek suddenly published an article by reporter Geoffrey Cowley on several HIV-negative AIDS cases. Researchers at the AIDS conference interpreted the article as a political green light, and began pouring forth dozens of reports of previously unmentioned AIDS patients without HIV, from both the United States and Europe. The situation began reeling out of control, re-opening the question of whether HIV is the true cause of AIDS. Anthony Fauci, director of AIDS research at the National Institutes of Health, and James Curran of the CDC raced to Amsterdam on Air Force Two to take charge. The best they could do on the spot was to listen to the reports, promising to resolve the situation. In reality, they had decided to suppress the whole matter.
Three weeks later, the CDC sponsored a special meeting at its Atlanta headquarters. The scientists reporting HIV-free AIDS cases were invited, as was Cowley, the Newsweek reporter. The unexplained AIDS cases were relabeled with an unmemorable mouthful of a name Idiopathic CD4+ Lymphocytopenia, or ICL so as to break any connection between these cases and AIDS. The ICL cases were airily dismissed, and Cowley was persuaded to cooperate more closely with the CDC in the future. His next article toed the official AIDS line perfectly, containing little news. The issue had died, and so had the media coverage.
The media had known of these same HIV-free AIDS cases long before the public episode, but had continually censored the story. Lawrence Altman, the EIS member who had become the head medical writer for the New York Times, admitted to Science magazine that he knew of cases for several months but did not break the story because he didnt think it was his papers place to announce something the CDC was not confident enough of to publish. The Times, of course, has long cultivated an image of publishing all the news thats fit to print.
The era of infectious disease, the age when most people died of tuberculosis, malaria, yellow fever, or polio, ended long ago in the industrial world. But the Epidemic Intelligence Service, a relic of the past, grows ever larger in its membership and influence. Its clandestine methods and near-invisibility allow the CDC virtually to manufacture epidemics, and to make the whole process appear spontaneous. Cloaked in science, the hidden agenda aims at expanding public health controls over private beliefs and lifestyles. Healthy suggestions are one thing; exploiting hysteria to impose emergency powers is quite another.
EIS agent Donald Francis certainly knew what he meant in speaking of the opportunity that the HIV epidemic provides for public health. The time has come for outsiders to understand as well.