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Kimberly Bergalis

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Kimberly Bergalis
Born
Kimberly Ann Bergalis

(1968-01-19)January 19, 1968
Tamaqua, Pennsylvania, U.S.
DiedDecember 8, 1991(1991-12-08) (aged 23)
Fort Pierce, Florida, U.S.
Cause of deathAIDS-related complications
Resting placeSaints Peter and Paul RC Lithuanian Cemetery
Alma materUniversity of Florida
Known forFirst known case of clinically-transmitted HIV

Kimberly Ann Bergalis (January 19, 1968 – December 8, 1991) was an American woman who was one of six patients purportedly infected with HIV by dentist David J. Acer, who was infected with HIV and died of AIDS on September 3, 1990.[1]

Background

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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. A devout Catholic, Bergalis always maintained that she was a virgin and that she never used I. V. drugs.

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 display symptoms of AIDS and was diagnosed with the disease in January 1990.[2] The initial report from the Centers for Disease Control and Prevention (CDC) [3] stated that she had likely acquired her infection from her dentist, which prompted Acer to write an open letter requesting that his patients be tested for HIV infection. The Florida Department of Health and Rehabilitative Services tested over 1,000 patients, discovering two additional HIV-positive patients.[4] The CDC would eventually identify a total of ten HIV-positive patients and subsequently retraced six of the infections to Acer.[5]

CDC investigation

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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' HIV infection was linked to Acer.[5]

The CDC had closed and published its investigation in July 1990 without further verification or follow-up, but litigation against Acer's malpractice insurance continued through the 1990's. Depositions, private investigator reports, and medical records were leaked to journalist Stephen Barr writing for Lear's Magazine. The court documents revealed that the genetic test used by the CDC was an early test that was unverified. Dr. John Witte, Florida's top AIDS official, called the evidence of transmission "scientifically inconclusive." Investigators also discovered Kimberly Bergalis had lied to CDC investigators about her sexual history and other possible risk exposures, and another patient allegedly infected by Acer was discovered to have had intercourse with a prostitute who later died of AIDS. Medical records showed a third patient the CDC claimed Acer had seen often and for extensive procedures had only visited Acer's office once for a cleaning by a hygenicist - a treatment making exposure to HIV highly unlikely and deliberate infection impossible. The hygenicist also testified claims of shoddy sanitary practices were not true. The chief of Retrovirology at Mt. Sinai Medical Center in Miami also discovered five cases of HIV with similar genetic strains to Acer that had no link to Acer or his patients, testifying "it is as likely the patients got HIV from the community." Finally, Bergalis developed AIDS two years after her treatment by Acer, but only 1 percent of patients go from infection to illness that quickly.

In context, the Ryan White CARE Act was being debated in Congress, but it was met with opposition because HIV infection was perceived to be caused by stigmatizing risk factors such as homosexuality, substance use, and sexual promiscuity. The media hype around Acer seemed motivated to create "innocent" as opposed to "deserving" victims. Testifying to Congress, Bergalis claimed "I did nothing wrong" and legislators were moved by the story of a white self-proclaimed virgin victimized by a reckless gay man. The case of the "Florida Dracula Dentist" has gone down in AIDS history alongside "Patient Zero" Gaetan Dugas as legends who have been unfairly demonized.

The time between Bergalis' dental procedure and the development of AIDS (24 months)[9] was short; 1% of infected homosexual/bisexual men[10] and 5% of infected transfusion recipients[11] develop AIDS within two years of infection.

Political reaction

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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.[12] 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 Dannemeyer mandating HIV tests for healthcare workers, and permitting doctors to test patients without their consent.[13]

Death and posthumous controversy

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On December 8, 1991, Bergalis died of AIDS-related complications at her home in Fort Pierce, Florida.[1] Her funeral was held on December 12 in her hometown of Tamaqua, Pennsylvania, after which she was buried in Saints Peter and Paul RC Lithuanian Cemetery.[14] Shortly after Bergalis’ death, a small park on Hutchinson Island South, Florida, was renamed Kimberly Bergalis Memorial Park in her memory.[15]

Nearly three years after Bergalis’ death, in June 1994, CBS aired an episode of 60 Minutes that included a segment covering Acer and the patients he allegedly infected. The episode alleged that Bergalis, who said she was a virgin, had been treated for genital warts, a sexually transmitted disease, and showed her on videotape allegedly claiming to have had sex with two different men during her life. However, none of Bergalis' former serious 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.[16] Stephen Barr, a journalist who contributed to the show, rebutted this dismissal.[17][18][dubious – discuss]

In 1990, Congressman Ted Weiss, who was skeptical of the CDC's conclusions, requested a formal investigation by the Government Accounting Office (GAO, in 2004 renamed General Accountability Office), an independent auditing, evaluation, and investigative body responsible to Congress. A GAO technical team reviewed the CDC's actions and studied its evidence and conclusions. Their report fully supported the CDC report and refuted the claims of Barr and other skeptics, point by point[citation needed]. The principal investigator of the GAO team, Mark Rom, Ph.D., later published an analysis of the case.[19] Neither the CDC nor the GAO was able to solve the mystery of just how Bergalis acquired the HIV virus from Acer, but neither agency doubts that this did happen somehow.[citation needed]

References

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  1. ^ a b 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). "Update: transmission of HIV infection during invasive dental procedures". Morb. Mortal. Wkly. Rep. 39 (4): 519–521. PMC 1488431. PMID 1737316.
  4. ^ "2 New AIDS Infections Deepen Florida Mystery". The New York Times. 1990-09-22. Retrieved 2010-12-13.
  5. ^ a b Hillis, DM; Huelsenbeck, JP (1994). "Support for dental HIV transmission". Nature. 369 (6475): 24–5. Bibcode:1994Natur.369...24H. doi:10.1038/369024a0. PMID 8164734. S2CID 4337834.
  6. ^ Ou, Chin-Yih; et al. (1992). "Molecular epidemiology of HIV transmission in a dental practice". Science. 256 (5060): 1165–1171. Bibcode:1992Sci...256.1165O. doi:10.1126/science.256.5060.1165. JSTOR 2877255. PMID 1589796. S2CID 21603554.
  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. ^ CDC (1990-07-27). "Possible Transmission of Human Immunodeficiency Virus to a Patient during an Invasive Dental Procedure". Retrieved 2007-02-28.
  10. ^ 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.
  11. ^ 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 Med. 321 (14): 947–52. doi:10.1056/NEJM198910053211406. PMID 2779617.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  12. ^ Editorial staff (December 30, 1991). Kimberly Bergalis, R I P National Review
  13. ^ Hilts, Philip J. [1], The New York Times, September 27, 1991, accessed December 13, 2010.
  14. ^ Todd, Susan (December 13, 1991). "Hundreds Mourn Bergalis". The Morning Call. mcall.com. Retrieved May 27, 2018.
  15. ^ Wilson, Jean Ellen (2014). Legendary Locals of Fort Pierce. Arcadia Publishing. p. 124. ISBN 978-1-467-10127-1.
  16. ^ 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. S2CID 46175330.
  17. ^ 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. S2CID 8371112.
  18. ^ 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. S2CID 20992451.
  19. ^ Mark Carl Rom, Fatal Extraction: The Story Behind the Florida Dentist Accused of Infecting his Patients and Poisoning Public Health, Jossey-Bass, 1997.
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