AIDS Patient Zero – InfoBarrel

It was so unusual at the time . Doctors, helpless to find the cause of death for the Noe family, preserved some tissue samples.  In 1988, further testing showed Noe, his wife, and his daughter had all been HIV-positive

The very first air flight attendants (in the 1920s) were men.  These positions were desirable; the men who did these jobs executed their duties more like up-scale, futuristic train porters and ship stewards than as menials.  As with many professions in that era (especially in service jobs such as telephone operators, bank tellers, et al) the sky porters known as “stewards” were exclusively male.  World War I saw the shift from male to female telephone operators and bank tellers; with a dearth of male workers during World War II, employers turned to the fairer sex to fill their employment needs in the airline industry, too. 

Gaëtan Dugas was a French-Canadian born February 20, 1953.  His life was on a collision course with history.  In 1972, Dugas first became sexually active.  [He would later claim he had over 2,500 sexual partners in his lifetime, whether all male is unknown.  He may have been bisexual.] 

By the 1950s, this homophobia was rampant, and in the conservative times of Eisenhower and McCarthyism, men were slowly pushed out of the steward jobs.

As further incentive to not hire men as flight attendants, the death of a gay steward in 1954 became a scandal sufficiently great to lead to a rash of “fag bashings” (both gay men and lesbians were targeted) in Miami, Florida.  It was one of the nation’s worst anti-gay outbreaks in history. 

The hedonism of the 1970s raged unchecked, and by the middle of the decade “gay” culture became pop culture.  Gay male partiers in the mid 1970s found an outlet on New York’s Fire Island.  Gay men rented time-share space in houses on the island and partied their summers away “in season”. 

He started out as a hairdresser.  Wanting to travel, this French-speaking Canadian learned that flight attendants for Air Canada had to be bi-lingual.  He moved to Vancouver and learned English to qualify for the job.  He found work as a flight attendant on Air Canada.  This career choice allowed him the freedom to move around the world, visiting exotic locales, and meeting many strange men for anonymous sexual encounters.  In 1977, he was legally married in Los Angeles, California, in an illegal attempt to gain United States citizenship.

Mr. It existed as “slim disease”; the condition was universally ignored though many Africans died after mysteriously wasting away.  In 1959, about the time the Manhattan Jamaican shipping clerk died of his rare pneumonia, a blood sample from a Congolese man was taken and preserved.  Years later, this proved to be HIV-infected.  This Congolese man’s fate is unknown (whether he developed full-blown AIDS and died from it or not).  Similarly, a preserved lymph-node biopsy specimen taken from a Congolese woman in 1960 later proved to be HIV-positive.

A year earlier, a Portuguese man known only as Senhor José died under mysterious circumstances.  He was treated at the London Hospital for Tropical Diseases to no effect.  In later years, examination of preserved tissues verified he died of AIDS; the causative virus, HIV-2 was present, making him the first known confirmed victim.  Genetic research on the virus indicated he probably contracted the disease in 1966 in Guinea-Bissau (on the northwest coast of Africa).  Three gay men in California and six Haitian immigrants to the United States were later confirmed as AIDS victims from that same year.

The commercial airlines recognized the goldmine presented by hiring female “stewardesses”.  Certainly, they were paid less.  There was also marketability in women that men did not have – women could be hawked by an airline as possible sex partners for the discriminating male traveler choosing its service over another.

This virus, after much international wrangling for recognition of discovery (with a particularly aggressive and bombastic US virologist lobbying for a claim that he had found it first–he did not) was later named Human Immunodeficiency Virus or HIV. 

“I’m Candy – Fly Me!”

His first months in the hospital were spent with his doctors cutting back on his water and salt intake, and they wrapped and raised his legs, all to cut down on his tissue’s swelling.  Despite this, the inflammation moved up his body and into his lungs.  Antibiotics were tried in varying dosages, but Rayford’s condition continued to deteriorate. 

For one gay man, however, being a steward was all he’d needed to satisfy both his wanderlust and his physical lust. 

Gaëtan Dugas died in Quebec City, Quebec, Canada, on March 30, 1984, at the age of 31.  His cause of death was kidney-failure brought on by his weakened condition from an onslaught of infections and ailments from AIDS.

As early as his 13th year or sooner, he was sexually active.  Beginning in 1966, he started having some physical problems that seemed chronic.  His legs swelled, and he developed sores on his genitals and body. 

Noe’s condition stabilized, but then flared up again in 1975 (coincidentally the same year a strange disorder called “slim disease” was reported in Africa for the first time, the beginnings of epidemic AIDS).  In addition to the respiratory condition and joint pains he developed motor skill problems and dementia before he died. 

The teen seemed stabilized by late 1968 (when he was around 15 years old).  He had been transferred to Deaconess Hospital by then, and in March 1969, however, all of his symptoms reappeared and rapidly worsened.  His breathing labored; his white blood cell count (as part of routine blood work) was noted to have dropped dramatically.  The only thing concurred at the time was that Rayford’s immune system had been somehow compromised.  He developed a fever and died either in the late hours of May 15, 1969, or the early hours of May 16 (sources differ).  His primary physician recalled, “Eventually his entire body constituted almost one wave of hard lumps and watery swellings.”

First denying he was sick, he later willfully and maliciously spread the disease to unsuspecting partners.  After having casual sex in a darkened room once, a male interviewee later reported he had turned on a light in the room where Dugas lay naked on a bed.  This man spotted the lesions (Kaposi’s sarcoma) that were the classic earmarks of “gay cancer” on Dugas’ chest.  When he remarked upon it, Dugas replied sardonically, “It’s gay cancer.  Maybe you’ll get it.”

Thus, by the late 1940s male flight attendants were not only undesirable, they were suspect as well.  Occupying a job with women that devoted itself to customer service, good manners, and fine grooming, the stewards garnered suspicions of being “queer”.

The Greek letter “?” always refers to the end of an event or series, not its beginning.  Dugas was “Patient Zero”, not “Patient ?” – if the intent was to use such a Greek designation, he would have been named “Patient Alpha” (“?” or “?”)  for “the beginning”.  It is known that Dugas from the earliest investigations, based on diagrams the CDC (and others) created interlinking sexual contacts among those diagnosed with or dead from the mystery disease, was referred to from the start as Patient Zero (not Omega or “O”).

He had a chlamydia infection (a bacterial venereal disease), clearly indicating he was sexually active.  His doctors also uncovered evidence of the herpes simplex virus and the virus responsible for Epstein-Barr.  Robert Rayford was not terribly forthcoming with his doctors, partly due to his retardation leaving him mostly uncommunicative, but also because he was embarrassed by something.

Current scientific research is clear: sometime in the 1930s, a simian form of immunodeficiency virus mutated sufficiently and made the leap across species to become a contagious disease of people. 

The Road to Zero

Gateway to the West

AIDS is what defined the decade of the 1980s, a decade that lived in fear beneath the penumbra of a certain and tortuous death from a highly communicable pathogen.  

The direct lineage of HIV-1 was traced to two groups of mutations that formed in the primates that carried the simian version.  One of the groups was dated to between 1847 and 1907; another subgroup dated to between 1606 and 1871.  HIV-2 made the leap most likely between the date range of 1856 and 1922.  Thus, it can be seen some prototypical version of the AIDS virus can be dated to the early 17th century.

In the end one can see there is no modern-day “Patient Zero”.

He led doctors to believe any of his sexual activities were strictly heterosexual, even claiming at one point to having a girlfriend (who failed to surface at the time).  [This female was found some time later and was found to be in perfect health, relative to HIV and AIDS, from which one can only surmise she and Rayford had no intimate sexual intercourse or such activities were rare enough she was not exposed to critical levels by whatever ailed him.]

Finally, in 1968, the boy was admitted to St. Memory Elvin-Lewis was kind enough to respond to this piece in person.

Occasionally, medical mysteries initially thought solved are found later to have very different truths at their cores.

The music scene was fueled by this gay celebration, none more blatantly than by a vocal group of disco hustlers calling themselves “The Village People”.  They dressed in favorite and stereotypical gay icon costumes – a policeman, a construction worker, a cowboy, a gay biker, and a Native American.  They were hugely successful for a short time with big sellers “In the Navy” and “YMCA”.  More subtly, Donna Summer performed her brand of dance music that was embraced by the gay community as was she.

AIDS in the United States was isolated in pockets of contagion until the promiscuity (homosexual or otherwise) of the 1970s gave the disease a clear path of propagation in humans.  IV drug use, on the rise in the 1970s and early 1980s, also provided another avenue of blood-exchange necessary for the virus to thrive. 

One such mystery concerned the AIDS epidemic in America.  As long as the killer remained comfortably within the gay community not much was done to investigate.  As soon as AIDS found its way into the heterosexual population, though, suddenly America’s interest in ferreting out the cause was paramount.  Panic stricken virologists and other epidemiologists worked feverishly to isolate the source of this sexually transmitted disease first endemic among homosexual men. 

Omega Man

The End of Days was seemingly at hand.

Of a most enlightening nature was Rayford’s adamant refusal of any rectal exams.  It seemed that he may have been exposed to homosexual activity (assuming the submissive role in anal intercourse).  One of his attending physicians believed that he had been a victim of sexual abuse (a very likely scenario considering Rayford’s socio-economic background).  He could also have been “pimped out” against his will by someone who procured males to engage with him.  To date, this aspect of his life is unclear.

The disease it spawned was rechristened, in light of its indiscriminate virology, to Acquired Immune Deficiency Syndrome or AIDS.  That same year that 248 cases of the disease were reported, local health departments in conjunction with the Centers for Disease Control (CDC) in Atlanta began investigating.

Of the 248 cases known before the detection of the virus, interviewing led to the shocking revelation that at least 40 AIDS victims had one thing in common: all had either had sex with a certain male, blond, gregarious Air Canada flight attendant, or they had sex with someone who did.  This networking connection was made in 1984, and it was critical – it meant medical and public health officials investigating the source of AIDS might have finally gotten the breakthrough they needed. 

Dating America’s exposure to AIDS is irrelevant: AIDS is a global problem.  And continuing research has led to many more interesting facts about the spread of HIV.

Almost any medical professional worth his or her license, whenever a patient dies of a strange ailment, takes the precaution of preserving tissue and blood samples for future research.  It is extremely fortunate that some doctors going all the way back to the late 1950s had been so far-sighted.  Working backward and re-examining suspicious or otherwise unresolved deaths from contagion globally proved enriching in piecing together the history of AIDS. 

Homophobia was so great by the late 1950s almost no airlines in the United States would hire men as flight attendants – even Eastern and Pan Am stopped hiring stewards.  Stewardesses, however, were very desirable.  They were marketed as young, beautiful, and sexually available–this was hardly an acceptable career choice for any he-man.  In the same way that the sexual orientation of male nurses was suspect, only “pansies” wanted to be stewards.

Diverting conversations occurred between Rayford and his primary care givers when questioned about his sexual activities.  His doctors had not considered homosexuality initially, and all conversations, such as they were, seemed to be taken as referring to female sexual contacts.

Ground Zero

Air Canada

Certainly, the African-American teenager Robert Rayford (who had never been outside the city of his birth) was not Patient Zero, either – somebody had to give it to him in the first place.

The criteria for entry were pure sadism: one night only women might be allowed in; other times, a sloppily dressed man might be sent away while another, looking exactly like that man but “famous”, would be let in.  Gay-themed parties were held there often, and casual sex in the bathrooms and the “exclusive” privacy lounge was common among attendees.

False Positive

Grethe Rask was a Danish surgeon who had traveled to Zaire in 1972 to lend medical aid for the sick there.  She returned to Denmark in 1976 and became relentlessly ill.  Her symptoms confounded her colleagues.  She died in December 1977.  Several years later in 1984, it was confirmed through testing she was HIV-positive.  During her time in Zaire, it was known she was directly exposed to blood – it is believed this was the source of her infection.

He wrote myriad articles on the subject and penned a stage play, “A Normal Heart”, that did well.  In May 2014, this stage play was brought to the small screen.  It was presented as a movie on HBO starring Jim Parsons (of “Big Bang Theory” TV fame).  The story documented the earliest days of the AIDS epidemic in America told from the perspective of the New York City/Fire Island cohort.  It is engaging: it is what TV can do (but usually fails to do except in rare cases like this one).

Gay and straight partiers alike finally found their Valhalla, however, in New York City in a crummy little club in the 1970s called Studio 54.  This rat hole was converted into a hot spot known all over the world.  Celebrities fell all over themselves to get in and be seen there.  Its allure was its faux air of exclusivity.  No club before or since carried the cachet of Studio 54.  Co-founded and owned by a cabaret-style, (almost a caricature) flamboyantly gay man, Steve Rubell, and a straight-laced heterosexual lawyer, this kitschy club defined hipsters in the Seventies. 

In 1979, before Dugas was infected, a bisexual German concert violinist, Herbert Heinrich, died.  In 1989, after testing of medical samples from his body, it was learned he was HIV-positive. 

Before Robert Rayford in the US, there was a possible case found in a dead Jamaican native named Ardouin Antonio.  He came to the US in 1927.  He was working as a shipping clerk for a clothier when he died at age 49 on June 28, 1959, in Manhattan.  He had developed a very rare kind of pneumonia, seemingly out of the blue.  Decades later the doctor who had performed Antonio’s autopsy was asked to re-evaluate the case.  Did he think Antonio possibly died of AIDS?  “You bet .

Dr. 1952-1953).

Meanwhile, as a symbolic sign of the coming Armageddon, Studio 54 was forced to close its doors for liquor license violations and tax evasion; entrepreneurs Steve Rubell and his business partner were sentenced to short terms of imprisonment.  [Rubell later died of AIDS.]

Dugas may have personally, and directly, been responsible for dozens of AIDS cases (and no telling how many more indirectly), but he did not bring AIDS to the US, nor was he the first confirmed AIDS victim.  As noted, several California men and some Haitian immigrants were found later to have succumbed to the disease before Dugas.

Gaëtan Dugas, the narcissistic and embittered flight attendant, alternately feeling morose and spiteful about his condition, was given the code name “Patient Zero”, the source of the AIDS epidemic in North America. 

Author’s note

Larry Kramer was actively and aggressively involved with what was then known as “gay cancer” in the early 1980s when the disease first made its poisonous presence visibly known in the United States as “gay cancer”. 

Because of the baffling nature of his case, doctors preserved several tissue and blood samples for later evaluation.  In 1987, eighteen years after his death, molecular biologists at New Orleans’ Tulane University tested specimens of Rayford’s preserved blood and tissues.  Their findings were stunning: a virus “closely related or identical to” HIV-1 was detected.  Further confirmation testing in 1989  proved Robert Rayford (African-American teenage male of St. . . Louis, Missouri) was the earliest confirmed victim of AIDS in North America.

From a front-line perspective

Certainly it was not Gaëtan Dugas (though, like Typhoid Mary over half a century before him, many deaths could be placed squarely on his doorstep). 

Instead, about the only thing that can be said of HIV is that its “Ground Zero” location was almost certainly Central Africa.  

Running Dugas to ground, however, was pointless.  At the time, there were no criminal laws penalizing the willful spread of a known fatal disease (since then, law changes allow charges of attempted and pre-meditated murder to be brought in many states against anyone who is HIV-positive purposefully engaging in unprotected sexual intercourse with an unwitting partner).

This good person also kindly corrected some of the misinformation about Rayford via a personal e-mail and was also kind enough to forward professional papers on the subject.  One such paper, in Lymphology from 1973, gives, perhaps, the best clinical synopsis of the case.  Another article, entitled Documentation of an AIDS Virus Infection in the United States in 1968 (by the same doctor and others), is also a “must read” for anyone interested in the earlier origins of AIDS in America. 

The music was disco, the dance beat adapted from gay men and their party scene.  The mock S&M dance moves, the sweaty bodies, the throb of the music, the drugs consumed, and the fact that not just anyone could get in heightened its allure.

There is an apocryphal story that Patient Zero was really Patient “O” (as in the 15th letter of the English alphabet, first letter of the word “Omega” for the last letter of the Greek alphabet, ?).  Furthermore, it was alleged that a journalist misinterpreted the “O” (for “?”), and instead wrote up his report, referring to the AIDS’ source as “Patient 0” [“zero”] instead.

On October 31, 1980 – ominously enough, Halloween night – the French-Canadian gay male steward Gaëtan Dugas visited a gay bathhouse for the first time on a layover in New York City.

Concern for dying gay men was not paramount on America’s mind.  As more cases of the mysterious killer emerged, the name was changed from “gay cancer” to “gay-related immune deficiency” (GRID).  This, at least, was an open recognition that whatever was causing the disease was compromising a body’s immune system.  It didn’t explain, however, the rather esoteric choice of gay men (and soon discovered, IV drug users) by an unintelligent, non-sentient pathogen as victims.  It wasn’t until the first heterosexual cases of “gay cancer” emerged that the disease was examined more closely.

A strange disease lurked among the gay denizens and creepers of the bath houses, though.  Men began dying of pneumonia and other respiratory illnesses, but only after drastically losing weight and developing horrific skin lesions on their faces, necks, backs, and chests.  This disease became known in the gay community as “gay cancer”.  It was particularly volatile, and it progressed rapidly.  Dugas caught it early, possibly with his first encounter in the New York gay bathhouse on Halloween 1980.

In 1976, a Norwegian sailor, designated with the alias “Arvid Noe”, died; his wife and nine-year-old daughter died the next year of the same wasting disease.  In 1961, the 15-year-old Noe had sailed on his first voyage to Africa.  He worked a merchant vessel that plied along Africa’s west coast from mid-1961 to mid-1962; during this voyage he was treated for gonorrhea.  He sailed again to Africa in 1964, with a port of call in Kenya in eastern Africa.  In 1966, Noe started suffering from chronic joint pain and recurrent lung infections.  By 1968, he could no longer pass a physical to sail, so he worked as a long-haul truck driver. 

Years later, once medical science, and particularly genetics testing, had reached a greater level of technological advance, a revision of the “Patient Zero” findings of 1984 seemed necessary.  What was learned by later research was both fascinating and horrific simultaneously.  It turned out, HIV had not only been in the world for over a century, but it had been in the United States as early as 1966. 

Molecular research shows the AIDS epidemic of the 1980s stemmed from a viral strain that had entered the US via Haiti about 1966.  Other strains have been isolated as well.  As in cases like Robert Rayford’s, the disease died with him (though he probably infected others, those people likely did not have access to the sheer number of sexual partners that, for example, Gaëtan Dugas had, and died before spreading it much). 

And the real Patient Zero – the HIV-Adam or HIV-Eve – lived and most likely died there, somewhere in the Congo, unknown and unrecognized for the catastrophic role he or she would play in human history. 

Gaëtan Dugas fit right in with the gay community of the bath houses.  He was blond, voluble, and open.  Sex for him was a series of anonymous engagements, many times conducted hastily in bathroom stalls.  He took on whatever he felt like.  As well as many other men, he was developing what would become known as “The Clone Look”: close-cropped hair, largish but well-groomed mustache, muscle shirts, short shorts.  [The quintessential version of “The Clone Look” would be Freddie Mercury (rock band Queen’s lead vocalist who died of AIDS) after about 1981.] 

In his wake, one of the unfortunate legacies he left was a renewed homophobia relative to male flight attendants.  They became a lightning rod for America’s fear and anger over AIDS and its links with homosexuality.  “Patient Zero”, Gaëtan Dugas, was reviled; in death he was even accused of bringing HIV to North America and spreading it around the country.

This doctor handled, and talked with (though reported as largely uncommunicative), Robert Rayford personally for a period during Rayford’s confinement, and also attended Rayford’s autopsy, confirming the KS diagnosis and noting the preservation of tissue samples that later were shown to carry the variant of the HIV-1 virus.

Less Than Zero

But, it doesn’t end there. 

Anal scarring also indicated repeated sexual penetration.

There is an interesting correlation between homosexuality and the airline industry.  At least, there is a publicly perceived correlation as it pertains to airline flight attendants.

Both his wife and daughter developed an illness that mimicked his symptoms, and they died in 1977.   The swelling in his legs was bothersome, his genitals and legs were covered in scrofulous skin, and his testicles were severely swollen.  He was also emaciated (having lost much weight suddenly), and even though he was an African-American male he was considered “pale”.  He also had shortness of breath.  His symptoms led his caregivers at Barnes Hospital to conclude that one of his problems was lymphedema (a swelling caused by lymphatic problems).  This was only a tiny part of his health issues, however.

Dugas remained unrepentant.  He originally denied that whatever disease it was he had could be transmitted sexually.  His own words on the subject: “Of course I’m going to have sex.  Nobody’s proven to me that you can spread cancer.”  His depraved indifference to his sexual partners’ well-being was summarized with “It’s their duty to protect themselves.  They know what’s going on out there.  They’ve heard about this disease.”  The last element of his bitterness was voiced by his wish to take others with him: “I’ve got gay cancer.  I’m going to die and so are you.” 

Dugas, meanwhile, knew he was sick.  He didn’t know exactly what was wrong, but he had developed the skin lesions, associated with “gay cancer”.  But one can’t spread cancer, of course, because cancer isn’t contagious.  He indiscriminately continued having sex with men as his whims overtook him.  His “advantage” was his mobility – as a flight attendant, he might be in any part of the US, Canada, or the world on a moment’s notice.  His bitterness about having gay cancer crossed over into his lackadaisical attitude about possibly harming others.

Rayford lived in a brownstone in a poor neighborhood in St. Louis, Missouri.  His mother’s name was Constance Rayford, and he had a brother named George.  Rayford was described as slender.  His retardation left him relatively uncommunicative from shyness. 

AIDS now had a face.

Gay men realized the danger.  Many made the intuitive leap early that perhaps certain activities, such as anal intercourse, might be transmitting the causative agent.  Others flatly refused to believe that their lifestyles might be endangering the health of themselves and of others.  They felt it was a perceived backlash against gay men.  Higher-profile gay men (many closeted during their lifetimes) and activists within the gay community began dying as well as underground sub-culture members (the “Crisco, leather, and fisting” set).

***

The dubious distinction of being America’s “Patient Zero” – the first documented and verifiable case of AIDS in the country – belongs not to Dugas but to a mildly mentally retarded black teenager named Robert Rayford (born ca. Louis City Hospital, then transferred to Barnes Hospital (now Barnes-Jewish Hospital) in St. Memory Elvin-Lewis, thank you so much for not only your contributions to science but to my humble efforts at disseminating it for general readership.  I truly appreciate it.

In conjunction with Studio 54, other bars for gay men to frequent thrived.  Another meeting place was the bath houses still found in many larger cities.  Once serving the utilitarian function for neighborhood residents to bathe (considering most homes up until the late 1920s did not have indoor plumbing) these quaint reminders of The Good Old Days were social gathering places for gay men.  They were prevalent in New York City and in San Francisco.  [Bette Midler, a great favorite among gay men, got her start singing in gay bath houses; her piano player in those days was songwriter/musician Barry Manilow).

Update note:Dr. Somewhere, there was a Patient Zero, the epidemiological well-spring from which this plague spewed forth.. . many cases of AIDS have been autopsied that we didn’t even know had AIDS.”

This makes little sense. 

By April of 1982, 248 cases of the disease were reported nationwide with many others too afraid or indifferent to see a doctor.  A virus was isolated in 1983 by French scientists (as Europeans were also recognizing and treating patients with “gay cancer”, many of whom were decidedly not gay). 

In America, the results of further research led to the conclusion that Gaëtan Dugas had not been the true “Patient Zero” after all.

Good investigative work requires dogged determination.  Running an enigma to ground can take years. 

The term “velvet rope” came into existence then – a red velvet rope (as one might see in a museum keeping patrons at a safe distance from a particularly priceless exhibit) became the literal and symbolic barrier between the plebes on the street and the hipsters within.  Each night crowds gathered outside Studio 54’s doors; admission was granted whimsically by a group of door men and many times by Steve Rubell himself. 

The airline industry developed glamour.  The titillation of a sexy stewardess in uniform, pandering to any business traveler’s ego, was priceless.  These were women without boundaries, women who went anywhere, anytime.  Therefore, they must be promiscuous.  The unspoken possibility of sex with a globe-trotting gal was also alluring.  Married women were aggressively discouraged from working as stewardesses.  The single women, all within a certain preferred range of body type, height, and attractiveness, were wanton women (in the minds of the average male of the day).  Although morbid obesity was not the problem in the 1940s it is today, there were no “big girls” on board.

The discrimination in the labor market meant the United States Supreme Court had to step in and force airlines to hire male flight attendants.  This happened in 1971 after nearly 20 years of female-dominated service.  Even then, the Court’s decision forcing US airlines to hire men was greeted with derision in the press.  It also raised homophobic fears of placing men in such a servile and sexualized role. . Memory Elvin Lewis

Dr. Kramer was a writer in New York and a part of the gay culture.  He, however, decided that merely watching his friends die quietly wasn’t enough. 

Tracing backward from Haiti (the source of the US strain in 1966) put the disease firmly in Central Africa. Louis. 

Without a precise diagnosis, Rayford’s cause of death was attributed to the catch-all vagary “loss of vitality”.  Intractable fluid imbalance and lung disease were listed as contributors.  An autopsy revealed a surprise – his body carried a very rare cancer called Kaposi’s sarcoma internally (though he had but one external lesion on his right thigh).  [Today, this cancer and its lesions are bellwethers of AIDS.] 

He was admitted with multiple, and strange, symptoms (given his tender age)

Biggest Gambling Countries In The World

Related links:

Singapore offered the very first casino some years ago which then became the world’s third largest-gaming center after Macau and Las Vegas. H2 Gambling Capital has released the list of biggest gambling countries due to average gaming losses.

Australia is the craziest country when it comes to gaming and gambling. In this country, gaming companies bet people on whether the central bank’s interest will increase or not. Reportedly, over 75 percent of adult Canadians took part in the games last year in which the most popular games are lotteries and Scratch and Win cards.

Top Online Gambling Mistakes

Australia

Gaming Losses Per Adult: $1,288

Gaming Losses Per Adult: $517

Finland

Canada

Gaming Losses Per Adult: $553

Las Vegas is well-known as the gambling industry of the world; however, American people are not the biggest gamblers on Earth. Otherwise, Australia is the only country that allows online bets on sports but prevents gamblers from using the Internet to place bets during live games.

The most favorite gambling activity in Italy is electronic gaming machine. According to business advisory firm MAG Consulenti Associati, the electronic gaming makes up half of Italy’s total gaming revenues in first half of 2011.

Australia: Biggest Gambling Country in the World

Gaming Losses Per Adult: $1,174. Furthermore, the slot machines named pokies are the most favorite game in Australia with an estimated number of 75-80 percent of problem gamblers. Although the government has imposed an entry fee of S$100 ($80.50) for citizens entering the casino, the country’s gaming revenue is expected to hit $6.4 billion in 2011 and outpace Las Vegas.

Gaming Losses Per Adult: $517

Interestingly enough, the country’s national lottery company, Veikkaus, belongs to the government and is operated by the ministry of education. Most profits go to education, arts and culture.

Gambling’s Famous Icons

Gaming Losses Per Adult: $1,288

Gaming Losses Per Adult: $568

Singapore

Gaming Losses Per Adult: $553

Italy

Gaming Losses Per Adult: $1,174

Gaming Losses Per Adult: $568

Era of Online Gambling

The potash-rich province of Saskatchewan is home to the biggest gamblers in Canada

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The majority of the well-known casino and poker online sites are run by reputable companies who’ve been within the gaming niche for quite a long time. Most poker pros will agree the psychology of poker is an extremely important a part of the things they’re doing well. This is often a vital skill in enhancing your poker game. The administration of the site is going to be processed every day causing you to be enough time to concentrate on your online marketing strategy.

. Playing inside a live game is very totally different from playing on-line poker. This skill isn’t attainable in internet poker room play; you need to be sitting over the table out of your opponents to achieve this expertise. Customer retention is with you.

It usually takes a few weeks to possess your casino and poker online gaming site fully operational an internet-based, after which it’s your decision they are driving traffic towards your website. Creativity in marketing and customer retention is crucial in the current competitive online entertainment business and something is only able to concentrate on the right players by understanding the players themselves.

casino and poker online need constant attention which is essential that you offer good customer care out of all languages of the target markets. Locate a good home game or look

for a local card room if at all possible and go play a couple of times per month if you’re able to. Play casino and poker online to determine more hands and make use of the ease of a web-based poker site whenever you cannot get free from the home or simply possess a very little time to experience.

The immediacy from the internet has exposed a brave “new world “for gambler. If you fancy a flutter you will get your fix.

Within the recent game playing industry events, which I joined, I overheard a discussion between two guys and one of them instructed another that using a casino website is a means to make quick money online. You may either to setup and manage your personal customer care team otherwise allow the operator handle this for you personally.

casino and poker online are a good spot to play if you have use of a card room in your town I’d recommend spent some play at live games. There aren’t many players who claim eternal loyalty to some gaming site and therefore the active gaming cycle on the particular site can vary from weeks to a few months. The program of these sites happen to be produced by mainly several specialist developers plus they all try to provide you with as enjoyable and realistic an event as you possibly can that you should play casino poker online. You now are becoming to the facets of poker that cope with playing another players and not simply them you’re dealt. In on-line poker you won’t ever need to be in person together with your opponent whereby live games you can observe your attacker so that you get the chance to determine any tells that they’re going to exhibit. It is therefore vital that you stabilize your casino and poker online have fun with real live games to operate in your skills

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They reached the top position after defeating Sri Lanka team by an innings and 24 runs. Because of their performance they … For Publishers:

India Vs Sri Lanka 1st T20 Live Streaming, India Vs Sri Lanka 1st T20 Match Live Score

By: Lucy Hanes | Dec 9th 2009 – The First T20 Match between India and Sri Lanka is going to happen on 09, December, 2009 at Vidarbha Cricket Association Ground, Nagpur. Indian cricket team is No.1 cricket team in the ICC Test rankings.

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They reached the top position after defeating Sri Lanka team by an innings and 24 runs.

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India Vs Sri Lanka 1st T20 Live Streaming, India Vs Sri Lanka 1st T20 Match Live Score

By: Lucy Hanes | Dec 9th 2009 – The First T20 Match between India and Sri Lanka is going to happen on 09, December, 2009 at Vidarbha Cricket Association Ground, Nagpur. Because of their performance they … Indian cricket team is No.1 cricket team in the ICC Test rankings.

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A guide to Biloxi and Gulfport casinos

The high winds and water surges of Katrina pushed many of them hundreds of feet inland and smash several to pieces. The most popular sports team is the New Orleans Saints; the LSU Tigers and Alabama Crimson Tide seem better represented than either of Mississippi’s SEC members.

Treasure Bay Casino and Hotel – The smallest casino in Biloxi, Treasure Bay is able to offer friendly staff and some of the most reasonable rates in town.

Island View Casino Resort – The only casino located in Gulfport, Island View seems to thrive on the more affluent surroundings and short drive from Biloxi.

On a ten mile stretch of Route 90, the main thoroughfare through Biloxi and Gulfport, aptly named Beach Boulevard, sit nine large casino and hotel resorts (select casino name for individual review):

Biloxi and Gulfport are very much beach communities. They are the only two casinos which people regularly walk between. The Grand, Isle, and Palace are all located at the eastern end of Biloxi.

Hard Rock Hotel & Casino – Located in the heart of town, the Hard Rock boasts a touch of Hollywood glamour and hosts some of the best entertainment acts in town.

Margaritaville Casino and Restaurant -The Jimmy Buffett empire throws its hat into the Biloxi casino market.

In 2005 the entire face of the Gulf Coast was irreversibly marked by the devastation of Hurricane Katrina. At the time, Mississippi state law prohibited land-based gaming and the casinos were housed on floating barges. Only the IP and Boomtown are a short distance from Beach Boulevard.

IP Casino Resort & Spa – A short drive off Beach Boulevard, the monolithic tower of IP soars over its neighbors and gives guests all the luxury of a high-end resort.

Isle Casino Hotel – On the western edge of town, Isle sits directly upon the beach and gives visitors great access to both the Gulf and Back Bay.

Located an hour east of New Orleans and an hour west of Mobile is the gambling town of Biloxi, Mississippi. Along with great southern barbeque, one finds an abundance of shrimp, crawfish, and crab in the local cuisine. It is a resilient community, married to the water, where the trees, once broken by Katrina, have been carved into beautiful dolphins and birds.

Grand Casino – The Biloxi member of the Caesars Entertainment empire, the Grand is the gaming mega-giant’s spacious and versatile property with a beach front location.

Palace Casino Resort – Seated on the Back Bay of Biloxi, the Palace is a stylish gambling venue, and the only non-smoking casino on the Gulf Coast.

The Beau Rivage and Hard Rock sit directly next to each other and comprise the center of gambling action in Biloxi. In October of 2005, Mississippi revised the laws to allow onshore gambling,facilitate reconstruction, and save an industry vital to its economy.

Kessler Air Force Base is located in Biloxi and adds a military presence of both active and retired personnel. There are countless abandoned buildings, driveways that lead to nothing, and empty concrete slabs where buildings once sat.

One cannot visit Biloxi and Gulfport without being aware of the proximity of Louisiana and Alabama. Kessler is home to one of the Air Force’s larger medical units as well as its large fleet of planes, known as “hurricane hunters,” that are used to monitor meteorological conditions.. Although New Orleans received most of the media attention during the storm’s aftermath, Biloxi and Gulfport still bear the devastating scars prominently. Visitors that tire of the casinos can spend a day in the sunshine, rent a jet ski, or go for a peaceful bike ride along the beach.

Boomtown Casino – Themed after a 19th century mining and ranching settlement, Boomtown prides itself on being the “local’s casino” of Biloxi.

Although the casinos of Biloxi and Gulfport do not, for the most part, neighbor one another, most of them are situated directly upon Route 90. Island View is the only casino in Gulfport, a short, 15 minute drive from Biloxi. The influences of both Louisiana and Alabama are felt throughout this sleepy beach community, parked on the sand of the Gulf of Mexico. Biloxi, like its neighbor, Gulfport, is a mix of southern sunshine and Caribbean attitude.

Beau Rivage Resort & Casino – French for “beautiful shore,” famed Las Vegas developer Steve Wynn has made the Beau Rivage into Biloxi’s premier, award-winning casino.

Seated upon the sands of Biloxi and looking out upon the horizon that stretches over the Gulf of Mexico, it is not hard to imagine why Jefferson Davis chose this location for his retirement. Surprisingly, its home state of Mississippi seems to have less cultural influence upon Biloxi than these neighborings. The residents of the area are a complete mix of people drawn from the entire length of The United States’ Gulf of Mexico shoreline, from Texas to Florida.

Many casinos in Biloxi were severely damaged by Hurricane Katrina. The city operates on island rhythms, strummed by Jimmy Buffett, and gives visitors a nice place to escape for a little while. The pace of life is easy going and relaxed, as if on permanent vacation

Make Bets That Assure You A Win

Make sure you have maintained a betting limit , instead of wagering with hefty bucks, play with a small amount many times.

As the grand soccer world cup 200 is gearing near, players have great opportunity to try hand in making lucrative bets. You can also take a look on online lives scores of the matches and take the reviews of expert’s punter

Make your thoughts clear had have a strong base to make the most of this soccer betting season.

Managing your betting amount is a crucial part to consider while you are placing soccer bets. Many times you might be very close to win,but end up losing. Websites guides players about recommendable bookmakers, betting tips, free bets and bonuses which let the players to have a unique betting style.

By: Pedro Walker

Article Directory: http://www.articledashboard.com

The real of of online soccer betting is not as simple as the flip of a coin which lets you decide outcome of the match. Website offering betting tips have plethora of tips along with a statistical analysis that guides you and let you focus on the certainty of the bets at stake. It is essential to make a strong by soccer betting,you do not easily lose your calm and play with utmost patience.

Online-betting.me.uk provides all information that you require for placing winning soccer bets. Both of the teams have unbeatable good players,but then you should make bets after doing plenty of research work,don’t just stick to one,play smartly.

All of us are aware that betting is a risky affair,this unpredicted event can take you to deep profits and at the same time you can lose also. Losing with a small amount will not be a disaster,you can easily make other bets with more excitement and fun.

The money making strategy in soccer betting is all about taking advantage from the information available,the more you are acquainted with latest trends the more you have chances of making as much money as you can. However, despite of being an unpredictable affair betting lets you make huge money within a short span. Here you get trusted and reliable statistics, tables, betting tips and latest results that relates to football betting. It’s quite visible that Spain and Brazil are hot favorites for this soccer season, with presence of other teams,you need to carefully analyze their individualized performance and then place bets. . Making money from soccer betting is all the matter of taking advantage from the information. Generally people get excited and make bets for larger amount all the time,this can lead them to debts because bankroll emptied quite early. Online betting websites are a great source which provide players with enriched betting odds, higher stakes and array of bets for novices as well experienced punters

10 Websites and Games Like Club Penguin (Virtual Worlds)

If you are a fan of Club Penguin looking for another fun virtual world to play or a parent seeking information about other safe online games like Club Penguin for your child (or children) then this page will prove to be an invaluable resource.

There are many websites and games like Club Penguin that offer a great experience for children, teenagers and even their parents.

I originally put this list together for a family friend and decided to share it here so other fans of the Club Penguin universe can find similar experiences that are both fun, friendly and safe. If you have any additional favourite games please don’t hesitate to share them in the comment section at the end of the page.

This flood of games into the market has produced some real great games like Club Penguin but also many poor game experiences and even some fantastic ones that have closed down (such as ToonTown Online and Star86) which can also be frustrating after having invested so much time in a game that you love.

While Club Penguin was one of the first really successful games in this space there has been a huge increase in the number of virtual worlds targeted at tweens over the past few years as companies quickly realise it is a huge (and growing market).

Caribbean Casinos – free article courtesy of ArticleCity.com

And finally, no one under the age of 18 is allowed in Caribbean casinos, so schedule other activities for the youngsters before you hit the casinos.

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This article was posted on February 13, 2006

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The gorgeous island of Puerto Rico is home to about a dozen old-world-style casinos. The Atlantis’ expansive 30,000-square-foot area, which includes 78 table games and approximately 1,000 slot machines, has helped earned the Atlantis Casino its reputation as an immaculate gambling palace. First, each island has its own laws and rules when it comes to gambling, so be sure to find out the details about the island you visit. The four largest casinos in The Bahamas are the Atlantis Casino on Paradise Island, the Crystal Palace Casino on New Providence Island, and The Crowne Plaza Golf Resort & Royal Oasis Casino and Our Lucaya, both on Grand Bahama Island.

While visiting the Caribbean travelers will find a number of glitzy casinos and hotels and resorts with on-site gambling.

The Caribbean region has a lot of hot gaming spots and casinos. Croix in the Virgin Islands, and Antigua. Located on the premises of the Wyndham Nassau Resort on Cable Beach, the Crystal Palace Casino has about 700 slot machines and 38 tables for games such as blackjack, craps, roulette, and baccarat.

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Caribbean Casinos

 by: Danielle Mitchell

Caribbean Stud Poker

Before heading to the slot machines, there are a few things casino patrons should remember. By Puerto Rican law, all casinos have to be located on the property of hotels or resorts. During your stay in Puerto Rico, you can enjoy fine dining, exciting nightlife, and spectacular gambling fun all under one roof. Vincent and St. Since it began in Aruba, the popularity of Caribbean stud poker has grown tremendously in the region and is even played in Las Vegas.

Gamers are often drawn to The Bahamas which is popular for great casinos and gambling action. Along with state-of-the-art slot machines, table games, and other types of gaming fun, Caribbean casinos also offer other nightlife options including dance clubs, discos, and bars. The biggest difference between Caribbean stud poker and traditional poker is that instead of playing against other players, you go against the dealer. Second, the hours that some casinos are open may vary depending on the season, so find out ahead of time before making your plans. But unlike American and European casinos, the gambling atmosphere in the Caribbean is more relaxed, and most of the island casinos are not open 24 hours a day. Although gambling is illegal for residents of The Bahamas, tourists can try their luck at any of the region’s spectacular casinos. So not only can you wage bets during your sunny island vacation, but you will also find many other ways to let your hair down at Caribbean gambling palaces.

Some popular casinos on the island include the Hyatt Regency Cerromar, Hilton Ponce and Casino, Westin Rio Mar Resort Casino, Ritz Carlton San Juan, which is the first Ritz Carlton casino, and many, many more. Caribbean stud poker is a combination of blackjack and poker – the rules of play are similar between the two games. This poker variation started in Aruba in the 1980s, reportedly by some cruise ship directors who were out to make a buck. The combination of sugar-sand beaches and tropical island ambiance with all the glamor and excitement of Las Vegas makes for an ideal vacation destination for many travelers. Finally, the newest casino in the Bahamas is Our Lucaya Resort, which offers several gambling options.

Compared to many other popular casino card games, Caribbean stud poker has a pretty short history.

Casinos in Puerto Rico

Caribbean Islands Featuring Casinos

Gambling in The Bahamas

The world-famous Atlantis Casino is the largest casino located in the Caribbean. Many of these glamorous gambling establishments are located in the historic city of San Juan, and most require that their patrons dress formally. There are so many choices when it comes to gambling in the Caribbean that you’re sure to find the right island with the perfect casino to fit your style and your ideal vacation. The Crowne Plaza Golf Resort & Royal Oasis Casino is a luxurious and exciting casino located within a plush hotel that has great choices of various games, slots, and other gambling opportunities. The Atlantis also features several restaurants, outdoor terraces, and gaming lessons for the novice gambler. All players are allowed to see one of the dealer’s cards, which is dealt face up.

Other islands in the Caribbean that feature dazzling casinos and exciting gambling are the Dominican Republic, Aruba, Curacao, St. Maarten, St. Casinos in Puerto Rico are some of the most exciting in the Caribbean region because of their extravagant historical décor, hot gaming, as well as their award-winning restaurants, live entertainment, array of bars and lounges, and much more.

The Crystal Palace Casino is another sizzling casino found in The Bahamas