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International Notes Update: Acquired Immunodeficiency Syndrome -- Europe

Ten countries provide the World Health Organization (WHO) Collaborating Centre on Acquired Immunodeficiency Syndrome (AIDS), Paris, France, with regular data, making follow-up and study of the AIDS situation possible in Europe (1); these countries are: Denmark, France, the Federal Republic of Germany, Greece, Italy, the Netherlands, Spain, Sweden, Switzerland, and the United Kingdom.

A total of 421 AIDS cases were diagnosed in these 10 countries (although onset of illness may have occurred elsewhere) up to July 15, 1984 (Table 1). In October 1983, the same countries reported 215 cases at the first meeting on AIDS, organized by the WHO Regional Office for Europe in Aarhus, Denmark (2). AIDS cases have increased nearly 100% in 8 months. Estimates of the rate of AIDS cases per million population vary considerably from one country to another. However, uneven geographic case distribution was found within the individual countries and also in other parts of the world.

Seven percent of the cases reported in these 10 countries occurred among women. Forty-nine percent of all patients were in the 30- to 39-year age group. Two cases occurring in children under 1 year of age were reported in France, the first in a Zairian child whose mother also had AIDS, and the second, in a Haitian child whose parents both had the disease.

Of the total patients recorded, 349 (83%) came from the 10 countries mentioned above (Table 2). Three other groups accounted for a considerable percentage: (1) the group of patients from countries in the Caribbean region, with 18 cases (4.3% of the total), including 17 Haitian patients (reported in France) and one patient from Dominica (reported in the United Kingdom). Except for three Haitians, these patients were living in Europe before the appearance of the first signs of the disease; (2) the group of patients from Africa included 39 cases (9.3% of the total). These patients came from Zaire (18), Congo (nine), Gabon (three), Mali (two), Zambia (two), Cameroon (one), Cape Verde (one), Ghana (one), Togo (one), and Uganda (one). The cases were diagnosed and reported in France (27 cases), Switzerland (six), the United Kingdom (two), the Federal Republic of Germany (two), Greece (one), and Italy (one). Thirty-two of these patients were living in Europe before the appearance of the initial symptoms; (3) the third group ("other nationalities") included 15 patients (3.6% of the total), consisting mainly of patients coming from the Americas: United States (seven), Argentina (one), Canada (one), Nicaragua (one), and Peru (one). The four other patients came from the following countries: Albania (one), Pakistan (one), Portugal (one), and Yugoslavia (one). Seven of them (four United States citizens, one Argentine, one Canadian, and one Pakistani) were not living in Europe when the first symptoms appeared.

Of the patients from the 10 European countries, 87.4% were male homosexuals, 3.4%, hemophilia patients, and 1.4%, drug abusers, while none of the known risk factors could be found for 6.9% of patients of both sexes. Among the latter, women comprised slightly more than 2% of the total. The 12 hemophilia patients were reported in the Federal Republic of Germany (five cases), Spain (three), France (two), and the United Kingdom (two). The five drug-abuse patients were reported in Spain (three cases) and the Federal Republic of Germany (two). The two patients for whom the only risk factor identified was blood transfusion were reported in France. The first had received transfusions in Haiti and Martinique at an interval of a few days; the second had received a transfusion in Paris. Both were given transfusions following traffic accidents.

In almost all patients from the Caribbean and Africa observed in Europe, none of the known AIDS risk factors were found. One Haitian patient (out of 17) and one African patient (out of 39) said they were homosexuals.

Women without known risk factors comprised 22% of the Caribbean cases and 33% of the African cases. Among patients of other nationalities, 13 were homosexuals; two were also drug abusers. The two patients (one Pakistani and one Portuguese) for whom no risk factor was found had lived in Equatorial Africa during the 5 years preceding diagnosis of the disease. Reported in WHO Weekly Epidemiological Record 1984;59:305-7.

References

  1. World Health Organization. (No. 32, get title) Wkly Epidem Rec 1984;59:249-50.

  2. World Health Organization. Acquired immune deficiency syndrome (AIDS) update. Wkly Epidem Rec 1983;58:351.



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