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March 4, 1988, Vol 259, No. 9 >
ARTICLE | March 4, 1988

Do Alternate Modes for Transmission of Human Immunodeficiency Virus Exist?: Title and subTitle BreakA Review FREE

Alan R. Lifson, MD, MPH
[+] Author Affiliations

Reprint requests to the AIDS Office, San Francisco Department of Public Health, 1111 Market St, Fourth Floor, San Francisco, CA 94103 (Dr Lifson).


JAMA. 1988;259(9):1353-1356. doi:10.1001/jama.1988.03720090043032
Text Size: A A A
Published online
Article
References

Transmission of human immunodeficiency virus (HIV) is known to occur perinatally, through sexual contact, and after exposure to infected blood or blood products. The possibility that breast milk may transmit HIV continues to be evaluated. There is no epidemiologic evidence that contact with saliva, tears, or urine has resulted in HIV infection. However, because HIV has (in some cases rarely) been isolated from these body fluids, guidelines have been developed to reduce more extensive exposures to such secretions. Laboratory and epidemiologic data strongly indicate that HIV is not transmitted through immune globulin preparations, the hepatitis B vaccine, or contact with insects. Increasing evidence from many studies also indicates that HIV is not transmitted through casual contact. All individuals need to be aware of how HIV is and is not transmitted, to reduce high-risk behaviors and to avoid unnecessary fears and actions.

(JAMA 1988;259:1353-1356)

REFERENCES

1 +
 Update: Human immunodeficiency virus infections in health-care workers exposed to blood of infected patients. MMWR 1987;;36:285-289.
2 +
Matthews GW, Neslund VS:  The initial impact of AIDS on public health law in the United States— 1986. JAMA 1987;;257:344-352.
3 +
Thiry L, Sprecher-Goldberger S, Jonckheer T, et al:  Isolation of AIDS virus from cell-free breast milk of three healthy virus carriers. Lancet 1985;;2:891-892.
4 +
Ziegler JB, Cooper DA, Johnson RO, et al:  Postnatal transmission of AIDS-associated retrovirus from a mother to an infant. Lancet 1985;;1:896-897.
5 +
Lepage P, Van de Perre P, Carael M, et al:  Postnatal transmission of HIV from mother to child. Lancet 1987;;2:400.
6 +
Senturia YD, Ades AE, Peckham CS, et al:  Breast-feeding and HIV infection. Lancet 1987;;2: 400-401.
7 +
 Recommendations for assisting in the prevention of perinatal transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus and acquired immunodeficiency syndrome. MMWR 1985;;34:721-726, 731-732.
8 +
Groopman JE, Salahuddin SZ, Sarngadharan MG, et al:  HTLV-III in saliva of people with AIDS-related complex and healthy homosexual men at risk for AIDS. Science 1984;;226:447-449.
9 +
Ho DD, Byington RE, Schooley RT, et al:  Infrequency of isolation of HTLV-III virus from saliva in AIDS. N Engl J Med 1985;;313:1606.
10 +
Levy JA, Kaminsky LS, Morrow WJ, et al:  Infection by the retrovirus associated with the acquired immunodeficiency syndrome. Ann Intern Med 1985;;103:694-699.
11 +
Fultz PN:  Components of saliva inactivate human immunodeficiency virus. Lancet 1986;;2:1215.
12 +
Wahn V, Kramer HH, Voit T, et al:  Horizontal transmission of HIV infection between two siblings. Lancet 1986;;2:694.
13 +
Drummond JA:  Seronegative 18 months after being bitten by a patient with AIDS. JAMA 1986;;256:2342-2343.
14 +
Tsoukas C, Hadjis T, Theberge L, et al: Risk of transmission of HTLV-III/LAV from human bites. Presented at the Second International Conference on AIDS, Paris, June 23,1986.
15 +
Rogers MF, White CR, Sanders R: Can children transmit HTLV-III/LAV infection? Presented at the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Oct 1,1986.
16 +
McCray E, and the Cooperative Needlestick Surveillance Group:  Occupational risk of the acquired immunodeficiency syndrome among health care workers. N Engl J Med 1986;;314:1127-1132.
17 +
Saviteer SM, White GC, Cohen MS, et al:  HTLV-III exposure during cardiopulmonary resuscitation. N Engl J Med 1985;;313:1606-1607.
18 +
Gerberding JL, Bryant-LeBlanc CE, Nelson K, et al:  Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions. J Infect Dis 1987;; 156:1-8.
19 +
Klein RS, Phelan JA, Freeman K, et al:  Low occupational risk of human immunodeficiency virus infection among dental professionals. N Engl J Med 1988;;318:86-90.
20 +
Gerberding JL, Nelson K, Greenspan D, et al: Risk to dental professionals (DP) from occupational exposure to human immunodeficiency virus (HIV). Presented at the 27th Interscience Conference on Antimicrobial Agents and Chemotherapy, New York, Oct 6,1987.
21 +
Salahuddin SZ, Groopman JE, Markham PD, et al:  HTLV-III in symptom-free seronegative persons. Lancet 1984;;2:1418-1420.
22 +
Darrow WW, Echenberg DF, Jaffe HW, et al:  Risk factors for human immunodeficiency virus (HIV) infections in homosexual men. Am J Public Health 1987;;77:479-483.
23 +
Moss AR, Osmond D, Bacchetti P, et al:  Risk factors for AIDS and HIV seropositivity in homosexual men. Am J Epidemiol 1987;;125:1035-1047.
24 +
McCusker J, Stoddard AM, Mayer KH, et al:  Behavioral risk factors for HIV infection among homosexual men at a Boston community health center. Am J Public Health 1988;;78:68-71.
25 +
Peterman TA, Stoneburner RL, Allen JR, et al:  Risk of human immunodeficiency virus transmission from heterosexual adults with transfusionassociated infections. JAMA 1988;;259:55-58.
26 +
 Recommendations for prevention of HIV transmission in health-care settings. MMWR 1987;;36( (suppl 2S) ):3S-18S.
27 +
 Additional recommendations to reduce sexual and drug abuse—related transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus. MMWR 1986;;35:152-155.
28 +
 Education and foster care of children infected with human T-lymphotropic virus type III/ lymphadenopathy-associated virus. MMWR 1985;; 34:517-521.
29 +
Fujikawa LS, Salahuddin SZ, Palestine AG, et al:  Isolation of human T-lymphotropic virus type III from the tears of a patient with the acquired immunodeficiency syndrome. Lancet 1985;;2:529-530.
30 +
Tervo T, Lahdevirta J, Vaheri A, et al:  Recovery of HTLV-III from contact lenses. Lancet 1986;;1:379-380.
31 +
Conte JE:  Infection with the human immunodeficiency virus in the hospital: Epidemiology, infection control and biosafety considerations. Ann Intern Med 1986;;105:730-736.
32 +
 Recommendations for preventing possible transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus from tears. MMWR 1985;;34:533-534.
33 +
Wells MA, Wittek AE, Epstein JS, et al:  Inactivation and partition of human T-cell lymphotropic virus type III during ethanol fractionation of plasma. Transfusion 1986;;26:210-213.
34 +
 Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus infection. MMWR 1986;;35:231-233.
35 +
Tedder RS, Uttley A, Chiengsong-Popov R:  Safety of immunoglobulin preparation containing anti—HTLV-III. Lancet 1985;;1:815.
36 +
Zuck TF, Preston MS, Tankersley DL, et al:  More on partitioning and inactivation of AIDS virus in immune globulin preparations. N Engl J Med 1986;;314:1454-1455.
37 +
 Lack of transmission of human immunodeficiency virus through Rh0(D) immune globulin (human). MMWR 1987;;36:728-729.
38 +
 Hepatitis B vaccine: Evidence confirming lack of AIDS transmission. MMWR 1984;;33:685-687.
39 +
Francis DP, Feorino PM, McDougal S, et al:  The safety of the hepatitis B vaccine: Inactivation of the AIDS virus during routine vaccine manufacture. JAMA 1986;;256:869-872.
40 +
Dienstag JL, Werner BG, McLane MF, et al:  Absence of antibodies to HTLV-III in health workers after hepatitis B vaccination. JAMA 1985;;254:1064-1066.
41 +
Muylle L, Vranckk P, Peetermans ME:  No HTLV-III antibodies after HBV vaccine. N Engl J Med 1986;;314:581.
42 +
Stevens CE, Taylor PE, Rubinstein P, et al:  Safety of the hepatitis B vaccine. N Engl J Med 1985;;312:375-376.
43 +
Kaplan JE, Oleske JM, Getchell JP, et al:  Evidence against transmission of human T-lymphotropic virus/lymphadenopathy-associated virus (HTLV-III/LAV) in families of children with the acquired immunodeficiency syndrome. Pediatr Infect Dis 1985;;4:468-471.
44 +
Redfield RR, Markham PD, Salahuddin SZ, et al:  Frequent transmission of HTLV-III among spouses of patients with AIDS-related complex and AIDS. JAMA 1985;;253:1571-1573.
45 +
Lawrence DN, Jason JM, Bouhasin JD, et al:  HTLV-III/LAV antibody status of spouses and household contacts assisting in home infusion of hemophilia patients. Blood 1985;;66:703-705.
46 +
Thomas PA, Lubin K, Enlow RW, et al: Comparison of HTLV-III serology, T cell levels, and general health status of children whose mothers have AIDS with children of healthy inner city mothers in New York. Presented at the First International Conference on AIDS, Atlanta, April 16, 1985.
47 +
Lewin EB, Zack R, Ayodele A: Communicability of AIDS in a foster care setting. Presented at the First International Conference on AIDS, Atlanta, April 16,1985.
48 +
Friedland GH, Saltzman B, Rogers M, et al: Additional evidence for lack of transmission of HIV infection to household contacts of AIDS patients. Presented at the Third International Conference on AIDS, Washington, DC, June 2,1987.
49 +
Berthier A, Chamaret S, Fauchet R, et al:  Transmissibility of human immunodeficiency virus in haemophiliac and non-haemophiliac children living in a private school in France. Lancet 1986;;2:598-601.
50 +
Jason JM, McDougal JS, Dixon G, et al:  HTLV-III/LAV antibody and immune status of household contacts and sexual partners of persons with hemophilia. JAMA 1986;;255:212-215.
51 +
Fischl MA, Dickinson GM, Scott GB, et al:  Evaluation of heterosexual partners, children, and household contacts of adults with AIDS. JAMA 1987;;257:640-644.
52 +
Mann JM, Quinn TC, Francis H, et al:  Prevalence of HTLV-III/LAV in household contacts of patients with confirmed AIDS and controls in Kinshasa, Zaire. JAMA 1986;;256:721-724.
53 +
 Recommendations for preventing transmission of infection with human T-lymphotropic virus type Ill/lymphadenopathy-associated virus in the workplace. MMWR 1985;;34:681-686,691-695.
54 +
Starcher ET, Dondero TJ, Lifson AR, et al: Lack of evidence for new transmission modes among AIDS patients. Presented at the Third International Conference on AIDS, Washington, DC, June 2,1987.
55 +
Becker JL, Hazan U, Nugeyre MT, et al:  Infection of cultured insect cells with HIV, the causative agent of AIDS, and demonstration of infection in African insects with this virus (French). C R Acad Sci III 1986;;303:303-306.
56 +
Chermann JC, Becker JL, Hazan U, et al: HIV related sequences in insects from central Africa. Presented at the Third International Conference on AIDS, Washington, DC, June 1,1987.
57 +
AIDS-Related Issues: Do Insects Transmit AIDS? Office of Technology Assessment, US Congress, 1987;.
58 +
Srinivasan A, York D, Bohan C:  Lack of HIV replication in arthropod cells. Lancet 1987;;2:1094-1095.
59 +
Lyons SF, Jupp PG, Schoub BD:  Survival of HIV in the common bedbug. Lancet 1986;;2:45.
60 +
Jupp PG, Lyons SF:  Experimental assessment of bedbugs (Cimex lectularius and Cimex hemipterus) and mosquitoes (Aedes aegypti formosus) as vectors of human immunodeficiency virus. AIDS 1987;;1:171-174.
61 +
Whiteside ME, Withum D, Tavris D, et al: Outbreak of no identifiable risk acquired immunodeficiency syndrome (AIDS) in Belle Glade, Florida. Presented at the First International Conference on AIDS, Atlanta, April 17,1985.
62 +
Castro KG, Lieb S, Jaffe HW, et al:  Transmission of HIV in Belle Glade, Florida: Lessons for other communities in the United States. Science 1988;;239:193-197.
63 +
 Acquired immunodeficiency syndrome (AIDS) in western Palm Beach County, Florida. MMWR 1986;;35:609-612.
64 +
Mann JM, Francis H, Quinn T, et al:  Surveillance for AIDS in a central African city: Kinshasa, Zaire. JAMA 1986;;255:3255-3259.
65 +
Quinn TC, Mann JM, Curran JW, et al:  AIDS in Africa: An epidemiologic paradigm. Science 1986;;234:955-963.
66 +
 Coolfont Report: A Public Health Service plan for prevention and control of AIDS and the AIDS virus. Public Health Rep 1986;;101:341-348.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
 Update: Human immunodeficiency virus infections in health-care workers exposed to blood of infected patients. MMWR 1987;;36:285-289.
2 +
Matthews GW, Neslund VS:  The initial impact of AIDS on public health law in the United States— 1986. JAMA 1987;;257:344-352.
3 +
Thiry L, Sprecher-Goldberger S, Jonckheer T, et al:  Isolation of AIDS virus from cell-free breast milk of three healthy virus carriers. Lancet 1985;;2:891-892.
4 +
Ziegler JB, Cooper DA, Johnson RO, et al:  Postnatal transmission of AIDS-associated retrovirus from a mother to an infant. Lancet 1985;;1:896-897.
5 +
Lepage P, Van de Perre P, Carael M, et al:  Postnatal transmission of HIV from mother to child. Lancet 1987;;2:400.
6 +
Senturia YD, Ades AE, Peckham CS, et al:  Breast-feeding and HIV infection. Lancet 1987;;2: 400-401.
7 +
 Recommendations for assisting in the prevention of perinatal transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus and acquired immunodeficiency syndrome. MMWR 1985;;34:721-726, 731-732.
8 +
Groopman JE, Salahuddin SZ, Sarngadharan MG, et al:  HTLV-III in saliva of people with AIDS-related complex and healthy homosexual men at risk for AIDS. Science 1984;;226:447-449.
9 +
Ho DD, Byington RE, Schooley RT, et al:  Infrequency of isolation of HTLV-III virus from saliva in AIDS. N Engl J Med 1985;;313:1606.
10 +
Levy JA, Kaminsky LS, Morrow WJ, et al:  Infection by the retrovirus associated with the acquired immunodeficiency syndrome. Ann Intern Med 1985;;103:694-699.
11 +
Fultz PN:  Components of saliva inactivate human immunodeficiency virus. Lancet 1986;;2:1215.
12 +
Wahn V, Kramer HH, Voit T, et al:  Horizontal transmission of HIV infection between two siblings. Lancet 1986;;2:694.
13 +
Drummond JA:  Seronegative 18 months after being bitten by a patient with AIDS. JAMA 1986;;256:2342-2343.
14 +
Tsoukas C, Hadjis T, Theberge L, et al: Risk of transmission of HTLV-III/LAV from human bites. Presented at the Second International Conference on AIDS, Paris, June 23,1986.
15 +
Rogers MF, White CR, Sanders R: Can children transmit HTLV-III/LAV infection? Presented at the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Oct 1,1986.
16 +
McCray E, and the Cooperative Needlestick Surveillance Group:  Occupational risk of the acquired immunodeficiency syndrome among health care workers. N Engl J Med 1986;;314:1127-1132.
17 +
Saviteer SM, White GC, Cohen MS, et al:  HTLV-III exposure during cardiopulmonary resuscitation. N Engl J Med 1985;;313:1606-1607.
18 +
Gerberding JL, Bryant-LeBlanc CE, Nelson K, et al:  Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions. J Infect Dis 1987;; 156:1-8.
19 +
Klein RS, Phelan JA, Freeman K, et al:  Low occupational risk of human immunodeficiency virus infection among dental professionals. N Engl J Med 1988;;318:86-90.
20 +
Gerberding JL, Nelson K, Greenspan D, et al: Risk to dental professionals (DP) from occupational exposure to human immunodeficiency virus (HIV). Presented at the 27th Interscience Conference on Antimicrobial Agents and Chemotherapy, New York, Oct 6,1987.
21 +
Salahuddin SZ, Groopman JE, Markham PD, et al:  HTLV-III in symptom-free seronegative persons. Lancet 1984;;2:1418-1420.
22 +
Darrow WW, Echenberg DF, Jaffe HW, et al:  Risk factors for human immunodeficiency virus (HIV) infections in homosexual men. Am J Public Health 1987;;77:479-483.
23 +
Moss AR, Osmond D, Bacchetti P, et al:  Risk factors for AIDS and HIV seropositivity in homosexual men. Am J Epidemiol 1987;;125:1035-1047.
24 +
McCusker J, Stoddard AM, Mayer KH, et al:  Behavioral risk factors for HIV infection among homosexual men at a Boston community health center. Am J Public Health 1988;;78:68-71.
25 +
Peterman TA, Stoneburner RL, Allen JR, et al:  Risk of human immunodeficiency virus transmission from heterosexual adults with transfusionassociated infections. JAMA 1988;;259:55-58.
26 +
 Recommendations for prevention of HIV transmission in health-care settings. MMWR 1987;;36( (suppl 2S) ):3S-18S.
27 +
 Additional recommendations to reduce sexual and drug abuse—related transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus. MMWR 1986;;35:152-155.
28 +
 Education and foster care of children infected with human T-lymphotropic virus type III/ lymphadenopathy-associated virus. MMWR 1985;; 34:517-521.
29 +
Fujikawa LS, Salahuddin SZ, Palestine AG, et al:  Isolation of human T-lymphotropic virus type III from the tears of a patient with the acquired immunodeficiency syndrome. Lancet 1985;;2:529-530.
30 +
Tervo T, Lahdevirta J, Vaheri A, et al:  Recovery of HTLV-III from contact lenses. Lancet 1986;;1:379-380.
31 +
Conte JE:  Infection with the human immunodeficiency virus in the hospital: Epidemiology, infection control and biosafety considerations. Ann Intern Med 1986;;105:730-736.
32 +
 Recommendations for preventing possible transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus from tears. MMWR 1985;;34:533-534.
33 +
Wells MA, Wittek AE, Epstein JS, et al:  Inactivation and partition of human T-cell lymphotropic virus type III during ethanol fractionation of plasma. Transfusion 1986;;26:210-213.
34 +
 Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus infection. MMWR 1986;;35:231-233.
35 +
Tedder RS, Uttley A, Chiengsong-Popov R:  Safety of immunoglobulin preparation containing anti—HTLV-III. Lancet 1985;;1:815.
36 +
Zuck TF, Preston MS, Tankersley DL, et al:  More on partitioning and inactivation of AIDS virus in immune globulin preparations. N Engl J Med 1986;;314:1454-1455.
37 +
 Lack of transmission of human immunodeficiency virus through Rh0(D) immune globulin (human). MMWR 1987;;36:728-729.
38 +
 Hepatitis B vaccine: Evidence confirming lack of AIDS transmission. MMWR 1984;;33:685-687.
39 +
Francis DP, Feorino PM, McDougal S, et al:  The safety of the hepatitis B vaccine: Inactivation of the AIDS virus during routine vaccine manufacture. JAMA 1986;;256:869-872.
40 +
Dienstag JL, Werner BG, McLane MF, et al:  Absence of antibodies to HTLV-III in health workers after hepatitis B vaccination. JAMA 1985;;254:1064-1066.
41 +
Muylle L, Vranckk P, Peetermans ME:  No HTLV-III antibodies after HBV vaccine. N Engl J Med 1986;;314:581.
42 +
Stevens CE, Taylor PE, Rubinstein P, et al:  Safety of the hepatitis B vaccine. N Engl J Med 1985;;312:375-376.
43 +
Kaplan JE, Oleske JM, Getchell JP, et al:  Evidence against transmission of human T-lymphotropic virus/lymphadenopathy-associated virus (HTLV-III/LAV) in families of children with the acquired immunodeficiency syndrome. Pediatr Infect Dis 1985;;4:468-471.
44 +
Redfield RR, Markham PD, Salahuddin SZ, et al:  Frequent transmission of HTLV-III among spouses of patients with AIDS-related complex and AIDS. JAMA 1985;;253:1571-1573.
45 +
Lawrence DN, Jason JM, Bouhasin JD, et al:  HTLV-III/LAV antibody status of spouses and household contacts assisting in home infusion of hemophilia patients. Blood 1985;;66:703-705.
46 +
Thomas PA, Lubin K, Enlow RW, et al: Comparison of HTLV-III serology, T cell levels, and general health status of children whose mothers have AIDS with children of healthy inner city mothers in New York. Presented at the First International Conference on AIDS, Atlanta, April 16, 1985.
47 +
Lewin EB, Zack R, Ayodele A: Communicability of AIDS in a foster care setting. Presented at the First International Conference on AIDS, Atlanta, April 16,1985.
48 +
Friedland GH, Saltzman B, Rogers M, et al: Additional evidence for lack of transmission of HIV infection to household contacts of AIDS patients. Presented at the Third International Conference on AIDS, Washington, DC, June 2,1987.
49 +
Berthier A, Chamaret S, Fauchet R, et al:  Transmissibility of human immunodeficiency virus in haemophiliac and non-haemophiliac children living in a private school in France. Lancet 1986;;2:598-601.
50 +
Jason JM, McDougal JS, Dixon G, et al:  HTLV-III/LAV antibody and immune status of household contacts and sexual partners of persons with hemophilia. JAMA 1986;;255:212-215.
51 +
Fischl MA, Dickinson GM, Scott GB, et al:  Evaluation of heterosexual partners, children, and household contacts of adults with AIDS. JAMA 1987;;257:640-644.
52 +
Mann JM, Quinn TC, Francis H, et al:  Prevalence of HTLV-III/LAV in household contacts of patients with confirmed AIDS and controls in Kinshasa, Zaire. JAMA 1986;;256:721-724.
53 +
 Recommendations for preventing transmission of infection with human T-lymphotropic virus type Ill/lymphadenopathy-associated virus in the workplace. MMWR 1985;;34:681-686,691-695.
54 +
Starcher ET, Dondero TJ, Lifson AR, et al: Lack of evidence for new transmission modes among AIDS patients. Presented at the Third International Conference on AIDS, Washington, DC, June 2,1987.
55 +
Becker JL, Hazan U, Nugeyre MT, et al:  Infection of cultured insect cells with HIV, the causative agent of AIDS, and demonstration of infection in African insects with this virus (French). C R Acad Sci III 1986;;303:303-306.
56 +
Chermann JC, Becker JL, Hazan U, et al: HIV related sequences in insects from central Africa. Presented at the Third International Conference on AIDS, Washington, DC, June 1,1987.
57 +
AIDS-Related Issues: Do Insects Transmit AIDS? Office of Technology Assessment, US Congress, 1987;.
58 +
Srinivasan A, York D, Bohan C:  Lack of HIV replication in arthropod cells. Lancet 1987;;2:1094-1095.
59 +
Lyons SF, Jupp PG, Schoub BD:  Survival of HIV in the common bedbug. Lancet 1986;;2:45.
60 +
Jupp PG, Lyons SF:  Experimental assessment of bedbugs (Cimex lectularius and Cimex hemipterus) and mosquitoes (Aedes aegypti formosus) as vectors of human immunodeficiency virus. AIDS 1987;;1:171-174.
61 +
Whiteside ME, Withum D, Tavris D, et al: Outbreak of no identifiable risk acquired immunodeficiency syndrome (AIDS) in Belle Glade, Florida. Presented at the First International Conference on AIDS, Atlanta, April 17,1985.
62 +
Castro KG, Lieb S, Jaffe HW, et al:  Transmission of HIV in Belle Glade, Florida: Lessons for other communities in the United States. Science 1988;;239:193-197.
63 +
 Acquired immunodeficiency syndrome (AIDS) in western Palm Beach County, Florida. MMWR 1986;;35:609-612.
64 +
Mann JM, Francis H, Quinn T, et al:  Surveillance for AIDS in a central African city: Kinshasa, Zaire. JAMA 1986;;255:3255-3259.
65 +
Quinn TC, Mann JM, Curran JW, et al:  AIDS in Africa: An epidemiologic paradigm. Science 1986;;234:955-963.
66 +
 Coolfont Report: A Public Health Service plan for prevention and control of AIDS and the AIDS virus. Public Health Rep 1986;;101:341-348.

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