1982: The AIDS epidemic: thirty years after scientists gave a frightening new disease its name, AIDS still afflicts millions of men and women around the world.

• Author: Altman, Lawrence K.
• Position: TIMES PAST

The patients had baffling problems. Many came in with painful white patches in their mouths. Others had swollen lymph nodes, purplish skin blotches, or uncommon infections of the lung or brain.

In the late 1970s and early 1980s, doctors like myself began seeing a scattering of such cases in otherwise healthy young men in California and New York. (In addition to being a reporter for The New York Times, I'm a doctor.)

We could usually diagnose the individual conditions--for example, the skin blotches were Kaposi's sarcoma, a rare cancer--but we couldn't explain why these patients had developed these ailments or even agree on what to call the overall disease.

In August 1982--after more than 450 cases involving men and women in 23 states were reported--the Centers for Disease Control and Prevention (C.D.C.) decided on acquired immune deficiency syndrome, or AIDS.

Thirty years later, AIDS has infected more than 60 million people worldwide and has killed at least halt that number in one of the worst epidemics in history. Teenagers today have grown up with little if any knowledge of the dark early days of AIDS. But they're worth recalling--as a reminder of both what can happen when confusion and fear surround a previously unknown disease, and of the changes and breakthroughs that the epidemic has brought about.

Looking back 30 years and with the wisdom of hindsight, it seems as if doctors, the public, journalists, and governments were shockingly slow to recognize an epidemic in the making and to take steps to try to contain it.

Because infectious diseases were no longer the major killers they had been even a few decades earlier, doctors had become overconfident. Smallpox had just become the first-ever disease to be eradicated, and most doctors overlooked a basic fact of biology: that a new infectious disease could appear at any time.

Researchers set out to investigate AIDS, but they were puzzled. Why were many of the earliest patients gay men? Could an infectious agent--something transmitted person to person--cause AIDS? If so, what was it?

In 1983, the first report that a virus, now known as H.I.V. (human immunodeficiency virus), causes AIDS came from researchers in Paris.

Immune System Attacked

With new blood tests, scientists soon found that H.I.V. infects women and heterosexual men too, and that the virus usually lies dormant in the body for about 10 years before developing into AIDS. It thus became clear that AIDS had been silently spreading around the world in the 1970s.

Scientists learned that the disease could be transmitted in a number of ways: through sex, blood transfusions, needles and syringes used to inject drugs, and from mother to child in the womb.

In the early years, AIDS was an almost certain death sentence. A healthy immune system fights off disease, but what is so terrible about AIDS is that it attacks the immune system itself, making a person vulnerable to all kinds of fatal infections that a healthy immune system could fight off.

My worst fears about the magnitude of what was clearly a global epidemic came in 1985, when I reported on AIDS in...