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52 Medico-Legal J. 3 (1984)

handle is hein.journals/medlgjr52 and id is 1 raw text is: THE MEDICO-LEGAL JOURNAL Founded 1901 1984 Vol. 52 Part One EDITORIAL AIDS The pattern of disease is always changing. New illnesses arise, sometimes reach epidemic proportion and then diminish in numbers to take their place in the established format of disease within a community. Others known for generations quietly disppear from the scene. Some of these changes are due to medical successes such as the introduction of antibiotics or vaccination programmes or other preventive medicine and public health measures. 1983 saw the emergence of AIDS (Acquired Immune Deficiency Syndrome) as a new disease of our time catching the public imagination with headlines such as Mystery Killer Illness. What is this new disease and is it really a danger to pathologists and to members of the public at large? AIDS is a disease of unknown etiology largely confined to homosexuals, drug addicts, Haitians and a small number of haemophiliacs. It was first recognised in the United States in 1981 but certainly in retrospect cases had begun to appear in the late 70's. I dealt with a case myself in my department in 1977 without recognising it. Patients with the disease seem to lack the normal body defence mechanisms and become prey to a wide range of infections usually with what are known as opportunistic organisms including parasites, certain viruses and fungi not normally seen as pathogens in man, and to rare malignancies of which the best known is Kaposi's sarcoma. This is a malignant tumour of the blood vessels and tissues of the skin particularly involving the feet and legs. There is no known treatment for the underlying condition and the mortality is very high. All that can be done is to treat intensively each infection as it arises and when that particular infection has been eradicated, return the patient to the milieu in which he lives. There he will almost inevitably contract another infection until the process goes on to its ultimate conclusion. The incubation period has been estimated to be 2 years or even up to 4 years in length and because of this and the fact that it has not been recognised before the number of patients is rapidly increasing. In the United States since 1979 the number

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