Robert Rayford

Robert Rayford
Born	February 3, 1953 St. Louis, Missouri, United States
Died	May 15, 1969 (aged 16) St. Louis, Missouri, United States
Known for	Alleged first known AIDS death in the United States

Robert Rayford (February 3, 1953 – May 15 or May 16, 1969), sometimes identified as Robert R. due to his age, was an American teenager from Missouri who is thought to have had the earliest case of HIV/AIDS in North America. Rayford's death was a mystery to doctors who could not account for his symptoms. The cause of his death remained unidentified until 1987.

Illness

In early 1968, a 15-year-old African-American teenager named Robert Rayford admitted himself to Barnes-Jewish Hospital (then called Barnes Hospital) in St. Louis, Missouri. His legs and genitals were covered in warts and sores. He also had severe swelling of the testicles and pelvic region, which later spread to his legs, causing a misdiagnosis of lymphedema. He had grown thin and pale and suffered from shortness of breath. Rayford told the doctors that he had had these symptoms since at least late 1966. Tests discovered a severe chlamydia infection. Rayford declined a rectal examination request from hospital personnel. Doctors treating Rayford suspected that he was homosexual, bisexual, or had engaged in receptive anal intercourse.

In late 1968 Rayford's condition seemed to have stabilized, but by March 1969 his symptoms reappeared and had worsened. He had increased difficulty breathing, and his white blood cell count had plummeted. The doctors found that his immune system was dysfunctional. He developed a fever and died at 11:20 pm on May 15, 1969.

Autopsy

An autopsy of Rayford, led by Dr. William Drake, uncovered several abnormalities. Small purplish lesions were discovered on Rayford's left thigh and his soft tissue. Drake concluded that the lesions were Kaposi's sarcoma, a rare type of cancer that then mostly affected elderly men of Mediterranean or Ashkenazi Jewish ancestry. Kaposi's sarcoma was later determined to be an AIDS-defining illness.

These findings baffled the attending doctors, and a review of the case was eventually published in the medical journal Lymphology in 1973. After the autopsy, blood and tissue samples were kept in cold storage at the University of Arizona and at the laboratory of Dr. Memory Elvin-Lewis, who had assisted in Rayford's autopsy.

Later investigations

Tests

In 1984, when HIV was first discovered (originally called HTLV-3), and was spreading rapidly in the gay male communities of New York City and Los Angeles, Dr. Marlys Witte, one of the doctors who, like Elvin-Lewis, had cared for Rayford before death and also assisted in the autopsy, thawed and tested preserved tissue samples from Rayford's autopsy, which tested negative. Three years later, in June 1987, Witte decided to test the tissue samples again using Western blot, the most sensitive test then available. The Western blot test found that antibodies against all nine detectable HIV proteins were present in Rayford's blood. A second test found identical results.

Impact on AIDS origin research

Rayford had never traveled outside the Midwestern United States and had told doctors he had never received a blood transfusion. Since Rayford's AIDS infection was almost certainly through sexual contact, and since he had never left the country, researchers presume that AIDS may have been present in North America before Rayford began showing symptoms in 1966. Moreover, Rayford also never ventured into cosmopolitan cities such as New York, Los Angeles, or San Francisco, where the HIV-AIDS epidemic was first observed in the United States. Doctors and others who subsequently investigated the case in the early 1980s speculated that Rayford may have been sexually abused and may have been a child-prostitute.

See also

• Arvid Noe, the earliest known European AIDS case.
• Index case
• History of HIV/AIDS
• Timeline of early AIDS cases
• Timeline of HIV/AIDS

References

Notes