Young Victims

AIDS may be the villain

At first the mysterious, deadly epidemic appeared to be confined to promiscuous male homosexuals. Next, it was detected in heterosexual drug abusers, Haitians and hemophiliacs. Now there is good evidence that acquired immune deficiency syndrome, or AIDS, has spread to a fifth group: children. In Atlanta last week the Centers for Disease Control reported 22 suspected cases of AIDS in children under five in New York, New Jersey and California. The CDC is cautious about confirming the diagnoses, but at least four cases seem well documented.

The reason for the uncertainty is that no one knows what causes AIDS, and there is no single laboratory test to certify its presence. AIDS usually begins with swollen glands, fever, loss of appetite and a rundown feeling. As the illness progresses, the immune system grows weaker, leaving the patient vulnerable to viruses, bacteria and other problems. Among the most pernicious of these is Pneumocystis carinii pneumonia (PCP), which has a 60% fatality rate, and Kaposi's sarcoma, a rare skin cancer that has stricken nearly 40% of AIDS victims, killing at least one-fifth of them. In the 17 months that the CDC has been tracking the epidemic, a total of 827 cases of AIDS have been reported in 33 states; 312 have ended in death.

The children who appear to have AIDS are mainly the offspring of high-risk parents. Of the four best-studied patients, two had Haitian parents and two were children of intravenous drug abusers. One child's mother appeared to have AIDS and died of PCP. This pattern provides strong support for the theory that AIDS is spread by an infectious agent. But, says Dr. Richard O'Reilly, an immunologist at New York City's Memorial Sloan-Kettering Cancer Center, "whether it is transmitted by close association after birth or through the placenta, we do not know."

Additional support for the infectious-agent hypothesis comes from the growing number of patients who may have contracted AIDS from blood transfusions. Eight hemophiliacs and two heart-transplant patients who received blood appear to have been infected in this manner. In addition, a San Francisco infant who received multiple transfusions at birth developed infections and other signs of AIDS. Some of the baby's blood came from a donor who was later diagnosed as an AIDS victim. As a result, blood-bank operators around the country are searching assiduously for a way to detect AIDS in blood.

The growing evidence that a transmissible agent may be involved bodes well for the eventual development of a vaccine for AIDS. Right now, however, there is not even a specific therapy. Says Pediatrician James Oleske of Newark, who has been treating eight of the children: "We are doing lots of things, but four have died. I am disheartened and frightened."

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