Global Health Chronicles

Dr. Bruce Evatt

David J. Sencer CDC Museum, Global Health Chronicles
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1:47 - Background/EIS training

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Partial Transcript: Let’s begin with your background.

Segment Synopsis: Dr. Evatt explains his unconventional path to medical school and his EIS training.

Keywords: C. Conley; C. Heath; D. Fellows; IBM mainframe; M. Gregg; Oklahoma; statistics; Wayne, Air Force ROTC [Reserve Officers’ Training Corps]

Subjects: Air Force; Berry Plan; Centers for Disease Control and Prevention (U.S.); Epidemic Intelligence Service [EIS]; hematology; Johns Hopkins University; National Institutes of Health [NIH]; Oklahoma; University of Oklahoma; University of Oklahoma Medical School; Vietnam War

11:22 - Reorganization of CDC and the labs

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Partial Transcript: Moving into 1976, can you tell us a little bit about the areas of focus at CDC before the AIDS epidemic began?

Segment Synopsis: Dr. Evatt discusses the reorganization at CDC, how that affected CDC's work and how he got into the Division of Host Factors

Keywords: Atlanta; Baltimore; hematology; immunology; law school; M. Evatt; national reference laboratory; pathology; social worker; W. Foege; wife

Subjects: acquired immune deficiency syndrome [AIDS]; Bureau of Epidemiology; Bureau of Labs; CDC; Division of Host Factors; Johns Hopkins; laboratories

16:42 - Pre-AIDS epidemic management of hemophilia

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Partial Transcript: Moving on to your work on AIDS, as a reminder, can you start by explaining the management of hemophilia in the early eighties?

Segment Synopsis: Dr. Evatt explains how the management of hemophilia had changed over time and how a whole system of care grew for hemophiliacs, and the setting for the start of the AIDS epidemic in 1980.

Keywords: cryoprecipitate; hemophilia treatment centers; lyophilized cryoprecipitate; plasma; transfusion progress

Subjects: hemophilia; hepatitis; World War II

21:14 - Was this a blood borne disease?

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Partial Transcript: In July of 1982, the MMWR reported on cases of Pneumocystis pneumonia in three persons with hemophilia A.

Segment Synopsis: Dr. Evatt describes when hemophiliacs cases started being reported as AIDS cases in the early years of the AIDS epidemic, what it was like to work with the blood banking community, as well as the epidemiology behind defining this new disease as blood-borne.

Keywords: adrenocorticotropic hormone [ACTH]; America’s Blood Centers [ABC]; American Association of Blood Banks [AABB]; amyl nitrates; blood; blood drives; blood transfusions; blood-borne; blood-borne diseases; Boston; Chapel Hill; D. Lawrence; donors; EIS officer; gay bath houses; H. Roberts; Haitians; hemophilia patients; homosexual community; homosexuals; immune disorder; immunological studies; Immunology Division; J. Bovey; J. Curran; J. Lusher; J. McDougal; L. Aledort; pentamidine; S. Ford; San Francisco; shoe-leather epidemiology; St. Louis; STD [sexually transmitted diseases] clinic; T. Spira; transfusion-associated cases; Washington, D.C.

Subjects: acquired immune deficiency syndrome [AIDS]; blood banking industry; California; Colorado; Florida; Food and Drug Administration [FDA]; health departments; hemophilia A; Hemophilia Foundation; HIV; Morbidity and Mortality Weekly Report [MMWR]; National Hemophilia Foundation [NHF]; National Institutes of Health [NIH]; Ohio; Pneumocystis pneumonia

52:35 - Blood donation guidelines

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Partial Transcript: By March of 1983, CDC, FDA, and NIH agreed on a set of guidelines published in the MMWR, and they were – I guess a compromise—where recommended members of groups at increased risk should avoid donating blood.

Segment Synopsis: Dr. Evatt talks about setting up guidelines that advised high-risk groups to not donate blood, the challenges of creating them, and the public’s response to these guidelines.

Keywords: A. Brownstein; E. Brandt; French; heat treatment; heat-treated factor; J. Curran; J. Jason; lyophilized [freeze-dried]; Patients with hemophilia; Rio de Janeiro; S. McDougal; San Francisco; W. Dowdle

Subjects: Alpha Laboratories; Armor; Baxter; Centers for Disease Control and Prevention (U.S.); Cutter Laboratories; Food and Drug Administration [FDA]; Germany; human immunodeficiency virus [HIV]; LAV [lymphadenopathy-associated virus]; Medical Advisory Council for the National Hemophilia Foundation; National Institutes of Health [NIH]; Public Health Service [PHS]; U.S. Hemophilia Foundation; World Congress of Hemophilia

67:50 - Hemophiliac and blood products infection rates

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Partial Transcript: It is said that many, many hemophiliacs and recipients of blood transfusions were infected during the two years between 1983 and 1985 (1983 and 1984). Is there an estimate of how many were infected?

Segment Synopsis: Dr. Evatt explains how difficult it was to estimate how many hemophiliacs and recipients of blood transfusions may have been infected with HIV/AIDS before blood was screened for virus antibodies and the ramifications faced by the public health community.

Keywords: blood products; gay populations; heat-treated factor; hemophilia patients; hemophiliacs; high-risk donors; high-risk groups; lawsuits; plasma; settlement; surveillance; transfusions

Subjects: acquired immune deficiency syndrome [AIDS]; blood-borne infections; hemophilia A; hepatitis B; hepatitis C; hepatitis epidemic; human immunodeficiency virus [HIV] epidemic; United States

81:29 - Personal views

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Partial Transcript: In closing, I just wanted to get your sense of the personal aspects of your work on AIDS.

Segment Synopsis: Dr. Evatt explains his personal feelings towards his work on AIDS at CDC and what could have been done differently in hindsight.

Keywords: American public; B. Gallo; communication skills; Nobel Prize; turf battles; W. Dowdle

Subjects: AIDS epidemic; Centers for Disease Control and Prevention (U.S.)