Global Health Chronicles

Dr. Kenneth Castro

David J. Sencer CDC Museum, Global Health Chronicles
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1:16 - Background and training

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Partial Transcript: Could you tell us where you grew up and about your early family life?

Segment Synopsis: Dr. Castro talks about where he grew up and his interest in medicine and marine biology.

Keywords: marine biology; snorkeling; social medicine; V. Sidel

Subjects: Centers for Disease Control and Prevention (U.S.); Montefiore Medical Center; Puerto Rico; State University of New York

5:31 - Encountering AIDS

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Partial Transcript: What were people thinking about this?

Segment Synopsis: Dr. Castro describes his first encounters with patients with AIDS and reading an article in the MMWR that was detailing what he was seeing in his patients.

Keywords: G. Friedland; Histoplasma; Kaposi’s sarcoma; pneumocystis; R. Klein

Subjects: acquired immunodeficiency syndrome [AIDS]; Morbidity and Mortality Weekly Report [MMWR]

10:51 - EIS and working at CDC

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Partial Transcript: How had you heard about EIS?

Segment Synopsis: Dr. Castro explains how he got interested in EIS and what it was like to work in CDC’s AIDS Activity group during the early years of the epidemic.

Keywords: A. Hardy; AIDS Activity; “4-H”; C. Cabradilla; D. Francis; epidemiology; H. Haverkos; infectious diseases; J. Ward; M. Chamberland; M. Rogers; P. Feorino; risk factors; S. Weiss; T. Peterman; W. Blattner

Subjects: acquired immunodeficiency syndrome [AIDS]; Epidemic Intelligence Service [EIS]; Johns Hopkins University

18:19 - No Identified Risk Cases

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Partial Transcript: Why was there so much focus on investigating these cases?

Segment Synopsis: Dr. Castro talks about how the importance of confidentiality when interviewing patients was important to maintain agency credibility and how CDC explored all possible risk factors for AIDS transmission.

Keywords: B. Darrow; Chicago; disease investigators; EIS officers; interviewing techniques; M. Chamberland; Miami; New York City; no identified risk cases [NIRS]; P. Thomas; R. Stoneburner; risk groups; sexually transmitted disease; transmission routes

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

25:03 - Patient rapport and confidentiality

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Partial Transcript: Can you pass along some of those tidbits right now, because I’m sure there’d be a lot of interest in applications in today’s world as well, for exploring new diseases?

Segment Synopsis: Dr. Castro talks about how the importance of confidentiality when interviewing patients was important to maintain agency credibility and how CDC explored all possible risk factors for AIDS transmission.

Keywords: “doc”; “running buddies”; Bronx; confidentiality; crack house; heroin; Kaposi’s sarcoma and opportunistic infections [KSOI]; risk factors; routes of transmission; sexual activity; sexual history; Task Force

Subjects: acquired immunodeficiency syndrome [AIDS]; human immunodeficiency virus [HIV]; New York; San Francisco; Texas

33:12 - Belle Glade investigation

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Partial Transcript: So, to start us off on the Belle Glade Story, can you begin by just telling us what was the problem that you and colleagues at CDC and in Florida were confronted with in Belle Glade?

Segment Synopsis: Dr. Castro recalls the highly publicized Belle Glade investigation regarding possible insect borne AIDS transmission and how everyone at CDC collaborated on the investigation to expedite the process.

Keywords: Atlanta; C. Calisher; C. MacLeod; D. Koniver; E. Murrow; heroin; insect-borne; J. Witte; Lake Okeechobee; M. Morgan; M. Whiteside; P. Marchbanks; prostitute; R. Wiewora; risk factors; S. Lieb; T.Monath; W. Cates; West Palm Beach; Winnebago camper

Subjects: Belle Glade, Florida; Centers for Disease Control and Prevention (U.S.); Institutional Review Board [IRB]; International AIDS Conference

47:33 - Belle Glade/Lessons learned

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Partial Transcript: What were the lessons to be learned from the investigation, because, again, it's early days in the epidemic, and we were still learning our way?

Segment Synopsis: Dr. Castro explains some of the lessons learned from the Belle Glade investigation was making sure the investigation was rigorous and in-depth with regard to risk factors and the strong laboratory experiments conducted by the division of vector-borne diseases.
GPS:

Keywords: fear; hemophiliac; in-depth interviews; R. White; risk factors; vector-borne

Subjects: acquired immunodeficiency syndrome [AIDS]; Centers for Disease Control and Prevention (U.S.); human immunodeficiency virus [HIV]

52:31 - Haitian Cases

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Partial Transcript: What made these cases so unusual, and what was the great puzzlement all about?

Segment Synopsis: Dr. Castro talks about a study that found no evidence that the category of Haitian should be consider a risk group and the political repercussions of that study.

Keywords: folk healers; GHESKIO [Group Haitian for the Study of Kaposi’s Sarcoma and Opportunistic Infections]; Haitian Creole; Haitian-Americans; J. Johnson; M. Fischl; Miami; New York; risk factors; S. Landesman; voodoo

Subjects: acquired immunodeficiency syndrome [AIDS]; Centers for Disease Control and Prevention (U.S.); Haiti

59:14 - New Disease consequences

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Partial Transcript: I’m curious about what the thoughts were back then, and have we made any progress.

Segment Synopsis: Dr. Castro explains the fear surrounding new diseases and the social, political and financial consequences.

Keywords: children; evicted; job loss; risks; routes of transmission

Subjects: acquired immunodeficiency syndrome [AIDS]; Centers for Disease Control and Prevention (U.S.); Ebola; Social Security Disability; Supplemental Security Income

63:41 - Healthcare worker exposure

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Partial Transcript: Can you describe a little bit about that?

Segment Synopsis: Dr. Castro talks about the challenges of taking care of CDC's global healthcare workforce in the event of a needle stick injury to one of them as well as the relationship between HIV and multidrug-resistant tuberculosis.

Keywords: : H. Jaffe; animal studies; B. Edlin; C. Lopez; community-based; drawing blood; field investigations; healthcare workers; J. Curran; J. Hughes; multi-drug resistant tuberculosis; National Center for Infectious Disease; needle stick injury; occupation health clinic; protocol; recommendations

Subjects: acquired immunodeficiency syndrome [AIDS]; Centers for Disease Control and Prevention (U.S.); Tuberculosis

70:08 - CDC's early response and personal effect of the epidemic.

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Partial Transcript: As you look back, are there any aspects of CDC's early response to the epidemic where you think CDC fell short or could have done a better job on, and by the same token, any aspect of the response that CDC particularly excelled in?

Segment Synopsis: Dr. Castro discusses how CDC's relatively rapid response to the epidemic relied heavily on the principles epidemiology and commitment by the individuals working on it. Also relates how his work/life balance was very important to him.

Keywords: "can-do-attitude"; casual inference; epidemiology; rapid response; W. Foege; work/life balance

Subjects: acquired immunodeficiency syndrome [AIDS]; Centers for Disease Control and Prevention (U.S.); Reagan administration