Global Health Chronicles

Dr. James Curran

David J. Sencer CDC Museum, Global Health Chronicles
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1:55 - Education/early work in public health

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Partial Transcript: Let’s begin with your background.

Segment Synopsis: Dr. Curran talks about his education and his path to a career in public health as a Commissioned Corps officer.

Keywords: Detroit, Ann Arbor, medicine, Venereal Disease Branch, OB/GYN, public health, Memphis Tennessee, gonorrhea, syphilis

Subjects: University of Notre Dame, University of Michigan, U.S. Public Health Service, Centers for Disease Control and Prevention (CDC), University of Tennessee

5:35 - Early involvement with AIDS

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Partial Transcript: Let’s shift our focus to your involvement with what was to become known as AIDS.

Segment Synopsis: Dr. Curran talks about his work as chief of the Research Branch of the Venereal Disease Control Division and how he became involved in work with what would become known as AIDS. He also describes his personal experience and connection to an AIDS patient early in the epidemic.

Keywords: VD (Venereal Diseases) control division, Hepatitis B, MMWR, gay men, STD, pneumocystis pneumonia, Los Angeles, M. Gottlieb, W. Shanderra, Epidemic Intelligence Service (EIS), New York City New York, Los Angeles California, San Francisco California, L. Laubenstein, Kaposi’s Sarcoma, D. Juranek, Phoenix Arizona, Hepatitis Division

Subjects: Acquired Immune Deficiency Syndrome (AIDS), CDC

11:53 - Establishment of Kaposi’s Sarcoma and Opportunistic Infections Task Force

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Partial Transcript: Almost immediately, CDC established a Task Force on Kaposi ’s sarcoma and Opportunistic Infections with you as coordinator.

Segment Synopsis: Dr. Curran talks about the political environment and the leadership at CDC in which the Task Force on Kaposi’s Sarcoma was created. He also talks about how CDC’s workforce teamed up to work on this emerging disease.

Keywords: President R. Reagan, President J. Carter, R. Reed, P. Robertson, B. Foege, EIS, budget, opportunistic infections, Parasitic Disease Drug Service, New York City, B. Safai, Memorial-Sloan Kettering, G. Ackerman, H. Jaffe, M. Guinan, pentamidine, surveillance

Subjects: CDC, New York University (NYU), Kaposi’s sarcoma (KS), pneumocystis (carinii pneumonia)

17:53 - Early Task Force priorities

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Partial Transcript: Can you say a little more about the top priorities for the Task Force at that time, surveillance or looking for cases, case definition?

Segment Synopsis: Dr. Curran talks about early Task Force priorities including surveillance and the challenges associated with establishing a specific case definition. He also talks about transmission theories for what would become known as AIDS and his early hope that the virus would follow a Hepatitis B model of transmission.

Keywords: case definition, Kaposi’s Sarcoma, EIS, H. Haverkos, opportunistic infections, B. Miller, lymphadenopathy syndrome, thrombocytopenic purpura, case definition, surveillance, New York, Hepatitis B, immune suppression, Dr. M. Guinan, sexually transmitted, gay men

Subjects: CDC, pneumocystis carinii pneumonia

25:40 - First case control study

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Partial Transcript: So following up on that, you did a case control study during that first year.

Segment Synopsis: Dr. Curran talks about the first case control study that was conducted and his involvement with the study New York. He also talks about the challenging process of finding well-matched controls in a gay population that was still very much closeted.

Keywords: case control study, H. Jaffe, M. Rogers, California, New York, gay men, STD

Subjects: CDC

30:16 - Realization of epidemic scale

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Partial Transcript: To interrupt the flow a little bit, when do you think you realized that this epidemic was huge, was going to be something very big, and was it yet at this early stage?

Segment Synopsis: Dr. Curran talks about the how early AIDS was increasing in scale more than most other epidemics and his realization that he was likely underestimating the number of cases at the time.

Keywords: President R. Reagan, underestimation, epidemic

Subjects: CDC

32:52 - Early federal support

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Partial Transcript: We talked about the Reagan era in Washington and some of the funding cutbacks.

Segment Synopsis: Dr. Curran talks about how CDC’s response was colored both by the challenge of isolating the virus and President Reagan’s failure to properly acknowledge the epidemic. He also praises CDC directorship for their response despite the lack of societal acknowledgment.

Keywords: New York, California, President R. Reagan, gay community, injecting drug use, B. Foege, President J. Carter, Senator R. Schweiker, E. Brandt, J. Mason, Senator O. Hatch, B. Roper,

Subjects: AIDS, National Institutes for Health (NIH), Health and Human Services (HHS), CDC, pneumocystis carinii pneumonia

38:38 - The early trips to New York City

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Partial Transcript: You mentioned you spent a lot of time in New York City that first year; 40 plus trips to New York.

Segment Synopsis: Dr. Curran talks about the importance of his relationships with leaders at the New York City Health Department and hospitals during the early years of AIDS. He also talks about his astonishment upon realizing that the academic community was recognizing the importance of the epidemic at the ICAAC meeting.

Keywords: opportunistic infection, New York, D. Sencer, New York City Health Department, D. Armstrong, Memorial Sloan Kettering, California, press, A. Balows, Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago

Subjects: CDC, Kaposi’s Sarcoma:

45:03 - Early gay community response

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Partial Transcript: There was a more organized gay community in New York City than other areas and, again, they formed the Gay Men’s Health Crisis to begin to address this in 1982.

Segment Synopsis: Dr. Curran talks about the gay community’s activist response to AIDS in New York and San Francisco. He also talks about how STD response differed in the gay community during the sexual revolution and the controversy over mandated closing of bathhouses in New York and San Francisco.

Keywords: B. Bolin; Bay Area Physicians for Human Rights; gay; Gay Men’s Health Crisis; H. Waxman; L. Kramer; Los Angeles; M. Conant; M. Silverman; Mayor Feinstein; N. Shram; New York City; P. Popham; R. Shilts; San Francisco; sexual revolution; STD

Subjects: CDC; HIV

55:28 - Moral response by the public

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Partial Transcript: In those early years there must’ve been a lot of morality discussions, you know, these people are getting what they deserve, the moral thing to do is reduce partners.

Segment Synopsis: Dr. Curran talks about the public’s shift from complacency to excessive fear after it was discovered AIDS was in the blood supply. He also talks about the importance of balancing a “barometer” of public discourse that ranged from complacency to fear.

Keywords: blood supply; press

Subjects: CDC

57:49 - Early press communications

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Partial Transcript: As evidenced today, you’ve always been a great speaker and communicator.

Segment Synopsis: Dr. Curran talks about the challenges associated with accurately communicating the general public’s risk for AIDS and his appearance in the first TV coverage of AIDS on Good Morning America. He also talks about the shortcomings of the press in acknowledging AIDS in its first couple of years.

Keywords: ABC; California; D. Berreth; F. Gifford; Good Morning America; New York; press; R. Shilts

Subjects: CDC; public health

62:50 - Relationship with other federal agencies/blood banking

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Partial Transcript: A critical role for CDC during these early years and continuing was to liaise with the other federal agencies.

Segment Synopsis: Dr. Curran talks about CDC contacts with other federal agencies (NCI; NIH; NIAID) and how these relationships were affected by blood and blood product HIV transmission. He also talks about the controversy associated with blood donation restrictions that were placed on certain population subgroups like gay men and intravenous drug users.

Keywords: A. Fauci; A. Friedman-Klein; blood product; blood supply; C. Everett Koop; California; D. Lawrence; E. Brandt; gay men; hemophilia; New York City; S. Solomon

Subjects: AIDS; Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA); CDC; Federal Drug Administration (FDA); Kaposi’s sarcoma; National Cancer Institute (NCI); National Institute of Allergy and Infectious Disease (NIAID); NIH

71:14 - 1983 CDC prevention recommendations

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Partial Transcript: So that was in ’82 and then in January of ’83 there was a meeting to try and come to some agreement on what recommendations should be given the surprise-or was it a surprise-was the blood banks were not ready to make strong statements against the donation of blood.

Segment Synopsis: Dr. Curran talks about the decision to use the term AIDS in mid-1982. He also talks about the first public meeting in 1983 to create blood donor restrictions and the misconceptions that the gay community and blood groups were unhappy with the recommendations.

Keywords: blood supply; DC; J. Koplan; Washington

Subjects: AIDS; American Association of Blood Banks; American Red Cross; Kaposi’s Sarcoma (KS); U.S. Public Health Service; World Health Organization (WHO)

74:02 - Leadership at CDC and beyond

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Partial Transcript: Well; in coming to a close; I’d like to ask you about leadership

Segment Synopsis: Dr. Curran talks about the importance of group effort and transparency in leadership at CDC. He also expresses his gratitude for having been involved in CDC leadership during the AIDS epidemic for 15 years.

Keywords: Ebola; Epidemic; Zika

Subjects: AIDS; CDC; Emory University