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Sandy Ford (born Sandra Lee Garrison, July 11, 1950 – April 11, 2015) was a drug technician for the
Centers for Disease Control The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services (HHS), and is headquartered in Atlanta, ...
in
Atlanta Atlanta ( ) is the List of capitals in the United States, capital and List of municipalities in Georgia (U.S. state), most populous city in the U.S. state of Georgia (U.S. state), Georgia. It is the county seat, seat of Fulton County, Georg ...
,
Georgia Georgia most commonly refers to: * Georgia (country), a country in the South Caucasus * Georgia (U.S. state), a state in the southeastern United States Georgia may also refer to: People and fictional characters * Georgia (name), a list of pe ...
. In April 1981, she identified unusual clusters of young
homosexual Homosexuality is romantic attraction, sexual attraction, or sexual behavior between people of the same sex or gender. As a sexual orientation, homosexuality is "an enduring pattern of emotional, romantic, and/or sexual attractions" exc ...
patients in
New York New York most commonly refers to: * New York (state), a state in the northeastern United States * New York City, the most populous city in the United States, located in the state of New York New York may also refer to: Places United Kingdom * ...
and
California California () is a U.S. state, state in the Western United States that lies on the West Coast of the United States, Pacific Coast. It borders Oregon to the north, Nevada and Arizona to the east, and shares Mexico–United States border, an ...
with
pneumocystis pneumonia ''Pneumocystis'' pneumonia (PCP), also known as ''Pneumocystis jirovecii'' pneumonia (PJP), is a form of pneumonia that is caused by the yeast-like fungus '' Pneumocystis jirovecii''. ''Pneumocystis'' specimens are commonly found in the lungs o ...
and
Kaposi's sarcoma Kaposi's sarcoma (KS) is a type of cancer that can form masses on the skin, in lymph nodes, in the mouth, or in other organs. The skin lesions are usually painless, purple and may be flat or raised. Lesions can occur singly, multiply in a limite ...
and alerted her supervisor about it. Those patients had
HIV/AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...
; pneumocystis pneumonia and Kaposi's sarcoma were later found to be AIDS-defining diseases. Ford was the first person to identify these clusters and the first to alert health officials about the coming epidemic.


Early life

Ford was born and raised in
Fresno, California Fresno (; ) is a city in the San Joaquin Valley of California, United States. It is the county seat of Fresno County, California, Fresno County and the largest city in the greater Central Valley (California), Central Valley region. It covers a ...
. Her father, Melvin Edward Garrison, was a plumber; her mother, LaVerne Francis Martin Garrison, was a homemaker. She graduated from McLane High School and attended both Fresno City College and
California State University, Fresno California State University, Fresno (Fresno State) is a public university in Fresno, California, United States. It is part of the California State University system. The university had a fall 2020 enrollment of 25,341 students. It offers 60 ba ...
.


Cluster discovery

In 1979, Ford moved to Atlanta and took a position at the
Centers for Disease Control The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services (HHS), and is headquartered in Atlanta, ...
in the Parasitic Diseases Division. She administered the Parasitic Diseases Drug Service, a CDC program that maintains supplies of medicines for a number of diseases not common enough in the U.S. for private pharmaceutical companies to profitably go through the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...
approval process. These were mostly
tropical diseases Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. The diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by for ...
, such as African sleeping sickness,
river blindness Onchocerciasis, also known as river blindness, is a disease caused by infection with the parasitic worm ''Onchocerca volvulus''. Symptoms include severe itching, bumps under the skin, and blindness. It is the second-most common cause of blindne ...
,
schistosomiasis Schistosomiasis, also known as snail fever, bilharzia, and Katayama fever is a neglected tropical helminthiasis, disease caused by parasitism, parasitic Schistosoma, flatworms called schistosomes. It affects both humans and animals. It affects ...
,
tapeworm Eucestoda, commonly referred to as tapeworms, is the larger of the two subclasses of flatworms in the class Cestoda (the other subclass being Cestodaria). Larvae have six posterior hooks on the scolex (head), in contrast to the ten-hooked Ce ...
, and
leishmaniasis Leishmaniasis is a wide array of clinical manifestations caused by protozoal parasites of the Trypanosomatida genus ''Leishmania''. It is generally spread through the bite of Phlebotominae, phlebotomine Sandfly, sandflies, ''Phlebotomus'' an ...
. Doctors needing one of the medicines would contact Ford, who would get clearance from a CDC physician and arrange for the drug's delivery. One of the drugs handled by the Parasitic Diseases Drug Service was
pentamidine Pentamidine is an antimicrobial medication used to treat African trypanosomiasis, leishmaniasis, '' Balamuthia'' infections, babesiosis, and to prevent and treat pneumocystis pneumonia (PCP) in people with poor immune function. In African trypa ...
, an
antimicrobial An antimicrobial is an agent that kills microorganisms (microbicide) or stops their growth (bacteriostatic agent). Antimicrobial medicines can be grouped according to the microorganisms they are used to treat. For example, antibiotics are used aga ...
medication used to treat
pneumocystis pneumonia ''Pneumocystis'' pneumonia (PCP), also known as ''Pneumocystis jirovecii'' pneumonia (PJP), is a form of pneumonia that is caused by the yeast-like fungus '' Pneumocystis jirovecii''. ''Pneumocystis'' specimens are commonly found in the lungs o ...
. The service purchased its supply from the British chemical company May & Baker. Pneumocystis pneumonia is caused by a yeast-like
fungus A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
named ''
Pneumocystis jirovecii ''Pneumocystis jirovecii'' (previously ''P. carinii'') is a yeast-like fungus of the genus ''Pneumocystis''. The causative organism of ''Pneumocystis'' pneumonia, it is an important human pathogen, particularly among immunocompromised hosts. P ...
''. (At the time, ''Pneumocystis jirovecii'' was known as ''Pneumocystis carinii'', and the resulting disease was commonly called ''Pneumocystis carinii'' pneumonia, abbreviated as PCP. ''Pneumocystis carinii'' was also believed at the time to be a parasite rather than a fungus.) In the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, pneumocystis pneumonia was very rare; as of a 1967 survey, there had only ever been 107 total recorded cases nationwide, all of them in immunosuppressed patients. But in February 1981, physician requests for pentamidine began to spike — and, unusually, the requests were for young male patients whose immune systems had no known reason to be suppressed. Ford handled nine such requests in a three-month period for young men in
New York New York most commonly refers to: * New York (state), a state in the northeastern United States * New York City, the most populous city in the United States, located in the state of New York New York may also refer to: Places United Kingdom * ...
and
California California () is a U.S. state, state in the Western United States that lies on the West Coast of the United States, Pacific Coast. It borders Oregon to the north, Nevada and Arizona to the east, and shares Mexico–United States border, an ...
. One New York doctor requested pentamidine for five different patients during the first three weeks of April alone. "I figured he should go back to medical school if he couldn't find a simple
neoplasm A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
," Ford told journalist Randy Shilts later. "People just didn't need this drug unless there was an underlying diagnosis of immunosuppression." That same physician also began requesting repeat doses of pentamidine for his patients. This was unprecedented, because the drug had previously always been effective with just a single dose. Soon after, a different New York doctor mentioned to Ford that five young gay men in the city had been diagnosed with
Kaposi's sarcoma Kaposi's sarcoma (KS) is a type of cancer that can form masses on the skin, in lymph nodes, in the mouth, or in other organs. The skin lesions are usually painless, purple and may be flat or raised. Lesions can occur singly, multiply in a limite ...
, a disease previously associated with elderly men in the
Mediterranean The Mediterranean Sea ( ) is a sea connected to the Atlantic Ocean, surrounded by the Mediterranean basin and almost completely enclosed by land: on the east by the Levant in West Asia, on the north by Anatolia in West Asia and Southern ...
,
Eastern Europe Eastern Europe is a subregion of the Europe, European continent. As a largely ambiguous term, it has a wide range of geopolitical, geographical, ethnic, cultural and socio-economic connotations. Its eastern boundary is marked by the Ural Mountain ...
, and
Middle East The Middle East (term originally coined in English language) is a geopolitical region encompassing the Arabian Peninsula, the Levant, Turkey, Egypt, Iran, and Iraq. The term came into widespread usage by the United Kingdom and western Eur ...
. Seeing a pattern, Ford took the cases to her boss, deputy director of parasitic disease Dennis Juranek, who asked her to write up her findings in a memo. She did so on April 28, 1981. That memo began the CDC's investigation of HIV/AIDS. It came three weeks before the first news story on the disease, which ran on May 18 in the gay newspaper '' New York Native''. A group of CDC epidemiologists began working on the unknown epidemic. An article titled "''Pneumocystis'' pneumonia — Los Angeles" highlighted five cases in the June 5, 1981, issue of the ''
Morbidity and Mortality Weekly Report The ''Morbidity and Mortality Weekly Report'' (''MMWR'') is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention (CDC). It was originally established as ''Weekly Health Index'' in 1930 ...
'', the CDC's newsletter on new
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...
information. This was the first reference to AIDS in the medical literature. A July 3 article, titled "Kaposi's Sarcoma and ''Pneumocystis'' Pneumonia Among Homosexual Men — New York City and California," raised the number of case reports to 39 patients; another article on August 28 increased the number of known cases to 108. Ford was able to detect the unusual clusters despite not being a physician or scientist. "Although she had no formal training in medical science," two CDC colleagues wrote in an obituary, "she had a prepared mind and thought like an
epidemiologist Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population, and application of this knowledge to prevent diseases. It is a cornerstone ...
." One CDC doctor, Bruce Weniger, said he and his fellow physicians didn't notice the pattern of pneumonia patients with no apparent cause for their suppressed immune systems. "I do recall getting doctors saying the patient doesn't have any of those nderlying causes and I didn't think anything of it...It was only Sandy who recognized that something was going on." At some point, later in the 1980s, a CDC staffer taped a paper-napkin sign to the door of Ford's office, which was Room 161 in CDC Building 6. It read: "In this room in the spring of 1981, the epidemic of what later became known as Acquired Immunodeficiency Syndrome was discovered."


Later life

Ford received a degree of national attention for her finding once the AIDS epidemic reached mainstream media. She is a significant figure in Randy Shilts' book '' And the Band Played On'' and she was interviewed for articles and documentaries. Ford continued working at the CDC for 34 years, until retiring in 2008. She died April 11, 2015, at age 64.


See also

* History of HIV/AIDS * Timeline of HIV/AIDS


References


External links


A CDC-written obituary in the journal ''Emerging Infectious Diseases''

Sandy Ford interviewed in a documentary on the CDC's early AIDS work
{{DEFAULTSORT:Ford, Sandy HIV/AIDS researchers 1981 in biology HIV/AIDS in the United States Centers for Disease Control and Prevention people American women epidemiologists American epidemiologists Scientists from Fresno, California 20th-century American scientists 20th-century American women scientists California State University, Fresno alumni