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Kimberly Bergalis (January 9, 1968–December 8, 1991) was an American woman who alleged she had contracted HIV from her dentist, David J. Acer. Contradictory reports about Ms. Bergalis' personal risk behavior, as well as conflicting opinions about the accuracy of the medical investigation of her HIV infection, have continued to make her case a controversial one that may never be conclusively resolved.

Bergalis' Claims

Bergalis, of Fort Pierce, Florida, claimed to be a virgin and to have never taken IV drugs or received a blood transfusion. She insisted that the only instance in which she could have been exposed to HIV was through her HIV-positive dentist, during a December 1987 procedure to have her molar teeth removed. Bergalis' dentist, Dr. David Acer, had been diagnosed with AIDS three months before performing the procedure and died in September 1990.

Initially, the U.S. CDC (Centers for Disease Control) supported Ms. Bergalis' contention that she had contracted HIV from Dr. Acer. CDC-conducted tests reported that there was a high correlation between the strain of HIV carried by Ms. Bergalis, and that carried by Dr. Acer.

Bergalis and the politics of HIV/AIDS

During the last months of her life, Ms. Bergalis' case was cited by some conservative politicians and journalists as an example of a 'blameless' HIV infection that had been allowed to happen due to the CDC and the healthcare industry being overly responsive to the concerns of AIDS activists and the gay community, with critics often noting that Dr. Acer was "... an admitted homosexual." In an obituary, the National Review wrote that Bergalis "...came to feel she had a special calling...to bring a glimmer of truth, however forlorn, into a debate characterized by confusion, denial, smugness, and suicidal self-indulgence... 'No sexual history' is how the jaded describe a chaste woman of 23 who, as Miss Bergalis explained to disbelieving interviewers, 'wanted to wait for marriage.' Marriage and its joys will never come for Kimberly Bergalis, but in her integrity and courage she affirmed that other things were also precious."

Bergalis actively participated in several actions by conservative congressmen to pass legislation restricting the activities of persons infected with HIV. Shortly before Bergalis' December 1991 death, and despite her frail and failing health, she testified before the U.S. Congress in support of a bill mandating HIV tests for healthcare workers, but the legislation did not pass.

Doubts about Bergalis' claims

Almost immediately after Bergalis' death, additional information about Ms. Bergalis' sexual behavior came to light, and medical authorities began questioning whether Acer had, in fact, had anything to do with Ms. Bergalis' HIV infection.

Ms. Bergalis' case remains the only instance where a medical worker — in this case, Dr. Acer, her dentist — has been identified as the source of a confirmed HIV infection ^[1].The CDC never presented any conclusion about the method of infection.

Later review of the CDC tests which claimed to have 'matched' the strain of virus contracted by Ms. Bergalis and that carried by Dr. Acer were cast into serious doubt as the technology for such procedures improved. Dr. Lionel Resnick, a Miami virologist who was skeptical of the CDC's initial conclusions in the Bergalis case, identified five individuals with no connection to Acer, yet who tested as having HIV strains "virtually identical" to Acer's when using the same procedure the CDC had used with Bergalis. ^[2]

Concerns were also raised about the veracity of Bergalis' claims that she had never engaged in sexual intercourse. In her book The Gravest Show on Earth: America in the Age of AIDS, author Elinor Burkett notes that doubt about the truth of Kimberly Bergalis' "virgin infection" claim "...was first raised at the February 1992 CDC meeting...a gynecological examination of Kimberly indicated that she had genital warts — the result of a sexually transmitted disease... Bergalis' vaginal opening was wide and her hymen was 'irregular at 3 and 9 o'clock,' conditions 'consistent with sexual intercourse.' Medical examinination also found lesions; a biopsy showed them to be human papillomavirus."

In June 1994, CBS's 60 Minutes aired a program reporting that Bergalis had been treated for genital warts, a sexually transmitted disease, and had admitted on videotape to having sex with two different men during her life.

Epidemiology reporter Stephen Barr, writing in the Annals of Internal Medicine in 1996, presented a lengthy analysis of the flaws in the original CDC investigation of Dr. Acer and the Bergalis HIV infection. In Barr's analysis, while none of the evidence excludes Acer as being the source of Bergalis' infection, there is no factual or medical evidence linking Acer to Bergalis' infection either. Barr states that, in his opinion, the lack of evidence does not support the conclusion that the Bergalis-Acer case is the one instance among tens of thousands of HIV infections in the U.S. where the virus was passed from a healthcare worker to a patient. As Barr puts it, there is "...a more plausible and more mundane explanation of this strange case." In his analysis, Ms. Bergalis was "... infected through well-documented routes of HIV transmission and not by the dentist."

Additional Information

A park in the city of Fort Pierce was renamed the Kimberly Bergalis Memorial Park.

References

^ MMWR - Guidelines for Infection Control in Dental Health-Care Settings
^ "The Gravest Show on Earth", Elinor Burkett, 1995, Houghton Mifflin, ISBN 0-395-74537-3.

External links

The 1990 Florida Dental Investigation: Is the Case Really Closed?An article from the Annals of Internal Medicine, reviewing some of the evidence in the case of Kimberly Bergalis
CMAJ
Mortality & Morbidity Weekly Report, December 2003 "Guidelines for Infection Control in Dental Health-Care Settings"

[1] MMWR - Guidelines for Infection Control in Dental Health-Care Settings

[2] "The Gravest Show on Earth", Elinor Burkett, 1995, Houghton Mifflin, ISBN 0-395-74537-3.

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 Initially, the U.S. CDC ([[Centers for Disease Control]]) supported Ms. Bergalis' contention that she had contracted HIV from Dr. Acer. CDC-conducted tests reported that there was a high correlation between the strain of HIV carried by Ms. Bergalis, and that carried by Dr. Acer.
-AIDS fells 4th patient of dentist grandmother taught others about disease
-http://www.aegis.com/news/mh/1994/MH941206.html
-Miami Herald - Sunday, December 18, 1994
-Lori Rozsa, Herald Staff Writer
-Barbara Webb, a retired schoolteacher and grandmother whose cheerful countenance and courageous campaigning on behalf of AIDS sufferers inspired fellow patients, died Saturday -- four years after learning the source of her illness was her dentist. She was 68.
-Webb is the fourth patient of dentist David Acer to die. She had lived with HIV for years; by last January, it had developed into full-blown AIDS. Three weeks ago, when the pain was getting so bad that even morphine didn't ease it, she left her Martin County home for the Hospice of Martin in Stuart.
-She died there Saturday of AIDS complications, said hospice spokeswoman Maureen Hoyt. It was her 25th wedding anniversary.
-"She passed peacefully," said Robert Montgomery, her attorney.
-Webb, a mother of three and grandmother of eight, never dwelled on her illness, said Pam Jett, who works at the hospice and became close friends with Webb when she began going there in June.
-"She was a warm, caring, vivacious person with a wonderful, zany sense of humor," Jett said. "She was a person who knew how to live her life in the present."
-In an interview with The Herald earlier this year, Webb said that if her suffering through AIDS did any good, it was to dispel myths about who can get the disease, and how.
-"Now when I think of all the people on God's green earth who had to test HIV-positive, I should have, because who else is going to speak so freely?" Webb said. "I have no hesitation speaking to anyone."
-The quiet and serenity surrounding Webb on her day of death contrasted markedly from her life.
-She was an active, bustling woman, talkative and inquisitive and busy educating the public about AIDS -- what had become her life's work, even though she knew the end was near.
-Webb was among six patients the Centers for Disease Control and Prevention confirmed was infected with HIV by Acer. Like Kimberly Bergalis, Acer's first and most famous victim, Webb championed the cause of mandatory testing for health care workers.
-"If this man had the courage and medical dignity to admit he had AIDS, we would've been spared," Webb said before Bergalis' death in 1991. "There is no reason for Kim to be dying and for me to be feeling terrible."
-Acer died of AIDS complications in 1990. Two days after his death, a letter he wrote to local newspapers was published in which he revealed he had AIDS and recommended to his hundreds of patients that they be tested for HIV.
-Webb was shocked at the news. Even after she tested positive for the virus, she still could hardly believe her Jensen Beach dentist -- who pulled four of her teeth -- had given her the illness. But CDC experts told her it was a 99.994 percent certainty that he did.
-Most of Acer's patients were sent to him by CIGNA, the insurance company used by several state agencies. Webb and some other patients of Acer's won $999,999 from Acer's malpractice insurance and an undisclosed sum from CIGNA.
-Webb scoffed at what she saw as obstacles from the medical community to her crusade for mandatory testing for health care workers.
-"She would get into a fit of pique over it," attorney Montgomery said. "She'd ask, 'Why can't they treat the disease like the public health menace that it is, instead of like a private problem.' "
-After learning she had HIV, Webb stayed in what she called her "AIDS closet" for six months, even after Bergalis -- a college student who had never had sexual intercourse or taken intravenous drugs -- went public.
-She said she saw that people didn't believe Bergalis' story and she wasn't eager to join the young woman under the harsh glare of public scrutiny. But silence was uncharacteristic for Webb.
-She soon spoke out and stood by Bergalis until her death. Webb moved to Palm City from New Jersey in 1977, teaching honors English at Martin County High School. In 1987, she was named Teacher of the Year.
-In 1988, high blood pressure forced her to retire. But she still taught frequently as a substitute. She didn't quit for good until 1991, when the AIDS medicine tired her too quickly. But she was tireless in fighting her disease. She kept a daily journal and investigated every medical breakthrough. Through it all, her friends say, she remained optimistic.
-"She was never bitter," Montgomery said. "She never lamented over it. Facing death the way she did impressed me as much as anything. She was a very courageous person."
-Webb is survived by her husband, Robert, and three grown children: Randy, Wendy and Cameron.
-The family asked that in lieu of flowers, anyone wishing to help might send donations to Hospice of Martin or to any organization that serves people with AIDS.
-The Associated Press contributed to this report.
-Dentist David Acer, who died of AIDS complications in 1990, is the only health professional known to have transmitted HIV to his patients. Six are known to have been infected:
-* Barbara Webb, Stuart, Fla., died on Saturday.
-* John Yecs Jr., Akron, Ohio, died in 1993 at 36.
-* Richard Driskill, Indiantown, Fla., died in 1993 at age 33.
-* Kimberly Bergalis, Fort Pierce, Fla., died in 1991 at age 23.
-* Sherry Johnson, 19, of Stuart, Fla., still living.
-* Lisa Shoemaker, 38, of Empire, Mich., still living.
-Keywords: aids; webb; dentist; acer
-MH941206
-Copyright © 1994 - Miami Herald. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Miami Herald, Permissions, One Herald Plaza, Miami, FL 33132-1693 TEL: (305) 376-3719.  http://www.herald.com.
 ==Bergalis and the politics of HIV/AIDS==