Kimberly Bergalis (9 January 1968–8 December 1991) was an American woman who alleged she had contracted HIV from her dentist, David 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 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 US 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 admited 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[citation needed]. The CDC never presented any conclusion about the method of infection, leaving the media to speculate that a disgruntled Acer had in some way 'purposely' exposed Ms. Bergalis to his blood during a dental procedure. This by itself would makes the case unique, and subject to re-examination.
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. [1]
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."
References
[1] "The Gravest Show on Earth", Elinor Burkett, 1995, Houghton Mifflin, ISBN 0-395-74537-3. [2] CMAJ
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