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The index case, primary case, or patient zero is the initial patient in the population of an epidemiological investigation,〔(【引用サイトリンク】title=Diseases - Activity 1 - Glossary, page 3 of 5 )〕〔(【引用サイトリンク】title=WordNet Search - 3.0 )〕 or more generally, the first case of a condition or syndrome (not necessarily contagious) to be described in the medical literature, whether or not the patient is thought to be the first person affected. An index case will sometimes achieve the status of a "classic" case in the literature, as did Phineas Gage. The index case may indicate the source of the disease, the possible spread, and which reservoir holds the disease in between outbreaks. The index case is the first patient that indicates the existence of an outbreak. Earlier cases may be found and are labeled primary, secondary, tertiary, etc. "Patient Zero" was used to refer to the index case in the spread of HIV in North America.〔(【引用サイトリンク】title=Patient Zero - definition of Patient Zero in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia )〕 In genetics, the index case is the case of the original patient (propositus or proband) that stimulates investigation of other members of the family to discover a possible genetic factor.〔(【引用サイトリンク】url=http://medical-dictionary.thefreedictionary.com/index+case )〕 == Gaëtan Dugas case ("Patient Zero") == (詳細はAIDS epidemic, a “patient zero” transmission scenario was compiled by Dr. William Darrow and colleagues at the U.S. Centers for Disease Control and Prevention (CDC).〔 This epidemiological study showed how “patient zero” had infected multiple partners with HIV, and they, in turn, transmitted it to others and rapidly spread the virus to locations all over the world (Auerbach et al., 1984). The CDC identified Gaëtan Dugas as a carrier of the virus from Europe to the United States and spreading it to other men he encountered at gay bathhouses.〔Pence, G. E. (2008). Preventing the Global Spread of AIDS. In Medical Ethics Accounts of the Cases That Shaped and Define Medical Ethics (p. 331). New York, USA, McGraw-Hill.〕 Journalist Randy Shilts subsequently wrote about Patient Zero, based on Darrow's findings,〔 in his 1987 book ''And the Band Played On'', which identified Patient Zero as Gaëtan Dugas.〔(Matt & Andrej Koymasky - Famous GLTB - Gaëtan Dugas )〕 Dugas was a flight attendant who was sexually promiscuous in several North American cities, according to Shilts' book. He was vilified for several years as a "mass spreader" of HIV, and seen as the original source of the HIV epidemic among homosexual men. Four years later, Darrow repudiated the study's methodology and how Shilts had represented its conclusions.〔(【引用サイトリンク】title=The Origin of HIV and the First Cases of AIDS )〕 A 2007 study published in the Proceedings of the National Academy of Sciences of the USA by Michael Worobey and Dr. Arthur Pitchenik claimed that, based on the results of genetic analysis, current North American strains of HIV probably moved from Africa to Haiti and then entered the United States around 1969, probably through a single immigrant. However, Robert Rayford died in St. Louis, Missouri, of complications from AIDS in 1969, and most likely became infected in 1966, so there were prior carriers of HIV strains in North America. The phrase "patient zero" is now used in the media to refer to the index case for infectious disease outbreaks, as well as for computer virus outbreaks, and, more broadly, as the source of ideas or actions that have far-reaching consequences.〔(【引用サイトリンク】title=Researchers trawl for Conficker's 'Patient Zero' - Techworld.com )〕 David Heymann, infectious-disease epidemiologist at the London School of Hygiene & Tropical Medicine, has questioned the importance of finding patient zero and has said: “Finding patient zero may be important in some instances, but only if they are still alive and spreading the disease. And more often than not, especially in large disease outbreaks, they’re not." 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「index case」の詳細全文を読む スポンサード リンク
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