Process Narrative:

The original rhetorical situation of this project was to present my revised primary source analysis and timeline to the public as an Omeka exhibit (click here to view). Due to this specific situation, I had to take special care to make sure the pages to the exhibit were visually appealing and not overly text-heavy. I also touched up both my analysis and timeline in order to make them more reader-friendly specifically with the audience in mind. My primary source analysis evolved dramatically from the original as I had learned a lot more about my primary source and its profound effect on the AIDS epidemic, along with ways of incorporating multimodality into the composition. I also included a lot more history and information about the social and medical background surrounding the report at the time of its release in my updated version. Over the course of this specific project, I learned a lot about the organization of text along with pictures and video on websites as I wanted to make my exhibit visually appealing to my audience.

The Morbidity and Mortality Weekly Report (MMWR)

is a weekly digest published by the CDC that reports public health information and recommendations from various states that the CDC deems important. Its history began in 1878 after the passing of the National Quarantine Act, which required the U.S. Marine-Hospital Service to check for and report infectious diseases at ports to the U.S. Surgeon General. This lead to the development of The Bulletin of the Public Health which evolved to be the modern-day MMWR. The MMWR has been influential in reporting various diseases and outbreaks such as Legionnaires in the 70’s, AIDS and toxic-shock syndrome in the 80’s, hantavirus pulmonary syndrome in the 90’s, and severe acute respiratory syndrome in the 2000’s. The MMWR for the week of June 5th, 1981 is important because it has become recognized as the first published report of the AIDS outbreak. The article pertaining to the AIDS outbreak was titled Pneumocystis Pneumonia- Los Angeles. It described the cases of 5 young men who were due treated for pneumocystis carinii pneumonia between October 1980 and May 1981. All of the men had confirmed cytomegalovirus (CMV) infection and candidal mucosal infection. They were also all active homosexuals.

Patient one was 36 years old and hadn’t had any serious health problem. He came into the hospital in September 1980 and was diagnosed with a CMV infection. He was treated but came back into the hospital in April 1981 after having a fever and cough. He was diagnosed with the P. carinii pneumonia and was still being treated at the time of publication of the article.

Patient two was a 30-year-old man who developed esophageal and oral candidiasis in January 1981. He reported to the hospital in February with the P. carinii pneumonia and CMV. However, in contrast to the other patients, he responded well to Amphotericin B treatment and was doing alright at the time of publication of the article.

Patient three was a 29-year-old man who reported to the hospital in February 1981 with the P. carinii pneumonia and CMV. He had been diagnosed with Hodgkin’s disease three years earlier but had been successfully treated for it. He did not improve with treatment and passed away shortly after admission to the hospital in March.

Patient four was 33 years old and hadn’t had any major health problems before this sickness. He developed the pneumonia and went to the hospital in March 1981 after having a fever for two months. There he tested positive for CMV and the P. carinii pneumonia. Despite undergoing the normal course of treatment, the man’s condition continued deteriorating and he eventually passed away.

Patient five was 30 years old and had not had any previous health issues. He was hospitalized in April 1981 after a five-month history of fever. Upon his admission it was discovered that he had P. carinii pneumonia and the CMV virus. The pneumonia responded to standard treatment but his fever still persisted at the time of publication of this article.

In summary of the cases, they were all homosexual young males who from the Los Angeles area who contracted CMV and P. carinii pneomonia. Two passed away while the others had continuing fever (none recovered fully). In the editor’s note of the article it is noted that the P. carinii pneumonia is almost exclusively contracted by drastically immunosuppressed people. He believed there was a connection between the CMV infection and the contraction of the pneumonia but stated that he did not have enough data to support this theory.

The Morbidity and Mortality Weekly Report from the week of June 5th, 1981 is very important to the history of AIDS because it was the first published report that established health problems due to immunosuppression within the homosexual community. Without its publication and nationwide reach it may have taken researchers much longer to establish the connections made in the report. This would have led to the search for treatment being delayed and many more dying from the disease. It is also very interesting that this particular article was not the cover article for the week (one about the Dengue fever was) as the writers had no idea of the impact it would have. The MMWR was most without a doubt influential in the fight against the AIDS epidemic.

The report is very different from many of the primary sources of my peers. Many of theirs have to do with activism or social things, while the report is purely scientific. This contrast helps to show how politically and socially charged of a topic AIDS has been, as there is very little out there that does not contain some type of bias. The report is further distinguished from my peers in that it was also the first item of any kind that tied multiple cases to one common disease (AIDS).