Acquired Immune Deficiency Syndrome (AIDS).

Central nervous system involvement is reported in 61 of 68 infants and children with asymptomatic AIDS (13 with ARC-AIDS-related complex) followed for 1 to 48 months (average, 18 mos) in the Depts of Neurology and Pediatrics at SUNY, Stony Brook, NY.


Acquired Immune Deficiency Syndrome (AIDS). Initiative Statute
Official Title and Summary Prepared by the Attorney General ACQUIRED IMMUNE DEFICIENCY SY~DRO~1E (AIDS). I~ITIA TI\,E STATUTE. Declares that AIDS is an infectious, contagious and communicable disease and that the condition of being a carrier of the HTL \' -III virus is an infectious, contagious and communicable condition. Requires both be placed on the list of reportable diseases and conditions maintained by the director of the Department of Health Services. Provides that both are subject to quarantine and isolation statutes and regulations. Provides that Department of Health Services personnel and all health officers shall fulfill the duties and obligations set forth in specified statutory provisions to preserve the public health from AIDS. Summary of Legislative Analyst's estimate of net state and local government fiscal impact: The fiscal effect of the measure could vary greatly depending upon how it would be interpreted by public health officers and the courts. If only existing discretionary communicable disease controls were applied to the AIDS disease, given the current state of medical knowledge, there would be no substantial change in state and local costs as a direct result of this measure. If the measure were interpreted to require added control measures, depending upon the level of activity taken, the cost of implementing these measures could range to hundreds of millions of dollars per year.

Background
Acquired immune deficiency syndrome (AIDS) is a disease that impairs the body's normal ability to resist harmful diseases and infections. The disease is caused by a virus that is spread through intimate sexual contact or exposure to the blood of an infected person. As of the preparation of this analysis, there was no readily available method to detect whether a person actually has the AIDS virus. A test does exist to detect whether a person has ever been infected with the AIDS virus and as a result has developed antibodies to it. A person infected with the AIDS virus mayor may not develop the AIDS disease after a period of several years. There is no known cure for AIDS, which is ultimately fatal.
As of June 30,1986, there were 5,188 cases of AIDS and 2,406 deaths from the disease in California. The State Department of Health Services estimates that up to 500,000 persons in California are infected with the AIDS virus, and that by 1990 there will be approximately 30,000 cases of AIDS in the state.
Existing Laws Covering Communicable Diseases. Local health officers have broad authqrity to take measures they believe are necessary to protect public health and prevent the spread of disease-causing organisms. However, this broad authority is limited to situations where there is a reasonable belief that the individual affected has or may have the disease and poses a danger to the public. The kind of measure taken by health officers varies, depending on how easily an organism is spread from one person to another. For example, to prevent the spread of a disease, local health officers may require isolation of infected or diseased persons and quarantine of exposed persons. In addition, persons infected with a disease-causing organism may be excluded from schools for the duration of the infection and excluded from food handling jobs. In some cases, these measures may be applied to persons suspected of having the infection or the disease.
Current AIDS Reporting Requirements. Physicians and other health care providers are now required to re-48 port cases of certain listed communicable diseases to local health officers who, in turn, report the cases to the State Department of Health Services. At the time this analysis was prepared, AIDS was not on the list of communicable diseases that must be reported to local health officers. However, AIDS is being reported under a regulation which requires an unusual disease, not listed as a communicable disease, to be reported by local health officers.
Under other provisions of law, hospitals are require -) report cases of AIDS to local health officers who, in , report the cases to the State Department of Health Services. Counties also report to the state the number of cases in which blood tests performed at certain facilities reveal the presence of antibodies to the AIDS virus, indicating that a person has been infected with the virus. Existing law does not allow the release of the names or other identifying information for persons who take the AIDS antibody test.
According to the State Department of Health Services, persons who have AIDS and persons who are capable of spreading the AIDS virus are subject to existing communicable disease laws. However, no health officer has ever taken any official action to require persons infected with the AIDS virus to be isolated· or quarantined, because there is no medical evidence which demonstrates that the AIDS virus is transmitted by casual contact with an infected person. In addition, no health officer has recommended excluding persons with AIDS, or those who are capable of spreading AIDS, from schools or jobs.

Proposal
This measure declares that AIDS and the "condition of being a carrier" of the virus that causes AIDS are communicable diseases. The measure also requires the State Department of Health Services to add these conditions to the list of diseases that must be reported. Because AIDS cases are already being reported, the measure wouIe" quire the reporting of those who are "carriers of the 1 J virus." Currently, no test to make this determination IS readily available.

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The measure also states that the Department of Health Services and all health officers "shall fulfill all of the duties and obligations specified" under the applicable laws "in a "·"'ner consistent with the intent of this act." Although ,~ leaning of this language could be subject to two different interpretations, it most likely means that the laws and regulations which currently apply to other communicable diseases shall also apply to AIDS and the "condition of being a carrier" of the AIDS virus. Thus, health officers would continue to exercise their discretion in taking actions necessary to control this disease. Based on existing medical knowledge and health department practices, few, if any, AIDS patients and carriers of the AIDS virus would be placed in isolation or under quarantine. Similarly, few, if any, persons would be excluded from schools or food handling jobs. If, however, the language is intemreted as placing new requirements on health officers, it could result in new actions such as expanding testing programs for the AIDS virus, imposing isolation or quarantine of persons who have the disease, and excluding persons infected with the AIDS virus from schools and food handling positions.

Fiscal Effect
The fiscal effect of this measure could vary greatly, depending on how it would be interpreted by state and local health officers and the courts. If existing discretionary communicable disease controls were applied to the AIDS disease, there would be no substantial net change in state and local costs as a direct result of this measure. Thus, the primary effect of this measure would be to require the reporting of persons who are carriers of the virus which causes AIDS. Very few cases would be reported because no test to confirm that a person carries the virus is readily available. If such a test becomes widely available in the future, more cases would be reported.
The fiscal impact could be very substantial if the measure were interpreted to require changes in AIDS control measures bv state and local health officers, either voluntarily or as ~ result of a change in medical knowledge on how the disease is spread, or as a result of court decisions which mandate certain control measures. Ultimately, the fiscal impact would depend on the level of activity that state and local health officers might undertake with respect to: (1) identifying, isolating and quarantining persons infected with the virus, or having the disease, and (2) excluding those persons from schools or food handling positions. The cost of implementing these actions could range from millions of dollars to hundreds of millions of dollars per year.
In summary, the net fiscal impact of this measure is unknown-and could vary greatly, depending on what actions are taken by health officers and the courts to implement this measure.

Text of Proposed Law
'Ibis initiative measure is submitted to the people in dance with the provisions of Article II, Section 8 of the--(:onstitution.
This initiative measure proposes to add new provisions to the law; therefore, the new provisions proposed to be added are printed in italic tJPe to indicate that they are new.

Section 1. The purpose of this Act is to: A. Enforce and confirm the declaration of the California Legislature set forth in Health and Safety Code Section 195 that acquired immune deficiency syndrome (AIDS) is serious and life threatening to men and women from all segments of society, that AIDS is usually lethal and that it is caused by an infectuous agent with a high concentration of cases in California; B. Protect victims of acquired immune deficiency syndrome (AIDS), members of their families and local communities, and the public health at large; and
C Utilize the existing structure of the State Department of Health Services and local health officers and the statutes and regulations under which they serve to preserve the public health from acquired immune deficiency syndrome (AIDS). j G86 Section 2. Section 3. In the event that any section, subsection or portion thereof of this Act is deemed unconstitutional by a proper court of law, then that section, subsection or portion thereof shall be stricken from the Act and all other sections, subsections and portions thereof shall remain in force, alterable only by the people, according to process.

Arguments in Favor of Proposition 64
Proposition 64 extends existing public health codes for communicable diseases to AIDS and AIDS virus carriers. This means that the same public health codes that already protect you and your family from other dangerous diseases will also protect you from AIDS. Proposition 64 will keep AIDS out of our schools, out of commerical food establishments, and will give health officials the power to test and quarantine where needed. These measures are not new; they are the same health measures applied, by law, every day, to every other dangerous contagious disease.
Today AIDS is out of control. There are at least 300,000 AIDS carriers in California, and the number of cases of this highly contagious disease is doubling every 6 to 12 months. The number of "unexplained" AIDS cases-cases not in "high-risk" groups, such as homosexuals and intravenous drug users-continues to grow at alarming rates. Indeed, the majority of cases worldwide fall into no identifiable "risk group" whatsoever. The AIDS virus has been found living in many bodily fluids, including blood, saliva, respiratory fluids, sweat, and tears, and it can survive upwards of seven days outside the body. There presently exist no cure for the sick and no vaccination for the healthy. It is 100% lethal.
AIDS is the gravest public health threat our nation has ever faced. The existing law of California clearly states that certain proven public health measures must be taken to protect the public from any communicable disease, and no competent medical professional denies that AIDS is "communicable." Despite these facts, politicians and special interest groups have circumvented the public health laws. For the first time in our history, a deadly disease is being treated as a "civil rights" issue, rather than as a public health issue.
The medical facts are clear. The law is clear. California law today makes it illegal for public health authorities to be informed of a large number of those (about 385,000) who can spread the deadly AIDS virus to others. How can they take the necessary steps to slow its spread as long as this is true?
Under existing law, a physician who encounters any of 58 reportable diseases is required to report to health officials. Included are several venereal diseases, such as syphilis and gonorrhea. Contact tracing is conducted. But, for those with the AIDS virus, not yet developed into AIDS, a special state law passed at the request of the male homosexual lobby prohibits contact tracing. Proposition 64 will require that those with the AIDS virus be reported a ~ other communicable diseases. It does not require qu,, __ .tine.
The cost of the AIDS epidemic in California, it is estimated, will be at least 59,400 lives by 1991 and almost $6 billion to be paid by insurance and/or taxpayers. Let's reduce those statistics by voting YES on Proposition 64.

Rebuttal to Arguments in Favor of Proposition 64
Would you let a stranger with no medical training or medical background diagnose a disease or illness that you have? Would you let a political extremist dictate medical policy? OF COURSE NOT.
The followers of Lyndon LaRouche suggest that the hands of the medical community have been tied. THIS IS NOT TRUE! In fact, the California Medical Association, the California Nurses Association, the California Hospital Association and other health professionals believe that Proposition 64 would seriously hurt their ability to treat and find a cure for AIDS. These health professionals are seriously concerned that years of research will be undermined by fear generated by this irrational proposition.
NO ONE has contracted AIDS from casual contact at a restaurant, grocery store, or in the workplace. Think for a moment. If it were true that AIDS is casually transmitted, clearly many more men, women and children would be ill. This is just not the fact. The followers of Lyndon LaRouche are at it again! Using partial truths and falsehoods, they are attempting to create panic in California. Say NO to PANIC. Vote NO on Proposition 64.