NEW S.T.D. A PUZZLE TO INVESTIGATORS
TERRE HAUTE -- When Ishmael Gradsdovich, 26, found a small bump on his penis, he wasn't alarmed. "Bumps happen," he says, in his best Forrest Gump. He thought that maybe it was a pimple, or an inflamed pubic hair follicle. But when the bump swelled, the homeless Gradsdovich went to a free, walk-in health clinic in Chicago where venereal warts were diagnosed.
Case closed, he thought. Although in women they have been linked to cervical cancer, venereal warts in males are, although annoying, embarassing, and sometimes unsightly, a minimal health problem.
But the case was far from closed, and in fact is a case study in an alarming new venereal disease that is worrying investigators.
The understaffed and undertrained Chicago clinic had misdiagnosed Gradsdovich. When the "wart" disappeared, he went back to his sexually promiscuous street lifestyle with a passion, so to speak. If anything, "I was hornier than ever before," he says.
That bump, misdiagnosed as genital warts, was the only known physical symptom of a venereal disease that is so new, and so strange, that it doesn't even have an accepted name yet in the medical literature. On the street it is known as "the clam" -- perhaps a reference to the shape of the indicative bump.
Now that investigators know what to look for and how, it is easy for them to make a correct diagnosis. Investigators were reluctant to reveal their method -- they want people who suspect they have a venereal disease to come to professional medical treatment rather than trying to treat themselves at home -- but the Herald has learned that a simple application of vinegar to the bumps is enough for a tentative diagnosis. Warts will pale to white when vinegar is applied, "the clam" will not.
Sex Drive Increases
What is alarming about this disease is not the medical consequences -- investigators have found no serious health problems associated with the disease, and many people may never know they have been infected. But this disease, unlike any other, changes the psychology of its victims in a very specific, direct way -- and a way designed to promote the spread of the disease.
People infected with "the clam," at some point shortly after the disappearance of the initial bump, find their sex drive increased to levels hardly known outside of the experience of adolescent boys. Furthermore, this seems to be accompanied by an increase in promiscuity -- with the number of sexual partners increasing, although this may be more a side effect of the constant arousal prompted by the infection than a direct effect of the disease.
"This isn't the first time a disease has prompted behavioral changes in order to promote its own spread in a population," says Dr. Isabel Rabit, writing in the journal Epidemiology. "Even the common cold, which assists its own spread by causing sneezing in its host is a pathogen which uses behavioral changes caused by its own infection to succeed in its chosen environment."
But this is the first time a disease in humans has gone beyond phisiological reflexes like sneezing and coughing, to change the psychology of its victims. Typhoid Mary spread typhoid fever by coughing while working in a restaurant. The disease caused the cough, but Typhoid Mary caused the epidemic by deciding to go to work. "The clam" works differently -- "It is as though there had been a strain of the disease that had made Typhoid Mary want to go to work," Rabit writes.
Disease has defenders
Because the disease has almost no physical symptoms, and no harm has been shown to the human body from being infected, some people with the disease aren't too unhappy about it. In fact, a world wide web (WWW) site on the internet has a section run by infected people, called "Aphrodiseaseiac" that contains messages with this radical view.
"We have a disease which makes us more loving, more sexual, and causes no harm. Spreading it is more than fun, it is holy. Join the sick!" says one of the readouts.
"It's possible," writes Kenneth MacTerrel in the journal Harmonic Dispatch, "that this is not a 'disease,' but an organism destined to live symbiotically with our own, encouraging more emotive, sensual behavior, and less of the competitive, war-like ethos which is causing so much harm in our society today. This 'disease' is not actually disrupting anyone's ease, and should be looked at instead as the catalyst for a new stage in human evolution."
"This is a ridiculous and dangerous attitude," says Dr. Lucy Axelrod of the Centers for Disease Control. "We don't know what this disease can do." She notes that AIDS sufferers were infected many years before they started showing symptoms of the disease. "In 1980, would these people have said that HIV was a harmless virus?" she asks. Axelrod, and others at the CDC, are worried that other, more harmful sexually transmitted diseases like AIDS may "piggyback" on "the clam," taking advantage of its effects to spread even more rapidly.
And at least one state legislator, Howard Albatros of Florida, has suggested that people with the disease should be tested for AIDS and if infected, quarantined indefinately. "People with this disease are a walking timebomb," he says, "a danger to public health worse than anything we've seen in this century."
Public health officials haven't suggested such approaches, but are worried still. "There are medications which subdue the sex drive," says Axelrod, "and these have been tried with some success, but we can't force people to take them, and many people prefer to go untreated. We recommend condoms, although not enough testing has been done to ensure that condoms actually prevent the spread of the disease."
Axelrod says that the "female condom," recently made available over-the-counter in drug stores, is likely to be the most effective way of stopping the spread of the disease, as the "bumps" associated with the disease and thought to be indicative of where the disease entered the body can occur anywhere in the pubic region, and not just in the regions normally protected by a standard condom.
Estimates as to the number of people infected vary widely, with one source guessing that "at least five thousand people are infected," and another believing that "as many as one out of every twenty-two adults in America" have the disease.
But nothing has been done which has any hope of slowing the spread of the epidemic, and in fact the infection has become sought out in some quarters. The Shell service-station hats which have become an inner-city fashion statement of late, and which was worn by lead singer X.Y. Zee of the group Farrr in their recent MTV hit "Storm Widow" are said to be indication that the person wearing it has the disease and is willing to "share" it.
Some have even talked about a phenomenon they're calling "clam diggers," in which people, typically young women, seek out partners with the disease in order to become infected and thereby increase their sex drive.
Ishmael Gradsdovich has mixed feelings about his own infection, saying he's a little scared of a feeling he describes as like being "possessed by some sort of alien," but enjoying the revitalization of his sexuality. He says he uses a condom, but doesn't want to go on medication which would reduce his sexual desire. "I haven't had sex this good since I was a teenager," he says. "But then again, I didn't like having a hard-on all the time when I was a teenager."
The Herald caught up to Gradsdovich in Terre Haute, where he is living as a guest of the Indiana State University Medical Center as one of forty people with the disease -- mostly homeless people like himself who were encouraged to join the study by promises of free housing and help getting public assistance.
Once a week, he is given a physical and given psychological and mental tests and is asked about his sexual habits. He told this reporter that in the three weeks he has been in Terre Haute, he has had five sexual partners, including one on the medical center staff, and recalls with pride that they all were impressed with his sexual vitality and his ability, as he puts it, "to get it up three or four times a night."
He says that he will disclose details about his disease to his partners "if they ask," by handing them a flier produced by the ISU Medical Center which sketches out the little that is known for sure, or suspected, in the medical community. And he claims that none of the partners he still communicates with has come down with "the clam."
Dr. Felix Leopard says that Gradsdovich's behavior, as randomly promiscuous and of uncertain safety as it is, is better than many. "Some don't use condoms at all, some have other S.T.D.s [sexually transmitted diseases], and most don't tell their partners anything." As for Gradsdovich's uninfected partners, "it's too early to tell. We don't know the incubation period of the disease, or much of anything about it. We suspect it's a virus, but that's about all we know."
Why aren't the medical center researchers isolating the subjects, protecting the public from this epidemic? "We feel that it's in the public's long-term interest to have an honest picture of the actual progress of the disease and its effects on an individual, rather than to hysterically quarantine the victims of the disease in the absence of any evidence that such actions are warranted."
This infuriated some Terre Haute residents, including the Rev. Tad Apron, who showed up with parishioners and other angry members of the community at a city council meeting last week to angrily vent their worries. "This isn't some sort of benign form of measles we're talking about here," the fiery and flamboyant Apron said, "this is a sex disease, threatening to turn you and your children into heat-seeking love missiles of death. We don't know how this disease kills, or how it spreads. Who knows but that these people may be infecting the workers at your day-care center, your local McDonalds, or your next-door neighbor? Who knows but that you could get this disease from a mosquito or a tick?"
Apron's rhetoric, and the pleas of the other citizens who spoke at the meeting moved the council to pass a resolution urging the medical center to "ensure that epidemic diseases are kept out of innocent communities." But because the center is outside of city limits, there was little non-symbolic action that the council could take. Apron vows to take the issue before [sic.] county board of supervisors in two weeks.
Medical center spokespersons, though, insist that while studies have not been completed yet, there is no evidence that the disease can be spread through casual contact, insect bites, or food-handling. It is not even certain that the disease can be transmitted through the blood (although the CDC is eager to come up with a way to test the nation's blood supply for the disease), and the one known case of an infant contracting the disease from an infected mother has been complicated by a dispute over whether sexual molestation may have been the real mode of transmission.
Which raises another issue. While no hard figures are available, there have been whispers among researchers that people with the disease are more likely to commit crimes such as rape and sexual molestation.
"This is one angle we are looking at," admits Axelrod, although "there isn't enough evidence one way or another yet, and even if it is shown that there is a correlation, this doesn't tell us much. It may be that the acts of molestation or rape are, because of the physical trauma they cause, more likely to spread the disease so that people who are prone to this sort of violent behavior are more likely to be infected. It is certainly premature to even begin to suggest that this disease causes violent sexual behavior."
Doria Gherkin, author of Men in Hate with Woman isn't buying it. "It's an open secret among researchers that men with this disease go on to commit date rape at astounding rates. It's a challenge to the feminist argument that rape is about violence, not sex. An increase in the male sex drive leads to an increase in rape -- the male sex drive is essentially a rape drive that goes wild in these cases. As I wrote, in Men in Hate, in male culture slow murder is the heart of eros. Men find violence sexy, and when they become sexually driven, they become compelled to violence."
"If it does turn out that this disease encourages rape or molestation," Axelrod says, "then it becomes a public health problem in a way that we're not used to."
Support groups formed
In San Francisco, a support group, called "The City Chowder Club," formed to discuss the problems associated with the disease. Starting as a discussion and education group, with speakers coming from the medical community to discuss options and current research, it quickly degenerated into a sex club. "The meetings are essentially fast-forward singles bars," one member told a writer for Epidemiology.
Ironically, others are suggesting just this approach to stop the disease -- channeling the expanded sex drive of the infected individuals into avenues which allow them to gratify their desires without spreading the disease to uninfected people. One scholar even suggested that an all-out effort be supported with public funds to design durable, inexpensive and effective masturbatory aids and that communities or subcultures of infected people be set up so that those with "atypical sexual needs" are able to pair off with each other.
With no consensus in sight, even such far out approaches as these have been reviewed with respect in the New England Journal of Medicine. And, until researchers like those at the University of Indiana give us real data on the mechanisms of the disease, this sort of guesswork and wishful thinking is all we have to work on.