Fauci warns of assumptions about monkeypox outbreak; compares situation with HIV/AIDS epidemic

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dr. Anthony Fauci, the White House chief medical adviser, warned against making assumptions regarding the global monkeypox outbreak, citing choices made during the early days of the HIV-AIDS epidemic.

In a piece written in the New England Journal of Medicine, Fauci and Dr. H. Clifford Lane said the emerging epidemiological pattern of cases bears a “striking resemblance” to early HIV/AIDS cases – including that most cases of monkeypox in this outbreak have been detected in men who have sex with men.

The virus usually spreads through direct contact with the skin of the lesion, and the researchers noted that there is some evidence that transmission requires prolonged or repeated exposure.

People can also become infected through contact with contaminated clothing or bedding.

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dr.  Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, sits down for a hearing of the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill, Thursday, Nov. 4, 2021, in Washington, D.C.

dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, sits down for a hearing of the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill, Thursday, Nov. 4, 2021, in Washington, D.C.
(AP Photo/Alex Brandon)

In particular, health officials have emphasized that the virus is not considered a sexually transmitted infection, although men believed to be at high risk for the disease are recommended to reduce their number of sexual partners and refrain from group or anonymous sex.

During the HIV-AIDS pandemic, the couple noted that the microorganism that caused the disease was unknown and, unlike today, no countermeasures such as vaccines were available.

“Given how little we know about the epidemiological features of the current outbreak, it is wise to heed an observation made during the first year of the HIV/AIDS pandemic: ‘…any assumption that it will be limited to a certain segment of our society is really an assumption without scientific basis.’ Therefore, additional detailed epidemiological and observational cohort studies, serosurveys and ongoing monitoring of new cases are critical,” insisted Fauci and Lane, who serves as NIAID’s deputy director for clinical research and special projects. Fauci will leave his position as White House chief medical adviser and NIAID director in December.

This 2003 electron microscope image, provided by the U.S. Centers for Disease Control and Prevention, shows adult, oval-shaped monkeypox virions, left, and globular immature virions, right, obtained from a sample of human skin associated with the prairie dog outbreak in 2003 .

This 2003 electron microscope image, provided by the U.S. Centers for Disease Control and Prevention, shows adult, oval-shaped monkeypox virions, left, and globular immature virions, right, obtained from a sample of human skin associated with the prairie dog outbreak in 2003 .
(Cynthia S. Goldsmith, Russell Regner/CDC via AP)

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They said the challenge for the future is to ensure the efficient and equitable availability and distribution of countermeasures, as well as to conduct the rigorous studies needed to determine what the clinical efficacy may be, identify potential safety concerns, and guide use.

Lessons learned during the responses to AIDS and COVID-19 should help us mount a more efficient and effective response to monkeypox, and the monkeypox response, in turn, should help inform our response to the inevitable next emerging or re-emerging infectious disease of pandemic potential,” the pair concluded.

dr.  Anthony Fauci, America's top infectious disease expert, wears a facemask during the White House's COVID-19 Response Team's regular conversation with the National Governors Association at the South Court Auditorium in the Eisenhower Executive Office Building on the White House Campus, Monday, December 27, 2021, in Washington, DC

dr. Anthony Fauci, America’s top infectious disease expert, wears a facemask during the White House’s COVID-19 Response Team’s regular conversation with the National Governors Association at the South Court Auditorium in the Eisenhower Executive Office Building on the White House Campus, Monday, December 27, 2021, in Washington, DC
(AP Photo/Carolyn Kaster)

According to data from the Centers for Disease Control and Prevention, there are nearly 17,000 confirmed cases of monkeypox and orthopoxvirus in the US and 46,724 cases worldwide.

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According to the World Health Organization, the number of reported cases worldwide has fallen by 21% in the past week.

The Associated Press contributed to this report.

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