Fauci shares the ‘uh oh’ moment he realized monkeypox was getting out of control in a way that is ‘very reminiscent’ of HIV

Officially, more than 6,600 people across the US have been diagnosed with monkeypox since May 18, when the first domestic patient in this outbreak was discovered in Massachusetts . Public health experts say the true number of monkeypox cases in the country is probably much higher than that. Positive tests have been trickling in over the summer — first a drip, then a pour, up to a flood of new monkeypox diagnoses logged every day.

Now, at least three states (California, Illinois, and New York) have declared states of emergency for the disease, the White House has named a monkeypox response team, and the CDC is scrambling to bolster its “limited supply” of the one vaccine licensed for use against monkeypox in the US. But it was before all this — in late spring, early summer when data was starting to show monkeypox “efficiently” passing from person to person in the US — that Dr. Anthony Fauci got a sinking feeling he’s felt before.

“I said ‘uh oh,'” Fauci, chief medical advisor to President Joe Biden, told the podcast Science Vs. when asked what was going through his mind as the number of cases in the US outbreak kept growing and growing. “That’s very reminiscent of what we saw in the early days of HIV,” Fauci said, expressing concern.

Unlike past monkeypox diagnoses logged in the US, this year’s cases haven’t been confined to prairie dog owners and their close contacts , nor were they the result of recent travel to West Africa . Instead, by and large, the monkeypox lesions seen in this outbreak have been spreading in intimate areas of the body, among men who have sex with men. “It was sort of a gradual ‘oh my goodness,'” Fauci, who directs the National Institute of Allergy and Infectious Diseases, said.

“From the very first beginning, the epidemiological circumstances under which it occurred was very troublesome to me, having been there 41 years ago with HIV. ” Doctors and scientists in the US started researching the human immunodeficiency virus in 1981, “at a time when HIV was not yet discovered — We didn’t even call it AIDS,” Fauci told an oral history project in 2007. Initially, the disease was reported in just a handful of gay men living in Los Angeles.

Two of them died. At the time, Fauci thought maybe “it was just a fluke,” he told journalists gathered at a vaccine conference in 2019. In the early 1980s, Fauci said there was a lot of “confusion” about how the virus was transmitted, with people wondering: “is this a strange disease of gay men?” It was not.

HIV, like other viral diseases (including monkeypox) can impact anyone who’s vulnerable and exposed, under the right circumstances . “As it evolved, literally week after week after week, you’d get the unfolding and the evolution of the epidemiology — which made it clear that it wasn’t restricted just to gay men,” Fauci said. Unlike the HIV crisis, Fauci is hopeful that the current monkeypox outbreak won’t end up with millions of people infected around the globe needing treatment .

“Anything is possible, but it is unlikely,” he told Science Vs. “If we continue to put our foot on the pedal, get as many people vaccinated as possible, get control of it. I believe we can do that.

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