A prominent researcher discusses similarities, differences with the recent Ebola epidemic.
When AIDS first appeared in the early 1980s it was accompanied by widespread and discernable fear. The public did not understand the new virus or its transmission. Groups were scapegoated, there was suspicion against the government, exaggerated media coverage and people sometimes took extreme measures to protect themselves from infection.
Something not too dissimilar happened again last year, only this time with Ebola.
While public fear of HIV/AIDS has subsided in the nearly 35 years since it was first reported, the appearance of another deadly and poorly understood virus has elicited a similar response over heath and safety concerns, said Harold W. Jaffe, associate director for science at the Centers for Disease Control and Prevention, during a lecture Thursday (April 9) at the Yale School of Public Health.
“Must history repeat itself?” he asked the near-capacity audience in Winslow Auditorium. “I’d like to think the answer is ‘no.’ But maybe at least the initial response is inevitable.”
Jaffe delivered a Milbank Lecture in conjunction with the school’s centennial celebration this year. His was the second of six such lectures that will be delivered throughout the year as the school’s marks its milestone. While introducing Jaffe, Dean Paul Cleary described him as a “giant” in the field of HIV/AIDS and said that his scientific influence has touched many, including himself.
Jaffe outlined the history of the AIDS epidemic from when the first few cases were described in a scientific journal in 1981—well before it had its now familiar name—through to the present, when, despite some notable successes, the disease continues to claim millions of lives, particularly in developing countries.
In the intervening years, Jaffe touched on the story of Ryan White (an American teenager expelled from school after testing positive for the infection); fear that insects, particularly mosquitoes, would further spread the virus; the example set by Princess Diana in England and elsewhere to fight HIV/AIDS-related stigma; the work of former U.S. Surgeon General C. Everett Koop to educate people about the disease; the increased use of condoms; AIDS activism and the role it played in the introduction of new drugs; the effectiveness of combination therapies; and, most recently, the rise of PEPFAR and other organizations to stem the disease’s spread.
Jaffe noted that while both diseases are deadly, there are also stark differences. There is no effective vaccine for HIV/AIDS, while there are several promising vaccines for Ebola currently under development. HIV/AIDS can take up to a decade to incubate, whereas Ebola incubates within 10 days. The death toll associated with AIDS runs is many millions, while lives lost from the recent Ebola outbreak numbered in the thousands.
“Very sadly we have examples of overreaction to a perceived threat,” he said of the Ebola outbreak.
In the first Milbank Lecture of the centennial year (Feb. 3), Mitchell Gail, a senior investigator in the biostatistics branch at the National Institutes of Health, used the example of breast cancer to discuss the advantages and disadvantages of risk models in counseling patients and in public health work.
Such models are a useful—though imperfect—tool in making women aware of the probability that they will develop disease and in helping them, following disease diagnosis, decide on the best treatment strategy.
The next Milbank Lecture features Pia Britto, senior advisor for childhood development at UNICEF. Her talk will be held April 22 at 4:30 p.m. in Winslow Auditorium at the Yale School of Public Health.