An ongoing dialogue on HIV/AIDS, infectious diseases,
January 25th, 2025
Let’s Hope the MMWR Resumes Publication Sooner Rather Than Later
To us specialists in Infectious Diseases, there are certain verities we hold near and dear to our hearts:
- Antibiotics are miracle drugs, but the bugs will become resistant if we don’t use them responsibly.
- Certain childhood vaccines (e.g., measles, polio, H flu type B) stand as some of the greatest scientific accomplishments in human history.
- To understand infectious risks, you have to have good data, carefully sourced and analyzed.
Number 3 is why this week’s non-publication of the Morbidity and Mortality Weekly Report (MMWR) came as such a shock. MMWR is the CDC’s primary way of publishing and communicating important data for public health. It didn’t go out because of a communications pause at federal health agencies issued by the new administration. The gap in publication marks the first time in its more than 60-year history that the CDC didn’t release a new issue.
Want an example of how useful the MMWR is for us ID people? Here’s a good one:
Highlighted in red, dear friends, is the first report of the disease now known as AIDS occurring in five previously healthy gay men in Los Angeles. The text from this account has always struck me as a perfect example of careful but prescient scientific reporting:
The occurrence of pneumocystosis in these 5 previously healthy individuals without a clinically apparent underlying immunodeficiency is unusual … All the observations suggest the possibility of a cellular immune dysfunction related to a common exposure that predisposes individuals to opportunistic infections.
Spot-on accurate. The second MMWR detailing more AIDS cases occurred less than a month later. Remember, these publications appeared 2 years before the discovery of HIV, the virus that causes the disease.
Subsequent MMWR reports on the rising incidence of AIDS, the populations at risk, and the strong epidemiologic evidence for modes of transmission played key roles in figuring out what was happening on a national and global level. We knew even before the virus was discovered that sexual, perinatal, and blood-borne infection were all implicated, and that household and other “casual” contact posed little, if any, risk.
Want more recent examples of infectious threats all reported in MMWR? A partial list:
- SARS
- MERS
- Zika
- Ebola
- Chikungunya
- Candida auris
- Mpox
- H5N1 avian influenza
- Innumerable food-borne outbreaks
- And yes, of course, COVID-19
I put COVID-19 last because I strongly believe this is the primary motivation for the communications pause issued by the new administration. The pandemic was so horrifically disruptive — so traumatic — to our society that we’re still grappling with the best way to deal with it.
And one unfortunate coping mechanism is the urge to scapegoat individuals and organizations for what happened. The CDC and its publications were often in the center of this storm, and some now want to blame them for all that they were unhappy about.
Was CDC perfect? Of course not. But they tirelessly worked to get things right, and reported abundant COVID-19 data on case numbers, hospitalizations, deaths, and vaccinations that we all turned to regularly. To expect, in hindsight, that they would do so infallibly is setting an impossible standard — one no organization, government or otherwise, can meet.
Apparently, the MMWR staff are still at work, so let’s hope that the pause in communication is brief. There always will be infectious threats out there, with H5N1 avian influenza now being foremost on our minds. It’s only through careful and regular reporting of data that we can face these threats responsibly.
12 Responses to “Let’s Hope the MMWR Resumes Publication Sooner Rather Than Later”
Leave a Reply
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
Biography | Disclosures | Summaries
Learn more about HIV and ID Observations.
The combination of insanity, anger and ignorance being demonstrated recently is shocking even to me
Well put, Dr. Sax.
I remember that MMWR issue.I kept it and still have it in my library.
Sad times we live in…
This is so disheartening. I have been reading MMWR since the early 1990s. I am always quoting its reports and statistics to my students and telling them that if they want to take a deep, thoughtful dive into a topic, MMWR is a wonderful and highly-reliable source. I even have a joke-y meme about how topics in MMWR might not be the best Thanksgiving dinner conversation. I’m hoping it comes back soon, but frankly, I am not optimistic these days.
The damage to the country since last Monday is almost beyond belief. The credit goes to all those who voted for it.
This is vital information for those concerned about public health
What a shame and I look at you from the other side of the pond praying that common sense and science prevail. The profession needs to remain strong and relentless in the face of such adversity.
Thank you for all you’ve done.
I was an ID Fellow at UCLA and Wadsworth VA at that time, and actually consulted on some of the initial cases. We have done so much and come so far, and we can’t regress. We cannot allow this new administration to dampen our spirits, or our resolve. We must fight back and do whatever we can, which will ultimately benefit everyone.
Thanks Paul, since you bring up the first reports of AIDS I think we all should recall the politics of the time then and what it took to get us to where we are today re: treatment. I keep thinking the Silence = Death (still) and we need to do more than just hope…we need to tell our friends, our colleagues and our patients so they understand the risk and how our ability to provide care is diminished.
Another effect will be obtaining CME for my license renewal,I use the
Medical Letter publication that depends on a wide variety of studies that
will disappear.Only can pray this is a phase, but I fear it is not.
Barry Smiler,MD
Sarasota, Florida
I subscribed to the MMWR for years in family medicine and found it helpful for educating patients with poor sources of information. What other forms of censorship will be next?
I have been reading MMWR since 1975 so I certainly hope that we can continue to learn from its very useful , timely and pertinent data. I am very glad to read Dr Sax comments , or the lack of them as it relates the reason for this “ brief pause “. I would have hoped Dr Sax would have written about what scientists and influential leaders in the Infectious Disease community , and others , are planning on doing , or are doing so science may continue to be just SCIENCE , and we do not go back to the times ( not the times of cholera ) , the very recent times of COVID – 19 .
Thanks, Paul for this important piece. Using the Internet Archive, I found that the CDC’s influenza “FluView” (https://www.cdc.gov/fluview/surveillance/2025-week-03.html) was updated today as scheduled with the addition of last week’s data ending as of January 18. The H5N1 “Current Situation” website (https://www.cdc.gov/bird-flu/situation-summary/index.html) was updated this past Friday and again today with new data. Likewise, the Marburg “Current Situation” website (https://www.cdc.gov/marburg/situation-summary/index.html) was updated this past Thursday changing the situation from “Potential Marburg Outbreak” to “Marburg Outbreak” shortly after Tanzania reported its first positive confirmation of human infection. So, this is some evidence that data of active public priority are being posted, as the new administration said it would do during this pause.
The fact that nothing has leaked about the three articles regarding H5N1 reportedly planned to publish in last Thursday’s paused MMWR could mean these articles did not contain urgent updates. But I don’t want to sound Pollyannaish. The heavy handedness of pausing the MMWR for the first time ever in its history makes me very uneasy. It feels – intentional or not – intimidating. Especially as I recall the efforts during the last Trump administration of political appointees, who were angered that some MMWR reports related to COVID-19 seemed politically motivated, undertook unprecedented efforts to exert editorial control verging on censorship. See: https://www.politico.com/news/2020/09/11/exclusive-trump-officials-interfered-with-cdc-reports-on-covid-19-412809.
Will the new administration live up to its promise that by their self-appointed deadline of this Saturday, February 1 they will provide a way forward with timely review by a political appointee? What will that review consist of, and how timely will it be? We’ll have to wait and see. And keep watching closely.