A disease anywhere can be a disease everywhere tomorrow morning’: Public health expert on Ebola and the threat of future outbreaks
A deadly Ebola outbreak caused by the Bundibugyo virus is currently unfolding in the Democratic Republic of the Congo (DRC) and Uganda. According to the World Health Organization (WHO), the situation is a public health emergency of international concern, with 534 total confirmed cases and 93 deaths reported as of June 6.
Why is the Bundibugyo Ebola outbreak spreading?
The outbreak is concentrated in a remote, impoverished area of the DRC plagued by ongoing political violence and fighting. Dr. Ali S. Khan, a professor of epidemiology at the University of Nebraska and former assistant surgeon general, notes that a lack of government health services made the region vulnerable. This is the 17th Ebola outbreak to hit the DRC.
Detection was delayed because initial diagnostic tools only tested for the Zaire ebolavirus, not the Bundibugyo strain. This caused health officials to mistake the virus for other tropical febrile diseases. By the time the Ministry of Health used sophisticated testing to identify the strain, community transmission had already begun.
How does this outbreak differ from previous epidemics?
Unlike the Zaire ebolavirus, the Bundibugyo virus has no licensed vaccines or medicines. This lack of medical countermeasures makes it harder to save lives in healthcare settings and prevents the vaccination of high-risk groups, such as healthcare workers and direct contacts.
Response teams must rely on “boots-on-the-ground” public health. This includes strict case monitoring, humane quarantine of contacts, and ensuring safe, dignified burial practices. However, these efforts are hindered by a lack of trust in government and international partners.
What are the risks of global spread?
Modern travel has outpaced the incubation period of many viruses. Dr. Khan explains that a person could be infected in Bunia, DRC, and arrive in New York City before they even feel sick. This reality makes traditional border lockdowns and port closures ineffective.
Environmental factors are also increasing the risk of “spillover” from animals to humans. Climate change is pushing vectors like rodents, ticks, and mosquitoes into new territories. Furthermore, falling international development aid from the U.S., Germany, and other European nations has weakened the ability of low-income countries to identify these threats early.
What may happen next for vaccine development?
The WHO indicates that vaccines may not arrive for nine months. To accelerate this, Dr. Khan advocates for the adoption of mRNA technology, which allowed COVID-19 vaccines to reach FDA approval in less than nine months.
A possible next step is already underway via the Coalition for Epidemic Preparedness Innovations (CEPI) in Europe, which has invested $10 million into mRNA technology for the Bundibugyo strain. Other efforts may continue using modified classical vaccine methods, though these are generally slower.
The U.S. response could be impacted by its decision to leave the WHO, which may place the government outside the typical coordination loop. Continued disinformation and the erosion of public health authorities could further weaken the ability to respond to future pandemics.
Frequently Asked Questions
What are the primary symptoms of this outbreak?
Initial symptoms include fever, headache, and muscle aches, which often mimic malaria.
How many cases have been confirmed as of June 6?
There have been 515 confirmed cases and 91 deaths in the DRC, and 19 confirmed cases with two deaths in Uganda.
Why weren’t vaccines used immediately?
Unlike the Zaire strain, there are currently no licensed vaccines or medicines available for the Bundibugyo virus.
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