Expert: Bundibugyo Ebola strain spreading rapidly, but current U.S. threat is low

BUFFALO, N.Y. - Since the World Health Organization (WHO) declared a public health emergency on Saturday, Ebola cases in the Democratic Republic of Congo and Uganda have surged dramatically. The latest reports indicate more than 600 suspected infections and 139 suspected deaths linked to the virus.

Kelly Baker, PhD, associate professor of epidemiology and environment at the University at Buffalo School of Public Health and Health Professions, is an expert on infectious disease and antimicrobial resistance.

“The outbreak has rapidly spread from Democratic Republic of Congo (DRC) into Uganda and Sudan, says Baker, who also serves as director of the UB Center for Climate Change and Health Equity.

“The good news is that this outbreak was detected early and the WHO, aid sector and Pan-African response has been sudden and as effective as it can be given manpower and resources available to contain the outbreak.”

As a result, she says, the outbreak’s current threat to the U.S. is low. Below, Baker discusses the outbreak, including how it differs from COVID-19, the impact of the U.S. withdrawal from WHO, and how to best protect oneself from infectious diseases such as Ebola.

Spillover would require someone to have unprotected contact with bodily fluids of another infected individual who was recently in the DRC, Sudan, or Uganda, and then travel to the U.S. The most dangerous timeline would be travel within about a week of exposure when the traveler may not show symptoms and may be unaware of infection status. The virus is not transmitted by air, making this a different situation than COVID-19 or the flu. Also, the Democratic Republic of Congo and the Congo are U.S. Department of State Level 4 countries, which while not barring U.S. citizens from travel there, highly discourages that travel and makes it very difficult logistically. It could impact daily life and health for U.S. citizens abroad in DRC, Sudan, and Uganda.

The outbreak has rapidly spread, including spillover into Uganda, which receives more international visitors than Democratic Republic of Congo or Sudan. Africa Centres for Disease Control and Prevention and WHO suspect that there may be undetected cases that could have traveled to other neighboring nations. Many of the communities impacted by the virus are also in remote locations, making case detection and source tracking very difficult.

The future risk to the U.S. depends a great deal upon how successful African nations and international aid agencies are at detecting and quarantining cases. With the elimination of USAID [United States Agency for International Development] and the U.S. withdrawal from the World Health Organization, many of those nations now lack sufficient resources to detect and respond to the growing number of cases as rapidly and effectively as we would like. While many resources are being directed towards containing this outbreak, the gap left by U.S. government aid will make a difference in the effectiveness of that response and ergo the future risk that Ebola will be imported into the U.S. or affect U.S. citizens abroad.

The good news is that this outbreak was detected early and the WHO, aid sector and Pan-African response has been sudden and as effective as it can be given manpower and resources available to contain the outbreak. The U.S. public health and medical sectors are on alert and, if the outbreak widens, travelers from central Africa should expect enhanced surveillance at points of entry into the U.S. The U.S. has world-class clinical facilities capable of quarantining and treating any cases, should they occur.

Steps to minimize bringing Ebola into the U.S. include avoiding travel to the affected regions and if you are among the small number of people likely to be exposed, monitoring symptoms and voluntarily self-quarantining and monitoring symptoms for at least a week to protect family, friends, and community members should worsen your symptoms. And, as a general principle for prevention of most horrible infections, washing your hands after touching bodily fluids or public surfaces with soap and water before touching your eyes, mouth, nose, or genitals is always recommended.