JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – July 27, 2026 -EBOLA
“Around 60% of known infectious diseases in humans are zoonotic (diseases that are transmitted between animals and people), and up to 75% of new and emerging infectious diseases have animal origins, mostly from wildlife. Nearly all WHO Public Health Emergencies of International Concern have been caused by diseases of animal origin: H1N1 (2009), Ebola (2014), Zika (2016), Ebola (2019), COVID-19 (2020), Mpox (2022 and 2024), and now this 2026 Ebola outbreak, which is spreading across the region at an alarming pace and scale.”
“This current outbreak is particularly concerning because this strain of Ebola (Bundibugyo) has no approved vaccine or therapeutics, and available diagnostic tests often fail to detect it. This means case numbers are very likely underestimated, and the true scale of transmission is uncertain. The ongoing humanitarian crisis in the region, high population mobility, including urban spread, and confirmed cross-border transmission create the perfect conditions for quick escalation. Ebola has devastating consequences once it infects people, with previous outbreaks recording case fatality rates ranging from approximately 30% to 66%, underscoring the importance of preventing spillover before it occurs.’”
“Fruit bats are one of the natural reservoir hosts, meaning they can carry the virus long term without becoming sick themselves. But it’s not just bats: Great apes, monkeys, duikers, chevrotains, pangolins, and other species are intermediate hosts, meaning they can carry and pass the virus on to humans.
It’s no coincidence that many of these species are also commonly hunted, traded, and sold in bushmeat and wildlife markets across Central and West Africa. Recent research by my organization, World Animal Protection, documented the pangolin trade on TikTok in West Africa and highlights how wildlife trade networks are increasingly operating both in physical markets and online, expanding opportunities for zoonotic disease spread. People who handle or eat the bushmeat can become infected through direct contact with the blood, bodily fluids, or tissues of infected animals, with the virus spreading through communities, person-to-person.
The risks are man-made and wholly preventable. When wild animals are captured, transported, confined, and slaughtered under stressful and inhumane conditions, we create the perfect storm for disease. At every stage of the trade chain, from capture and transport to sale and slaughter, wild animals are exposed to stress, injury, deprivation, and close confinement with other species they would rarely encounter in the wild. This weakens animals’ immune systems and increases opportunities for pathogens to spread between species, including to humans.” (1)
“The number of confirmed Ebola cases in the Democratic Republic of Congo has increased to 3,200, including 1,405 deaths, government data showed on Sunday.” (2)
“The popular excuse is that aid cuts compromised surveillance systems and delayed detection. Then there are challenging field conditions in a large region with poor infrastructure, experiencing prolonged civil conflict, and chaotic population displacement. Also, socio-cultural resistance and mistrust of health workers, and lack of a specific vaccine against the Bundibugyo strain.
Is that sufficient justification? Many comparable factors were also present in the 2014-2016 West African outbreak that so far remains the largest to date, with 29,000 cases and 12,000 deaths. As an advisor in West Africa for the International Medical Corps (IMC), I experienced that epidemic directly on the ground – and equally noteworthy the delayed and incompetent WHO response. Bringing the epidemic under control ultimately required military assets from the US, UK, and France, and UN leadership superseding the WHO.
That episode posed an existential threat to WHO – as the world debated whether health emergency management should be taken away from the Organization to a new body. Fortunately, sense prevailed with the WHO reforms born out of the West African catastrophe. They included a beefed-up Health Emergencies Programme with new systems and a new Contingency Fund for Emergencies – as well as the birthing of a new, and assertive Africa Centres for Disease Control (CDC) to lead the continent’s public health challenges.
Following the Covid-19 pandemic, WHO’s International Health Regulations governing member states response to health emergencies were revised and in 2025 a Pandemic Agreement was approved by the World Health Assembly.
Ebola continues to spread in eastern regions of the Democratic Republic of Congo.
The question – unanswered so far – is why these new capacities, protocols, procedures, and partnerships are not making for a more effective showing in Congo? Is it because the post-2016 reforms are not being applied by a hollowed-out WHO, or are they irrelevant to Congo’s unforgiving realities?
Or is it that the joint Africa CDC and WHO Ebola response plan launched with much fanfare in early June has diffused leadership and accountability between Geneva and Addis? When two bodies declare the same emergency, share one under-filled budget, and apportion the command-and-control of a fast-moving crisis, where do you address concerns over a faltering response?
Post-outbreak evaluations will, no doubt, provide answers. But such exercises often say more about how to win past battles than tackling future ones. Meanwhile, immediate improvements to Ebola management in Congo cannot wait.” (3)
“Much has changed in the town since then. Uganda has developed a global reputation for its efficiency in containing infectious diseases, including H.I.V., Covid-19 and Ebola. While the disease is raging through communities in Congo, Uganda appears to have it under control.
There have been 20 confirmed Ebola cases in Uganda thus far, but the country has not registered a new case in more than a month. Fifteen of those patients came across the border, some to seek treatment in Ugandan hospitals. Aside from two patients who died, the rest have recovered. The others were quarantined and released, the authorities said this month. Bundibugyo has not recorded a single infection in this outbreak.
“They know how to handle it,” said Dr. Wessam Mankoula, who leads the country’s Ebola response unit at the Africa Centers for Disease Control and Prevention, referring to Ugandan health officials.” (4)
This year’s Ebola outbreak has spread faster than the worst on record, By CHINEDU ASADU, https://abcnews.com/Health/wireStory/numbers-years-ebola-outbreak-spread-faster-worst-record-135022178
“While Congolese officials say the sharp rise in cases appears to be slowing, they caution the outbreak has not yet peaked. The latest report by the country’s public health institute says transmission remains sustained, with recent fluctuations in cases likely influenced by reporting delays and ongoing data consolidation.
Contact tracing continues to lag, with only around 77% of known contacts monitored nationwide, well below the 95% target health officials say is needed to interrupt transmission.
Responders are struggling to understand how far the Ebola outbreak has spread and how much worse it might become.
U.S. Centers for Disease Control and Prevention researchers last month used computer modeling and found that in a worst-case scenario, the current Ebola outbreak could approach the worst in history.
The West Africa epidemic in 2014-2016 caused more than 11,000 deaths and took about eight months from the first case to reach 1,000 deaths.
The new outbreak’s origin is still a medical mystery. The vast majority of cases are emerging from unknown chains of transmission, the World Health Organization said.
The WHO continues to assess the risk from the outbreak as “very high” inside Congo and “high” in Uganda and neighboring countries, citing cross-border spread, frequent population movement and ongoing transmission in eastern Congo.” (5)
“Fourteen American travelers were quarantined at Fort Drum last week after returning from the Democratic Republic of Congo, where an Ebola outbreak is underway, according to published reports and 10th Mountain Division officials.
Officials said the travelers never showed any symptoms of Ebola and were not considered a risk of transmitting the disease.
The travelers flew from the Democratic Republic of Congo into Canada and attempted to enter the United States through border crossings in New York and Vermont. They were stopped at those crossings on Thursday and spent that night at the Vermont border crossing before being transported to Fort Drum on Friday.
At Fort Drum, the travelers were housed in apartment-style quarters and placed under observation by officials from the Centers for Disease Control and Prevention. They were released Monday and have since left the area by bus and plane.” (6)
‘There’s no salary’: DRC health workers tell of hardship as Ebola spreads, https://www.aljazeera.com/features/2026/7/24/theres-no-salary-drc-health-workers-tell-of-hardship-as-ebola-spreads
“No One Knows When It Will End”: A Doctor on the Ebola Emergency, https://www.newyorker.com/news/as-told-to/no-one-knows-when-it-will-end-a-doctor-on-the-ebola-emergency
By the Numbers: This year’s Ebola outbreak has spread faster than the worst on record, https://apnews.com/article/congo-ebola-virus-bundibugyo-toll-outbreak-3fd6e1785afac22bb848dbc39f52a77b
WHO Introduces Ebola Test, Launches Treatment Trial, https://www.medscape.com/viewarticle/who-introduces-ebola-test-launches-treatment-trial-2026a1000pac
More health workers strike as Ebola cases in Congo near 3,000, including over 1,300 deaths, https://www.rfi.fr/en/africa/20260725-more-health-workers-strike-as-ebola-cases-in-congo-near-3-000-including-over-1-300-deaths
“Four distinctively different illnesses have each made lots of headlines this summer: a hantavirus outbreak among passengers on a cruise ship that left folks adrift at sea for extra days and then sent some to quarantine; a measles outbreak that has featured Utah in a starring role; a nasty parasite-caused intestinal illness called cyclosporiasis that’s likely from fresh produce and an Ebola outbreak in the Democratic Republic of Congo that has killed more than 1,000 people and infected visitors from different countries.” (7)
1.It’s Not Like We Just Failed to Stop Ebola. We Caused It, by Monica List, https://www.zmescience.com/medicine/its-not-like-we-just-failed-to-stop-ebola-we-caused-it/
2.Congo Says Number of Confirmed Ebola Cases Rises to 3,200, Including 1,405 Deaths, By Reuters, https://www.usnews.com/news/world/articles/2026-07-26/congo-says-number-of-confirmed-ebola-cases-rises-to-3-200-including-1-405-deaths
3.Markets Offer Costly Cures while Courts Ensnare Prevention; meanwhile Ebola Response Stumbles, by Mukesh Kapila, https://healthpolicy-watch.news/markets-offer-costly-cures-while-courts-ensnare-prevention-meanwhile-ebola-response-stumbles/
4.A Thin Rope Holds the Line Against Ebola on Uganda’s Border, By Matthew Mpoke Bigg, https://www.nytimes.com/2026/07/26/world/africa/ebola-uganda-congo-border.html?smid=nytcore-ios-share
5.What experts are saying as Ebola outbreak in Congo and Uganda kills more than 1,000 people, By The Associated Press, https://www.wcax.com/2026/07/23/what-experts-are-saying-ebola-outbreak-congo-uganda-kills-more-than-1000-people/
6.14 Americans quarantined at Fort Drum after returning from Ebola outbreak country, By 7 News Staff, https://www.wwnytv.com/2026/07/24/report-14-americans-quarantined-fort-drum-over-ebola-concerns/
7.4 disease outbreaks making people sick this summer, https://www.deseret.com/lifestyle/2026/07/24/disease-outbreak-illnesses-made-headlines-ebola-cyclosporiasis-hantavirus-measles/
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai