#18,208
Given the spread of the Ebola Bundibugyo outbreak in the DRC and Uganda - and the aggressive estimates of its potential current and future size - the expectation is that at some point we could see sporadic exported cases to other parts of the world.
Earlier this week Hong Kong held an interdepartmental Ebola response exercise (see photo below), for that very reason.
While these cases could turn up anywhere - given current travel patterns - countries of the EU/EEA appear to be at highest risk outside of Africa. Today the ECDC has published ebola preparedness and response guidance for EU/EEA member nations.
Preparedness and response for imported cases of Ebola disease into an EU/EEA country
Operational support
18 June 2026
This operational checklist presents an overview of health preparedness and response planning elements for the potential importation of a case of Ebola disease into a European Union/European Economic Area (EU/EEA) Member State health system.
The current Ebola disease outbreak caused by Bundibugyo virus (BDBV) in the Democratic Republic of the Congo (DRC) and Uganda, which has been ongoing since May 2026, poses significant challenges due to its magnitude and to the complex setting. On 17 May 2026, the outbreak was elevated to a Public Health Emergency of International Concern (PHEIC).
As of today’s date, the overall risk of Ebola disease caused by BDBV for the general population in the EU/EEA is assessed as very low. The importation risk is estimated by ECDC to be approximately one importation per 24 000 travellers (90% Uncertainty Interval, UI: 13 000–54 000) from the main outbreak region (North Kivu and Ituri, DRC) to the EU/EEA, with a low probability. Nevertheless, it is important to be prepared for every eventuality, given the severity of Ebola disease.
This document is organised into four focus areas, representing the potential health system contact points of an imported Ebola disease case. All four areas must operate effectively and in coordination with public health services to prevent further community transmission.
Publication file
Preparedness and response for imported cases of Ebola disease into an EU/EEA country English (1.32 MB - PDF)
Due to its size (n=21 pages), I've only posted a couple of screenshots below. Follow the link to download the full report. I'll have a bit more after the break.
In the fall of 2014, during the West African Ebola outbreak, the United States saw its first Ebola transmission event at a Dallas Hospital, where a recent traveller from Liberia was treated for a fever.
The details are laid out in the CDC MMWR report Ebola Virus Disease Cluster in the United States — Dallas County, Texas, 2014 November 14, 2014 and numerous contemporary AFD blog posts (see here, here, here, and here).
The MMWR described the contact tracing process:
Initial tracing of potentially exposed contacts (i.e., "contact tracing") identified 48 close, unprotected contacts (i.e., had exposure to the patient, a potentially contaminated environment, or patient specimens without minimum recommended personal protective equipment [PPE]). Of the 48 contacts, 17 were persons within the community with exposure to the patient before he was admitted to the hospital and while he was symptomatic, 10 were persons who had been transported in the same ambulance that had transported the patient before it was completely cleaned and disinfected, and 21 were health care workers (HCWs) with potential exposures to body fluid without the protection of complete PPE. Beginning October 1, all 48 contacts underwent direct active monitoring (one in-person and one telephone follow-up per day to check for fever or symptoms of Ebola) for 21 days (the upper limit of the Ebola incubation period) from their last exposure date; six close community contacts were quarantined. Patient 1 died on October 8.
On October 11, a nurse (patient 2) previously involved in direct care of patient 1 developed fever (100.6°F [38.1°C]) and sore throat; she was confirmed to have Ebola by real-time PCR later that day. On October 14, a second nurse (patient 3) with similar exposure had a fever (100.5°F [38.1°C]) and rash and was confirmed to have Ebola by real-time PCR on October 15. Before her diagnosis, patient 3 had visited Ohio during October 10–13 (3). Contact tracing of patients 2 and 3 identified three household contacts of the two patients. Additional community contacts of patient 3 were identified from the Ohio visit and have been described (3).
Somewhat reassuringly, out of nearly 50 `close contacts' of the index patient, only 2 were infected. And thanks to proactive contact tracing, and daily monitoring, a larger outbreak was averted.
Despite this positive outcome, the U.S. response wasn't without its problems (see Nurses Claim Lack Of Safety Protocols For Dealing With Ebola), which included repeated poor risk communications, and which required some mid-course corrections (see NIH: `More Stringent’ PPE Standards For Ebola On The Way).
But out of this initial chaos, new protocols were developed (see HHS Launches National Ebola Training & Education Center) and we became better prepared for dealing with High Consequence Infectious Diseases (HCIDs).
Assuming we remember the lessons of 2014, we should now be in a much better position to deal with imported cases than we were a dozen years ago.
At least, that's the hope.
