Why the new Ebola outbreak has put global health experts on alert again

For many people, Ebola feels like a disease from another continent and another crisis. It appears in headlines for a few days, brings back memories of hazmat suits and emergency briefings, and then slowly fades from public attention. But health experts say the latest outbreak linked to the rare Bundibugyo strain is different for one important reason: it exposes how fragile global disease surveillance still remains, even after the world lived through Covid-19.The World Health Organisation’s decision to declare the outbreak in Congo and Uganda a Public Health Emergency of International Concern (PHEIC) has pushed Ebola back into global focus. The numbers may still appear small on paper, with eight laboratory-confirmed cases reported so far, but experts fear the real spread may be wider. More than 80 suspected deaths are still being investigated in affected areas, according to international health agencies.What makes this outbreak especially concerning is not just the virus itself, but the warning it carries. Infectious diseases no longer stay confined to one border, one country, or one health system. A delayed response in one region can quickly become a global challenge.The Ebola virus is not a single uniform disease. It exists in multiple strains, and each behaves differently in terms of severity, transmission, and treatment response. The current outbreak involves the Bundibugyo strain, one of the rarer forms of Ebola that has historically appeared far less frequently than the Zaire strain responsible for the devastating West Africa outbreak between 2014 and 2016.Dr Rohit Garg, Infectious Disease Specialist at Amrita Hospital, Faridabad, explains why this matters.“The Bundibugyo strain is less common than the Zaire strain, which caused the devastating West Africa outbreak a decade ago. One of the major concerns globally is that there is currently no approved vaccine specifically available for this strain.”That single detail changes the global response strategy. Vaccines developed during earlier Ebola outbreaks were primarily targeted against the Zaire strain. While those vaccines transformed outbreak control in recent years, they may not offer reliable protection against Bundibugyo.Scientists are now racing to study how this strain behaves, how quickly it spreads, and whether existing therapies can still reduce fatalities. The concern is not that Ebola has suddenly become airborne or unstoppable. The concern is that the world is once again facing a dangerous virus without a fully prepared defense system.According to the World Health Organization’s Ebola fact sheet, Ebola outbreaks can carry fatality rates ranging from 25% to nearly 90%, depending on the strain and access to treatment.One of the biggest misconceptions surrounding Ebola is the fear that it spreads through the air like influenza or coronavirus. Experts say that is not true.“Ebola is exclusively transmitted through the contact route, unlike influenza or Covid-19 where viruses can spread through airborne transmission as well,” explained Dr Garg. “Transmission typically occurs through direct contact with infected blood, body fluids, contaminated medical equipment, or unsafe caregiving and burial practices.”That means infection usually happens through close physical exposure. Family caregivers, healthcare workers, and communities handling patients without protective equipment often become the most vulnerable.But while Ebola may not spread as easily through casual contact, it can move rapidly in places where healthcare systems are already weak. In overcrowded hospitals, refugee settlements, conflict zones, or remote mining regions with poor sanitation, even small outbreaks can spiral quickly.The current outbreak is believed to have originated in the mining areas of eastern Congo before spreading across vulnerable border regions. Public health officials suspect the virus circulated silently for weeks before it was identified.That silent transmission window is what alarms epidemiologists most. By the time symptoms become visible at scale, the virus may already have crossed districts, borders, and healthcare facilities.The US Centers for Disease Control and Prevention (CDC) Ebola resource page notes that symptoms can initially resemble common viral illnesses, including fever, weakness, headache, vomiting, and muscle pain, making early detection difficult in regions with limited testing access. During almost every major Ebola outbreak in history, healthcare workers have carried an enormous burden. Doctors, nurses, ambulance staff, and caregivers often become infected while trying to save others.The current outbreak is already showing similar warning signs.“One of the biggest concerns in the current outbreak is the infection of healthcare workers,” said Dr Garg. “This raises concerns regarding healthcare-associated transmission, gaps in infection prevention and control measures, and the potential for amplification within health facilities.”When healthcare workers become infected, the consequences go beyond individual cases. Entire hospital systems can slow down. Fear spreads among staff. Patients stop seeking treatment. Routine care for childbirth, surgeries, vaccinations, and chronic diseases may also suffer.This was one of the harshest lessons from earlier Ebola crises. In some regions, more people died from disrupted healthcare services than from the virus itself.The Democratic Republic of Congo has faced repeated Ebola outbreaks since the virus was first discovered near the Ebola River in 1976. But experts say repeated outbreaks do not automatically make future outbreaks easier to manage. Armed conflict, mass displacement, mistrust in authorities, and weak sanitation systems continue to undermine response efforts.At the moment, health experts stress that there is no immediate reason for panic in India. Ebola is not spreading widely across countries, and no global pandemic emergency has been declared.Still, preparedness matters.“India’s disease surveillance systems, laboratory capabilities and airport screening infrastructure are significantly stronger today than they were in previous decades,” said Dr Garg. “However, in an interconnected world, infectious diseases can no longer be viewed as isolated regional problems.”Global travel has changed how outbreaks behave. A person carrying symptoms can cross continents within hours. Even if a virus does not establish widespread transmission in another country, imported cases can still test emergency systems.Hospitals are therefore being advised to remain alert, especially while evaluating patients with unexplained fever, bleeding symptoms, or recent travel history from affected African regions.India strengthened several public health systems after Covid-19, including airport screening, genomic surveillance, laboratory networks, and emergency coordination. But experts say the true test of preparedness lies in speed: how quickly a country can detect, isolate, trace, and respond before infections spread further. The deeper concern surrounding this outbreak is not only Ebola itself. It is the pattern the world keeps repeating.A virus emerges in a medically vulnerable region. Early warning signs are missed. Surveillance struggles to keep pace. Health workers become overwhelmed. International attention arrives only after the outbreak grows.Then comes the scramble.“The Covid-19 pandemic fundamentally changed how the world views outbreaks,” Dr. Garg said. “Infectious diseases anywhere can rapidly become concerns everywhere. Transparency in reporting, investment in public health infrastructure, rapid diagnostics and international cooperation are no longer optional — they are central to global health security.”That may be the most important lesson from the current outbreak. Ebola is not just a story about one virus in one part of Africa. It is a reminder that global health security is only as strong as the weakest healthcare system in the chain.The WHO has clarified that the current outbreak does not qualify as a pandemic emergency. However, the PHEIC declaration is meant to strengthen international coordination, improve surveillance, speed up containment, and prevent the outbreak from expanding further.In public health, delays often become disasters. And sometimes, the earliest warnings are the ones the world regrets ignoring later.Medical experts consultedThis article includes expert inputs shared with TOI Health by:Dr Rohit Garg, Infectious Disease Specialist, Amrita Hospital, Faridabad.Inputs were used to explain why the latest Ebola outbreak involving the rare Bundibugyo strain has raised serious global health concerns, and why experts say stronger surveillance, faster detection and public health preparedness are critical to preventing wider spread.