Reductions in Funding, Personnel Will Leave US Less Prepared for Future Infectious Disease Outbreaks

This is part of a series about high-consequence infectious diseases and the ongoing Hantavirus cluster associated with cruise ship travel and the Ebola outbreak in Africa. Clinicians with experience in these areas as well as public health policy include discussions around quarantines, monitoring protocols, treatment, and the significance of biopreparedness.

Americans Impacted by Hantavirus and Ebola

In the last several weeks, the world has become much more aware of the Hantavirus and a rare strain of Ebola. This spring, onboard the Dutch cruise ship, MV Hondius, several people were sickened with the Andes strain of the Hantavirus. In fact, 2 American cruise passengers were transferred to Emory University Hospital’s Serious Communicable Diseases Unit. One patient, who was experiencing symptoms, was treated in the hospital’s biocontainment unit, and the second patient remained asymptomatic and was kept for observation.¹

A rare strain of Ebola named Bundibugyo has spilled over into 2 countries in Africa. As of June 10, there have been 676 cases of Ebola, 136 patients hospitalized in isolation, and 136 deaths in the Democratic Republic of Congo (DRC). In Uganda, there were 19 cases and 2 confirmed deaths reported. ²

An American physician who was working in Africa contracted Ebola and he and his family were flown to Germany, where he was successfully treated and his family was observed in isolation.

In the face of these ongoing health crises, the current Health and Human Services (HHS) leadership and the Trump Administration has slashed funding, personnel, and biosurveillance and are not keeping the country prepared to deal with Ebola, Hantavirus, or any other outbreaks of high-consequence infectious disease.

The Trump administration withdrew funding from the World Health Organization (WHO), completely did away with the US Agency for International Development (USAID), and reduced essential personnel to the Centers for Disease Control and Prevention (CDC). It is also looking at reducing the total health aid it gives to DRC and Uganda.⁴

“There is absolutely very little concern about the public health of our country and protection against infectious diseases,” said Jason M. Goldman, MD, MACP, immediate past president of the American College of Physicians (ACP).

Lack of Reporting and Transparency

What is remarkable in searching for information on both Hantavirus and Ebola, it’s not the CDC that is the most commonly cited resource, but the WHO and European Centers for Disease Control and Prevention. Even without the US funding of the WHO, the organization has taken the lead in reporting cases and keeping the world informed about the Hantavirus cluster and Ebola outbreak. A role the US would have done in the past.

“We need a CDC that is fully funded, staffed, and functional, because it should be the repository of the information; it should be the guidance; it should issue the recommendations, so that we as physicians have that information and know how to treat our patients—both on an individual patient level, but also on a public health level—so we know what to expect and how to best inform and advise our patients,” Goldman said.

Existing Infrastructure, Personnel in Place

Fortunately, the US has infrastructure in place that predates the current administration and public health leadership. Despite the cuts being inflicted on biopreparedness budgets, programs and personnel today, there are existing protocols and specialized centers with trained medical personnel who are able to help Americans during the current HCID situations.

For example, 18 American passengers from the cruise ship linked to the Hantavirus cluster returned to the US and were monitored in specialized medical units. Sixteen passengers, including 1 who tested positive for the virus, were at the University of Nebraska Medical Center (UNMC), and 2 cruise passengers were treated at Emory.

At UNMC, these individuals were observed in the National Quarantine Unit (NQU), which is housed inside the Dr. Edwin G. & Dorothy Balbach Davis Global Center. The NQU is the only federally funded quarantine unit in the United States, designed specifically to house and monitor people who may have been exposed to high-consequence infectious diseases. Mark Rupp, MD, executive vice chair, UNMC Department of Internal Medicine, professor, UNMC Division of Infectious Diseases, explains the facilities are comfortable for patients, and include Wifi and exercise equipment. And they are engineered to be protective of the unit’s environment.

“It has negative pressure air-handling. All of the air in the hallway is sucked back into the patient rooms. It is passed through a HEPA filter before it gets exhausted to the outdoors. It does not mix with air for any other person within that building,” Rupp said in a previous interview with Contagion.

HCID Response Centers

Back in 2015, the Administration for Strategic Preparedness and Response (ASPR) established these programs to respond to HCIDs. These include the National Emerging Special Pathogens Training and Education Center, the National Special Pathogen System (NSPS), and the Regional Emerging Special Pathogen Treatment Centers (RESPTCs).⁵

There are 13 RESPTCs across the US responsible for building regional preparedness for HCID events. These centers interact and coordinate training with local and regional hospitals to aid them in dealing with individuals. One such unit is the University of North Carolina’s Special Pathogens Response Center (SPARC).⁵

In a previous interview with Contagion, William A. Fischer II, MD, director of emerging pathogens at (UNC)’s Institute for Global Health and Infectious Diseases (IGHID), spoke about the trainings that they conducted last year in preparation for the World Cup.

“We lead regional trainings to better prepare other health care facilities, because we're trying to make sure that anywhere a patient can present, they are prepared to identify and initiate safe delivery of care and then transfer that individual to a regional treatment center,” Fischer said.

Part of the training is to ensure any necessary quarantining of individuals is done in a way that minimizes the risk to the greater public. These national readiness exercises were named Tranquil Passport and were led by ASPR, and they tested a coordinated national response to an HCID scenario.⁶

Patchwork Outbreak Responses

According to ABC News, the CDC sent out an internal memo asking for people to help screen air travelers from Central Africa.⁷ The federal government’s decision to downsize the CDC left it scrambling. In addition, the CDC is trying to make a rule permanent giving it the ability to bar US entry to anyone, including legal permanent residents (LPR), during outbreaks.

“Restricting entry of LPRs, in addition to other non-US citizens, who originate from or have recently traveled through DRC, Uganda, and South Sudan would reduce the volume of higher-risk international arrivals requiring public health monitoring and follow-up. Limiting the number of potentially exposed travelers entering through major US ports of entry, federal, state, and local public health authorities could concentrate finite surveillance, screening, contact tracing, quarantine management, and medical monitoring resources on returning US citizens,” as written in the Federal Register.

Additionally, the US is building a medical unit in Kenya to address new potential Ebola cases. However, there are concerns from the US medical community around this approach.

“It raises serious questions about resources, timing and the level of care Americans sent there will receive. At a time when this outbreak is already challenging to contain, decisions should be guided by science, transparency and what is best for patients and public health. Americans facing exposure to a deadly disease deserve confidence that decisions about their care are being driven by evidence, preparedness and patient safety during an active outbreak,” Ronald G. Nahass, MD, MHCM, FIDSA, president, Infectious Diseases Society of America (IDSA), said in a statement.³

This type of patchwork approach to biopreparedness could lead to missteps in patient care and public health responses. In speaking to clinicians who have been involved in preparedness, there is extensive training that needs to be revisited on a regular basis to ensure teams are ready to receive those who may have HCID and need specialized care.

Goldman notes the old Benjamin Franklin expression, "By failing to prepare, you are preparing to fail."

“If you don't have that infrastructure, you're giving the advantage to the infectious disease,” said Goldman. “It's not just the bench research in the laboratory; it's not just doing studies; it's also having teams able to go to those areas to be able to do onsite evaluations, see where the disease is coming from, see how it's spreading, and see how to try and contain it.”

The bottom line is Americans are affected by these high-consequence infectious diseases today and will be in the future. And as we know, COVID-19 started outside the US and became global. HCIDs are a plane ride away, and certainly with the World Cup here in North America, there are people flying from all over the world over the next month to watch the games. The question becomes will the US stay prepared for future outbreaks when federal policies don’t support biopreparedness initiatives?

References
1. Emory University Hospital receives two passengers following Hantavirus outbreak on cruise ship. Press release. Emory Healthcare. May 12, 2026. Accessed May 28, 2026.
https://www.emoryhealthcare.org/newsroom/2026/05/emory-healthcare-receives-two-passengers-following-hantavirus-outbreak-on-cruise-ship
2. Ebola disease outbreak in the Democratic Republic of the Congo and Uganda. European Centre for Disease Prevention and Control. June 12, 2026. Accessed June 13, 2026.
https://www.ecdc.europa.eu/en/ebola-outbreak-democratic-republic-congo-and-uganda
3. Statement on decision to send Americans exposed to Ebola to Kenya. IDSA statement. May 28, 2026. Accessed June 13, 2026.
4. Kent L, Hensler J. US funding cuts have hampered response to the deadly Ebola crisis, aid workers say. CNN. May 22,2026. Accessed June 13, 2026. https://www.cnn.com/2026/05/22/africa/ebola-us-aid-cuts-drc-uganda-intl
5. Tranquil Exercise Series Background. ASPR. Accessed June 14,2026.
https://aspr.hhs.gov/Tranquil-Passport/Pages/background.aspx
6. Tranquil Passport: testing the nation’s special pathogen readiness ahead of the FIFA World Cup. National Emerging Special Pathogens Training & Education Center. July 2, 2025. Accessed August 26, 2025. https://netec.org/2025/07/02/tranquil-passport-testing-the-nations-special-pathogen-readiness-ahead-of-the-fifa-world-cup/
7. Benadjoud Y et al. CDC asks staff to volunteer to help with Ebola screenings at airports amid DRC outbreak. May 27, 2026. Accessed June 13, 2026. https://abcnews.com/International/ebola-outbreak-risks-becoming-deadliest-record-irc-warns/story