Understanding the Ongoing Ebola Outbreak

This is part of a short series around high-consequence infectious diseases and the ongoing Hantavirus cluster associated with the cruise ship and the Ebola outbreak in Africa. The discussions with clinicians with experience in these areas will include dealing with quarantines, monitoring protocols, and the significance of biopreparedness in the face of these ongoing health crises and a reduced US infectious disease healthcare budget.

As of May 19, there has been a reported 531 people infected with Ebola, and 131 deaths associated with the outbreak, according to health authorities in Africa.¹ This outbreak involves the Bundibugyo virus disease (BVD). According to the World Health Organization (WHO), the case fatality rates in the past 2 BVD outbreaks have ranged from 30% to 50%, and there are no licensed vaccines or specific therapeutics against it. Nonetheless, some reporting shows that early supportive care is lifesaving for patients of the current outbreak.²

This current outbreak strain is different from the previously well-known Ebola Zaire virus, according to David Wohl, MD, professor of medicine in the Division of Infectious Diseases at UNC. That Zaire strain was associated with the West Africa Ebola outbreak of 2014 to 2016 that infected more than 28,600 people and over 11,000 died as a result.³ Wohl says this virus is not completely novel, but does not appear often.

“It's not completely new or unexpected, but it's not necessarily something that you think of first with an outbreak of Ebola more recently…This does seem to cause a little bit different disease than Ebola Zaire, and in that way, it causes a slower paced disease. It can still get people really sick, as we're seeing right now in Uganda, and the DRC [Democratic Republic of the Congo],” he said.

Wohl has experience being in hot zones in Africa working as a clinician treating high-consequence infectious diseases, and says exposure to Ebola has a standard quarantine period. For this ongoing outbreak, 1 American named Peter Stafford, MD, tested positive for Ebola, according to the international missionary organization Serge. He and the few other Americans who were exposed to the virus will be flown to an American military base in Germany for treatment and observation.¹

“What happens when you have someone who has an exposure, let's say a clinician who is examining a patient or doing a surgery or delivering a baby, those people who've been exposed are monitored for any signs or symptoms of having infection. So they're watched—mostly clinically to determine whether or not they become infected,” Wohl said. “And we think the incubation period of around 21 days is sufficient to monitor folks. So those folks would be quarantined.”

In terms of transmissibility, Wohl points out the potential differences of the Hantavirus and Ebola, while acknowledging this is more theoretical than definitive fact.

“With Ebola, as opposed to hantavirus, we think that you don't really get enough virus to transmit to other people until you become symptomatic,” Wohl said. “And that's not an ironclad rule, it's a principle that we believe based upon epidemiology and some other types of data, but I wouldn't bet the farm on it. But I would be less worried about someone who said, ‘well, you know, a few days ago I was interacting with someone who five days later became symptomatic.’ I wouldn't be too concerned about that person being exposed to Ebola,” Wohl said. “Ebola requires closer contact than something like Hantavirus, but with Hantavirus, there are data that people can have the virus in their blood days before they become symptomatic, so again, there may be a window period when you're shedding and not symptomatic, and we all discussed this with COVID, too. Remember that people could become infectious before they get sick and even test positive. So, with Ebola, probably less likely, but certainly a concern.”

Although individual cases of Ebola could come to the US—as it has in the past—Wohl is not as concerned about an outbreak happening here.

“The circumstances by which Ebola spreads in Africa are very different than how it could spread here. We just don't have the same sort of vulnerability due to our healthcare infrastructure, public health, etc.,” Wohl said. “But I do think it affects the world; it affects economies; it affects regional security. There's a lot going on in these different parts of the world. We don't want to see this kind of instability caused by disease. So, I think getting it under control helps people in the areas that are affected, and it helps us. So, we want to be able to stop outbreaks where they are emanating from, and that's a win-win I think for everyone.”

Look for the next episode in the series where Wohl discusses the Hantavirus including treatment considerations and how person-to-person transmission happens.

References

1.Smith A and Williams A. Ebola deaths rise sharply as outbreak’s ‘scale and speed’ worry WHO chief. Accessed May 20, 2026.
https://www.nbcnews.com/world/africa/ebola-outbreak-deaths-rise-scale-speed-concerns-who-congo-uganda-rcna345833

2. Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda. WHO. May 16, 2026. Accessed May 20, 2026.
https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON602

3.West Africa Ebola outbreak of 2014 to 2016. WHO. Accessed May 20, 2026.
https://www.who.int/emergencies/situations/ebola-outbreak-2014-2016-West-Africa