Monday, June 22, 2026

Looking at the data since 1976: low risk of global spread of Ebola disease

Most effective strategy to reduce exportation of cases: local, community-based case management, infection prevention and control at the outbreak source

European Centre for Disease Prevention and Control (ECDC)

Confirmed cases of Ebola disease exported outside Africa, 1976–May 2026 (n = 28) — image:
Since 1976, the authors idnetified 28 confirmed Ebola disease cases outside Africa: 25 primary imported cases and three secondary cases infected by another patient in the United States (US) or Europe.
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Credit: Eurosurveillance

In previous Ebola disease outbreaks in Africa as well as the current outbreak of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo, immediate neighbouring countries are most affected when it comes to cross-border spread. As decision-makers outside Africa may be considering border and travel policies to interrupt pathways for international transmission, van Zandvoort et al. identified and analysed all known Ebola disease cases outside Africa to assess the risk of undetected Orthoebolavirus transmission outside Africa and to put it into context with possible border and travel policies. [1]

The authors searched for all laboratory-confirmed Ebola disease cases that presented outside of Africa since 1976 to date across scientific articles, public health bulletins and news reports including cases due to Bundibugyo, Ebola and Sudan virus outside Africa with exposure in Africa and subsequent travel outside the continent, as well as cases with exposure outside Africa.

Two types of exported cases: medical evacuation and latent
In total, the search yielded 28 identified confirmed Ebola disease cases outside Africa during the period 1976 to May 2026 with 25 primary imported cases and three secondary cases infected by another patient in the United States (US) or Europe.

The analysis distinguishes between two types of primary exported cases. On the one hand the analysis included people who were medically evacuated, i.e. securely transported by air ambulance for treatment outside Africa following a confirmed infection. On the other hand, latent cases were defined as people who developed symptoms during or after their return from the outbreak region on a commercial flight. While the first group represents a known risk with the possibility to mitigate transmission risk with strict measures, the second group requires diagnosis and isolation.

Most of the identified cases (27) occurred during the 2014–16 Ebola virus epidemic in Western Africa and one during the ongoing 2026 Bundibugyo virus outbreak. The authors detected four latent cases, all of which were exported during the 2014–16 Ebola disease epidemic. These four cases were among 300,000 travellers who underwent screening at the time. However, all four were asymptomatic (and hence undetectable) at the point of both exit screening and entry screening. Three were returning healthcare workers responding to the epidemic and one had helped a pregnant person obtaining medical assistance.

Low overall risk of exportation
Based on these data, according to van Zandvoort et al., the crude overall risk since the year 2000 was 0.17 Ebola disease cases outside Africa per 1,000 reported cases in Africa (excluding medically evacuated cases). The authors conclude “our results suggest overall that the risk of case exportations is low and could be substantially mitigated by infection prevention measures at the outbreak source and among outbreak response workers, in concert with enhanced travel screening and monitoring for returning response workers, as recommended in WHO border and travel guidance for the current outbreak.

The authors thus have the view that “as exit screening in an outbreak-affected country aims to reduce case importations in other countries, it is a shared international responsibility. This may be best supported by strengthening local capacity for such screening.”

----Ends----

References/notes to editors:
[1] van Zandvoort Kevin, Procter Simon R, Azam James, Sherratt Katharine, Davies Nicholas G. The risk of global Ebola virus spread is low: epidemiology of Ebola disease cases outside Africa, 1976 to May 2026. Euro Surveill. 2026;31(24):pii=2600508. Available from: https://doi.org/10.2807/1560-7917.ES.2026.31.24.2600508

[2] Ebola disease is caused by viruses belonging to the genus Orthoebolavirus, Filoviridae family. There are four orthoebolaviruses that can cause disease in humans. See more: https://www.ecdc.europa.eu/en/ebola-disease

[3] Ebola disease outbreak in the Democratic Republic of the Congo and Uganda, ECDC outbreak page. Available from: https://www.ecdc.europa.eu/en/ebola-outbreak-democratic-republic-congo-and-uganda

Journal

Eurosurveillance

DOI

10.2807/1560-7917.ES.2026.31.24.2600508

Method of Research

Data/statistical analysis

Article Title

The risk of global Ebola virus spread is low: epidemiology of Ebola disease cases outside Africa, 1976 to May 2026

Article Publication Date

18-Jun-2026

Hantavirus and Ebola virus disease: 10 things to know

Canadian Medical Association Journal

Two deadly infectious diseases, Ebola https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260834 and hantavirus https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260789, have made headlines in recent weeks as they pose serious threats to public health. They both require rigorous infection and prevention control (IPAC) practices and often present with similar early symptoms.

Two succinct articles in CMAJ (Canadian Medical Association Journal) provide information about each disease for clinicians.

Hantavirus:

A nationally notifiable disease in Canada — In Canada, 4 to 5 cases are confirmed every year and must be reported. These are usually acquired from rodents in agricultural settings in Manitoba, Saskatchewan, Alberta, and British Columbia. The Andes strain is unique as it can be transmitted from person to person.
Causes 2 clinical symptoms — Strains in the Americas, which include the Andes virus featured recently in the news, cause hantavirus cardiopulmonary syndrome. The European and Asian strains cause hemorrhagic fever and kidney dysfunction. Both forms take about 2 to 4 weeks to incubate, and symptoms include fever, headache, muscle aches, and abdominal pain.
Serology and polymerase chain reaction (PCR) tests are diagnostic — The National Microbiology Laboratory in Winnipeg performs these tests.
Supportive treatment — As there is no specific antiviral treatment or vaccine for hantavirus, treatment is supportive to help alleviate symptoms.
IPAC protocols are essential — Patients with suspected Andes strain infection must be isolated with airborne, droplet, and contact precautions, with infectious diseases experts involved and public health notified.

Ebola virus disease:

Sporadic outbreaks have occurred in Central and West Africa since 1976 — There are 3 main viruses that can infect humans, and evidence suggests they come from fruit bats. Ebola virus is spread via person-to-person contact through bodily fluids like vomit, sperm, diarrhea, and blood, as well as by touching infected surfaces or objects. The current outbreak in the Democratic Republic of Congo is Bundibugyo ebolavirus, with a fatality rate of 30% to 50%.
Fewer than 50% of patients have hemorrhagic symptoms — Symptoms include fever of 38°C or higher, fatigue, muscle pain, and gastrointestinal distress. Incubation is 2 to 21 days, and diagnosis is made with PCR testing.
People with potential symptoms and exposure risk should be tested — People who have travelled to countries with Ebola virus disease or who have been in close contact with infected people or bats, primates, or game from the affected areas should be tested.
Stringent IPAC must be used for suspected cases — Health Canada has a detailed process for screening, assessment, and IPAC precautions, which must include a fit-tested N95 respirator, face shield, gloves, and fluid-impermeable gear for full protection.
Important advances in prevention and management of the disease have been made — Vaccines to prevent Zaire ebolavirus are very effective, and 2 antivirals can reduce mortality from 50% to 35%. However, there are no current vaccines or medications to prevent or treat Bundibugyo ebolavirus, for which supportive care is the main approach.

Journal

Canadian Medical Association Journal

DOI

10.1503/cmaj.260834

Method of Research

Literature review

Subject of Research

People

Article Title

Hantavirus”and “Ebola virus disease

Article Publication Date

22-Jun-2026

How H5N1 bird flu hid unrecognized for weeks in dairy cattle

Study reveals the biology of why the disease looked so different when it made the leap to cows, and offers a framework for spotting its next new guise more quickly

University of Pittsburgh

image:
Microscopic image of bovine mammary gland tissue showing influenza virus receptors (yellow) on mammary epithelial cells. The study identified receptor patterns that may help explain the susceptibility of the bovine mammary gland to H5N1 infection and its ability to support viral replication.
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Credit: Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh.

PITTSBURGH— When H5N1 bird flu first began infecting U.S. cattle in early 2024, diagnosis was elusive, because in cows, the disease looked completely different. Instead of affecting the lungs, as H5N1 does in other mammalian species, it caused severe infection in the cows' udders, largely sparing the lungs.

A study by University of Pittsburgh School of Public Health researchers published today in Science Advances provides the first mechanistic explanation for this peculiar new guise for H5N1, which now affects more than 100 bird and mammal species globally. The study also establishes a new way to help scientists spot bird flu’s next surprise move more quickly, saving precious time in mounting public-health measures to stem the spread.

The disease first appeared in dairy cattle along the Texas Panhandle as stubborn cases of severe, necrotizing mastitis, a painful inflammatory condition that damages tissues in the mammary glands.

"Mastitis is a classic disease in milk-production animals, and veterinarians were dutifully looking to all the usual suspects for the source, like bacterial pathogens," said senior author Suresh Kuchipudi, Ph.D., chair of Infectious Diseases and Microbiology at Pitt Public Health. "When the real culprit turned out to be bird flu, everyone in the field was caught completely by surprise. We hadn't even remotely considered that cattle could be a host for H5N1.”

In the weeks before the virus was identified, it moved from herd to herd, sickening the cattle—and contaminating their environments.

"If a cow is infected, it sheds a lot of virus into the milk," said Kuchipudi. "This raised concerns about occupational risk for farm workers. Also, there is a habit of feeding raw milk to domestic pets, like cats, and there have been instances of cats dying, which we studied previously." He stressed that fortunately, pasteurization is effective at killing the virus, underlining the importance of avoiding raw milk.

Kuchipudi has been studying influenza viruses for his entire career, with a particular focus on how receptor biology determines which species—and which tissues—can be infected. Typically, such studies involve staining cells for the presence of receptors that are known to work in a lock-and-key relationship with influenza, a subset of sugar-based molecules known as glycans.

In initial studies by other groups, such experiments suggested that flu‑related glycan receptors were present in the noses, tracheas and lungs of cows. The fact that the animals were nonetheless not developing respiratory infections told the team there was more to the story.

"Glycan biology is very complex," said Kuchipudi. "We realized that, to understand what was really going on, we would need to use more innovative technologies and map out the fine‑detailed architecture that enables the virus to bind to cells." Kuchipudi collaborated on the study with Harvard Medical School's Lauren E. Pepi, Ph.D., an expert in the methodology for comprehensively cataloging the entirety of glycan structures, dubbed glycomics.

Using a multimodal approach that combined binding experiments, staining methods and ultra‑high‑resolution imaging, the team revealed that not all glycan receptors were functioning the same in animals infected with bird flu. Only a particular subtype, known as N‑linked sialic acid receptors, could bind to H5N1. These receptors were virtually absent in cow airway tissue, but pervasive in udders, making them a "perfect breeding ground for the virus," Kuchipudi said.

The research provides a framework other scientists can use to potentially predict not just whether H5N1 can jump to new hosts, but also how.

"We can preemptively screen different species and different tissues within them for susceptibility," said Kuchipudi. "For example, would they exhibit respiratory symptoms? Would they show only mastitis, as in cows? Or would they show neurological disease, as our team has shown in cats? The lessons learned could potentially help prevent us from being caught by surprise again."

Other authors on the study were Surabhi Srinivas, M.S., Shubhada K. Chothe, Ph.D., Santhamani Ramasamy, Ph.D., Sougat Misra, Ph.D., Noel Chandan Nallipogu, M.D., MPH, and Lindsey LaBella, all of Pitt; Yin-Ting Yeh, Ph.D., of Pennsylvania State University; May Wang, B.S., of Harvard University; and Heidi L. Pecoraro, Ph.D., and Brett T. Webb Ph.D., of North Dakota State University.

This research was supported by Pitt Public Health, and the U.S. Department of Agriculture's National Institute of Food and Agriculture (FP00039373/AWD00010780).

# # #

About the University of Pittsburgh School of Public Health 

Founded in 1948, the University of Pittsburgh School of Public Health is a top-ranked institution of seven academic departments partnering with stakeholders locally and globally to create, implement and disseminate innovative public health research and practice. With hands-on and high-tech instruction, Pitt Public Health trains a diverse community of students to become public health leaders who counter persistent population health problems and inequities.  

www.upmc.com/media

Journal

Science Advances

DOI

10.1126/sciadv.aea2068

Method of Research

Experimental study

Subject of Research

Animals

Article Title

Receptor Basis of Unusual Tissue Tropism of Avian Influenza H5N1 Clade 2.3.4.4b Virus in Cattle

Article Publication Date

19-Jun-2026

COI Statement

Twisting quantum potential into reality

UTS researchers have discovered a new way to control tiny quantum light sources by twisting atomically thin layers of hexagonal boron nitride

University of Technology Sydney

Lead author Dr Angus Gale says the research gives scientists a new control mechanism for tiny quantum light sources, bringing them a step closer to being used in practical quantum technologies such as quantum computing, secure communication and ultra-sensitive sensing.

“You can measure these quantum emitters and see that they exist, but it’s hard to make them work in practice. This gives us a lever to get closer to that – a step towards the realisation of quantum technologies,” said Dr Gale.

In experiments, Gale and his colleagues were able to shift the colour and wavelength of the emitted light by a significant amount, with the size of the shift notable. Unlike many experiments where a device is made at one twist angle and left alone, they were able to pick up, twist and restack the material repeatedly, which was an unusual finding.

“We’re leveraging the fact that this material, hexagonal boron nitride (hBN), is layered. We can pick it up, stack it, twist it, and use that twist to modify the emitters. You can’t really do that with traditional materials like diamond or silicon carbide.”

“The benefit is that we used this twistable platform to shift the emission by a very significant amount,” said Gale. “Often when you control these systems, the amount of manipulation is very limited, but in this case the shift was much larger than expected.

“Rather than trying to make hBN defects behave like a traditional solid-state hosts, we took advantage of hBN’s own strength: its thin, layered, twistable structure.”

Gale describes the material as similar to thin slices of cheese rather than a solid block.

“With a block of cheese, you can’t really get to the flavour in the middle. But with slices, you can peel away layers, put them back together and change how they interact,” he said.

Supervising author Professor Igor Aharonovich explains that twisting layered materials is exciting because it can unlock new physics.

“You can take two layers that don’t do much on their own, put them together at a specific angle, and suddenly you have a completely different system,” said Professor Aharonovich.

“These materials could eventually be used for quantum computing communications and quantum sensing, which would help for applications such as healthcare, cybersecurity and improved GPS; and gives us more control over the building blocks needed to get there.”

Journal

Science Advances

DOI

10.1126/sciadv.aec0101

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Twist-controlled modulation of quantum emitters in hexagonal boron nitride

Article Publication Date

19-Jun-2026

Wider focus holds key to unlocking improvement in global injury care

University of Birmingham

Global health policymakers should focus on the way entire healthcare systems work together - improving one element does not always create better outcomes if the wider system is not ready.

Publishing their findings today (21 June) in BMJ Global Health, an international research team led by the University of Birmingham, Nottingham Trent University and Stellenbosch University reveals how well-intentioned changes to one part of a healthcare system can lead to worse patient outcomes.

In one of the first studies to capture the full complexity of a health system delivering injury care, researchers mapped how patients move through care, from seeking and reaching help, to receiving treatment, and remaining in care for recovery.

They found almost 1,000 interconnected factors that influence patient survival after injury in low- and middle-income countries (LMICs), which account for around 85% of injury-related deaths worldwide. However, health systems are highly complex and interconnected – improving one part can unintentionally create pressure elsewhere.

Researchers discovered that, among several possible interventions, enhancing trust in the healthcare system had the greatest impact on clinical outcomes. When trust is high more people seek care and outcomes can improve, but if too many people come in and services cannot cope, quality drops and trust can fall again.

Lead author, Justine Davies, Professor of Global Health Research at the University of Birmingham, said: “Our work clearly shows that improving care results in increased demand on the health system, but this must be matched by greater capacity and higher-quality services to prevent services becoming overwhelmed. Increased demand quickly can lead to delays, reduced quality of care, and declining trust, ultimately undermining the very improvements those changes were intended to achieve.”

The study analyses interactions which span multiple pathways of care and their interactions including: patient and community factors, such as beliefs, ability to pay, and trust; health service factors, including quality of care, staffing, and funding; and wider societal context, such as poverty, infrastructure, and policy.

Senior author Antuela Tako, Professor of Operations Research at Nottingham Business School, said: “Patient trust, perceptions of care quality, and people’s willingness to seek treatment were among the most influential factors shaping health outcomes. However, addressing these factors in isolation is not enough. For example, increasing trust can encourage more people to seek care earlier, improving recovery and reducing mortality and disability.”

The research calls for a fundamental shift in how health systems are understood and strengthened through multi-sector approaches, linking health policy with investments in workforce capacity, transport, education, communities, and economic development.

Kathryn Chu, Professor of Global Surgery at Stellenbosch University, said: “Conventional approaches are insufficient to deliver sustained improvement. Things can only be truly improved through a whole-system approach that consider wider social and economic factors and places patient trust, system design and equity at the centre of reform.”

The research involved researchers from the UK and South Africa – including University of Aberdeen, UK; Umeå University, Sweden; University of the Witwatersrand, South Africa; National Health Service (NHS), Grampian, UK; University of York, UK; Western Cape Government, South Africa; University of Cape Town, South Africa; and South African Medical Research Council.

The study was supported by a prestigious two-month residential team fellowship awarded by the Stellenbosch Institute of Advanced Studies (STIAS) to Professor Justine Davies, Professor Kathryn Chu, Dr Lucia D’Ambruoso (University of Aberdeen), Professor Laura Bojke (York University) and Professor Antuela Tako.

ENDS

For more information, please contact:

Tony Moran, International Communications Manager t.moran@bham.ac.uk or +44 (0)7827 832312
Helen Breese, PR and Research Communications Manager, helen.breese@ntu.ac.uk or +44 (0)115 848 8751

‘A systems approach to understand injury care in LMICs using causal loop diagrams’ - Justine I. Davies, Kathryn Chu, Lucia D’Ambruoso, Laura Bojke, Rene English, Heike Geduld, Sa’Ad Lahri, Hassan Mahomed, Richard Matzopoulos, and Antuela A. Tako is published in BMJ Global Health.

Notes for editors

The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 40,000 students from over 150 countries.
England’s first civic university, the University of Birmingham is proud to be rooted in of one of the most dynamic and diverse cities in the country. A member of the Russell Group and a founding member of the Universitas 21 global network of research universities, the University of Birmingham has been changing the way the world works for more than a century.

About Nottingham Business School at Nottingham Trent University

Nottingham Business School (NBS) at Nottingham Trent University (NTU) is a leader in experiential learning and personalisation of business, management and economics education and research - combining academic excellence with positive impact on people, business and society. NBS has an unrivalled level of engagement with business, public and voluntary organisations. With more than 8,500 students, NBS is also one of UK’s largest business schools.
NBS is part of the 1% of business schools worldwide to hold the Triple Crown of accreditation from EQUIS, AMBA and AACSB. It is also accredited by Small Business Charter, providing support and development for SMEs, and is a PRME Champion - held up as an exemplar and beacon by the United Nations Principles of Responsible Management Education (PRME).
In The Guardian University Guide 2026, all NBS subjects were ranked in the UK Top 20. Areas covering Accounting and Finance, Business and Management, Economics and Marketing and PR were all recognised for excellence in teaching, high student satisfaction and strong graduate career prospects.

About Nottingham Trent University

Nottingham Trent University (NTU) has been named UK ‘University of the Year’ five times in six years, (Times Higher Education Awards 2017, The Guardian University Awards 2019, The Times and Sunday Times 2018 and 2023, Whatuni Student Choice Awards 2023) and is consistently one of the top performing modern universities in the UK.
Students have voted us the best university in the UK and 1st in the UK for student employability (Uni Compare 2025).
NTU is 4th in the UK for number of undergraduate students (HESA 2023-24) with over 36,000 students and more than 4,000 staff located across six campuses. It has an international student population of 6,000 and an NTU community representing over 160 countries.
NTU owns two Queen’s Anniversary Prizes for outstanding achievements in research (2015, 2021). The first recognises NTU’s research on the safety and security of global citizens. The second was awarded for research in science, engineering, arts and humanities to investigate and restore cultural objects, buildings and heritage. The Research Excellence Framework (2021) classed 83% of NTU’s research activity as either world-leading or internationally excellent.
NTU was awarded GOLD in the national 2023 Teaching Excellence Framework (TEF) assessment.
NTU is a top 10 for sport (British Universities and Colleges Sport league table 2025) and was named as Sports University of the Year (Daily Mail University Guide 2025). It has also been ranked as 25th in the UK by the Guardian University Guide 2026.
NTU is a holder of the University Mental Health Charter recognising the commitment an institution has shown towards continuous improvement in the area of mental health and wellbeing.
NTU is the most environmentally sustainable university in the UK and second in the world (UI Green Metric University World Rankings, 2024).

Journal

BMJ Global Health

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

A systems approach to understand injury care in LMICs using causal loop diagrams

Article Publication Date

21-Jun-2026

Road to specialist physician jobs in Canada not always smooth

Canadian Medical Association Journal

Despite the need for specialist physicians, the road to securing a job is not easy, particularly in specialties without the ability to practice in private offices or clinics, such as critical care and some surgical specialties, according to new research in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.251882.

“This study sheds light on the complex and often opaque nature of the hiring process for physicians applying to resource-intensive jobs in Canada,” writes Dr. Nada Gawad, a general surgeon at The Ottawa Hospital and assistant professor, University of Ottawa, Ottawa, Ontario, with coauthors.

Barriers include a perceived lack of full-time jobs, lack of access to job listings, desire to stay near family, need for spousal employment, and lack of resources like funding and operating room time.

This study of physicians in Canada by specialists at the University of Ottawa and the University of Alberta provides insight into the lived experiences of physicians seeking work across the country. The research team interviewed trainees, recent graduates, program directors, and division chiefs from across Canada between 2021 and 2022 to understand hiring decisions for resource-intensive specialties and to develop suggestions to help people navigate the hiring journey.

The researchers identified 5 themes from the interviews: the process is difficult to navigate and poorly defined, hiring decisions emphasize perceived fit of the candidate and lack transparency, bias and inequity occur, mentors who take active steps to help with employment influence success, and perspectives differ across the different groups of interviewees.

“Although proactive and networked candidates were more likely to succeed, the emphasis on ‘fit’ in hiring decisions introduced an additional layer of complexity,” explained the authors. The emphasis on fit was particularly problematic as it is vague and subjective, and can work against equity, diversity, and inclusion (EDI). “Our findings, along with previous research in this area, suggest that reliance on ‘fit’ risks undermining EDI efforts. Specifically, fit may disadvantage candidates from diverse or underrepresented backgrounds, perpetuate homogeneity, and limit the pool of innovative perspectives and skills.”

Participants also pointed out that job postings were often formalities only, with a preferred candidate already identified. “Institutional preference for current hiring practices may contribute to applicant frustration and unintentionally result in inequitable and noninclusive physician hiring,” the authors write.

“These findings highlight the opportunity for improvement at the individual, program, institutional, and national levels to promote transparency and equitable access to employment opportunities among physicians.”

To help navigate the hiring process,

Trainees should consider their career goals early and network, contact institutions where they may want to work, and find mentors;
Training programs should host sessions on the job-hiring process and give advice on how to build a strong job application;
Hiring institutions should post future jobs once the need is identified and describe the type of candidate being sought;
National resident associations and speciality societies should host job hiring information sessions and create best-practice guidelines for job hiring.

“Addressing the challenges cited by participants requires a multilevel approach, including integrating formal career-planning curricula into residency; establishing transparent, best-practice hiring guidelines; and developing centralized job repositories,” the authors conclude.

An article on physician advocacy https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250995

explores the motivation for Canadian physicians to engage in advocacy and how they integrate into their professional identities to improve the health and lives of people in Canada.

Journal

Canadian Medical Association Journal

DOI

10.1503/cmaj.251882

Method of Research

Survey

Subject of Research

People

Article Title

The path to securing a resource-intensive physician job in Canada: lived experiences of decision-makers and trainees

Article Publication Date

22-Jun-2026

Monday, June 22, 2026

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