Transcript
Please Note: This transcript is not edited and may contain errors.
5:08
Benjamin Haynes, CDC Moderator
Thank you for joining us. Dr. Satish Pillai, who is leading CDC's Ebola response, will talk through the two MMWRs we just released about DRC and our risk assessment for the United States.
Then, Dr. Jason Asher, the head of our Center for Forecasting and Outbreak Analytics, will talk about the modeling MMWR. Then, we'll take your questions. Dr. Pillai?
CAPT Satish K. Pillai [suh-TEESH puh-LYE], M.D., M.P.H., Incident Manager for CDC's Ebola response
Thank you, Ben, and thank you all for joining us. This is an active Ebola outbreak, and CDC is working aggressively with federal and international partners to support response efforts.
Before we walk through the reports CDC is releasing today, I want to be clear about what is at the center of this outbreak: People in DRC and Uganda are living through something extraordinarily difficult in communities already strained by conflict, with limited health infrastructure and barriers to care. That sets the foundation for what we will talk about today.
CDC staff are in regular contact with public health officials in the countries with confirmed Ebola cases, working hand in hand to ensure they have the resources and support they need. We have responded to Ebola in DRC before; this is the 17th outbreak. We know what it takes to control, contain, and end an Ebola outbreak, and CDCs actions are directed to those objectives.
Today CDC is releasing three reports. Jason and I want to spend a few minutes explaining what they are and how they connect with one another.
They represent three distinct but related questions:
What does the outbreak in DRC and Uganda look like right now?
What does that mean for people in the United States?
And what could happen next in Central Africa — and under what conditions?
Each report answers one of those questions. Together, they demonstrate necessary public health response activities in action where we assess the situation, evaluate risk, and model the possibilities so we can plan and act decisively.
Let me start with the situation as we see it. The outbreak currently underway is serious, because of the scale of transmission, because of the conditions in the affected regions — including active conflict, and significant challenges to community access — and because of the demonstrated potential for this virus to spread when those conditions persist.
The Notes from the Field report documents this outbreak — which was first detected among clusters of healthcare workers — and has grown to be the largest Bundibugyo outbreak on record. It explains why containing this outbreak requires sustained resources and sustained attention. That is the foundation for everything else we are going to tell you today.
The second question is the one I know many of you will be focused on: What is the risk to people in the United States?
As I've said previously, for the general American public, the overall risk is currently low, which is consistent with assessments from other international public health organizations. Importation modeling by one of our partners indicates the likelihood that Ebola will be imported into the United States is low at present.
If a case were imported, the risk of sustained secondary transmission in the United States is also low, given the strength of our public health system and clinical infection control measures. Our assessment also takes into account that, if cases were to occur in the United States, the clinical implications for the infected individuals may be significant, and the public health resources that would be required respond to those cases would be considerable.
For Americans going about their daily lives, including those with travel plans that don't involve the affected countries, there is no recommended change in behavior at this time. Since mid-May, CDC, the Department of Homeland Security, and other federal agencies have enforced entry restrictions and are conducting public health screening at four airports to prevent Ebola from entering the United States.
There are currently no approved vaccines or treatments for Bundibugyo virus, which means our public health preparedness infrastructure, such screening, surveillance, infection control, is doing significant work, and it is doing that work well. Our assessment reflects current conditions, and we will update it as conditions change.
We released this dedicated risk assessment not because the risk is high but because we know there is concern about the outbreak. The risk is low. That is not reassurance for its own sake.
And, as always, CDC will continue to monitor the data and consider factors that could change this assessment.
I'll now turn it over to Dr. Asher to walk through the MMWR modeling what the outbreak could look like in Central Africa.
11:00
Jason Asher, Ph.D., Director of CDC's Center for Forecasting and Outbreak Analytics (CFA)
Thanks, Satish. Part of how we control an outbreak is understanding what it could become. That's what modeling is for. The third report is the one I want to spend a moment preparing you for, because modeling data is easy to misread, and in this area, misreading has consequences.
Our modeling analysis examines what this outbreak could look like over the coming months under a range of scenarios. I want to be clear about what that means. A scenario is not a forecast. It is a planning tool. It answers the question: If this condition holds, or this intervention succeeds, or this variable changes, what does the trajectory look like? We model scenarios so that decision-makers can prepare for potential future outcomes not so that we can predict which future will arrive.
Before I get into the details, I want to state the main finding plainly: Urgent action is needed to slow the spread of this outbreak and prevent it from becoming as large as, or larger than, the 2014-2016 West Africa outbreak. Without strong public health interventions, the modeling work suggests an outbreak of that scale is possible.
Specifically, we ran a set of scenarios to capture uncertainty about how big the outbreak is at this time and uncertainty about how well detection and isolation of symptomatic cases can be implemented.
Each scenario combined one assumed death count – 50, 100, or 200 – with one of four isolation levels – 20%, 50%, 70%, or 95%. This gives us several possible projections that show how different starting sizes and different amounts of isolation could affect cases and deaths over the next three months.
You'll now see a visual that shows our modeling.
Let me walk through this specific scenario, where we have assumed there were 50 Ebola deaths as of May 24, 2026. In this scenario, our model estimated that the outbreak likely started around mid-to-late February 2026.
Each of these stacked bars shows the distribution of simulated outbreak sizes over the next 3 months. As you can see from the first bar, if only 20% of cases enter isolation within two days of symptom onset, more than 20,000 cases are projected in 2 out of 3 of our scenarios. However, as you can see from third bar, if 70% of cases started isolating within that two-day period, there is a 94% probability of limiting the outbreak to fewer than 10,000 cases. This highlights the critical importance of rapid case identification and isolation.
Our models today are built on current data and our understanding of current conditions. They are designed to support action, not to generate alarm.
Now I'll turn it back to Satish.
14:28
Dr. Pillai
Thanks, Jason.
The situation in DRC and Uganda is serious and deserves serious, sustained attention. The modeling analysis we are releasing is a tool: one that shows where we need to direct resources and attention to keep the worst-case scenarios from becoming reality.
We have been in active communication with clinicians and state health officials to ensure the frontline is ready. And though the risk to the American public is low, we are prepared in the event there is a case of Ebola in the United States.
CDC can confirm a diagnosis within hours, and our Laboratory Response Network extends that capacity to 41 states and local public health labs across the country.
CDC has extensive clinical guidance, training, and strict infection prevention protocols for U.S. hospitals that may be evaluating suspected cases. And we coordinate closely with our sister agency, ASPR, should individuals need higher levels of care.
CDC also maintains rapid response capacity to deploy within 24 hours to support any state managing a suspected or confirmed case, with established protocols for contact identification, monitoring, and quarantine.
We've responded to Ebola and other viral hemorrhagic fever outbreaks before: in 2014, in 2019, and in outbreaks since. We know how to end this.
Our goal is control, containment, and ending the outbreaks in DRC and Uganda, and we are working every day toward that goal. Thank you.
Mr. Haynes
Thank you, gentlemen. Before we open for questions, I want to remind everyone: If you have a question, please raise your hand and make sure that your media outlet is indicated next to your name. Thank you.
OK, thank you. Youri from ABC, you wanna go ahead?
16:55
Youri Benadjaoud, ABC News
Hey, thanks for doing this call. Your report outlines four different scenarios based on public health measures in the Ebola outbreak. I'm seeing poor, moderate, high, and extremely high, based on case isolation and quarantine measures. What is the current situation on the ground right now with those public health measures?
17:15
Dr. Pillai
Currently, the situation is very fluid, and while the numbers are not completely known, based on the trajectory of the outbreak and the rapid extension into multiple different health zones over a short period of time, this appears to be in one of the lower end of the percentage of individuals that are being detected and isolated.
Mr. Haynes
Our next question is from Mike Stobbe from AP.
17:51
Michael Stobbe, Associated Press
Hi, thank you for taking my question. I... just to ask for a little more specifics, what Dr. Asher talked about, a scenario with 20% isolating is...are we at 20%? What percent are we at? And then, if I could also ask, how many of these scenarios would have us worse than the 2014-2015
West Africa outbreak? And then finally, who is this modeling targeted toward? Who are you trying to marshal resources from? Thank you.
18:26
Dr. Pillai
So, I'll start with, just restating the answer to the first, the first question. This is a dynamic situation. The percentages remain unclear as to the total percentage of individuals that are infected. Because diagnostic capacity continues to rise in the area, and the total individuals that are infected and requiring isolation remains unclear at this point.
Capacity is growing, but we can't give a percentage, but based on the trajectory and based on
the conditions on the ground, I would believe that the percentages are on the lower end of the scenarios that Jason outlined.
I'll defer to Jason on the second part, but part of the rationale for this set of MMWRs today is to highlight both the need for focusing and marshalling resources to contain an Ebola outbreak in an area of the world that has significant challenges, including conflict -- and the importance of ensuring that we can get the resources across the international community to focus on the known public health measures that can help contain and control an Ebola outbreak. And then the other part of that is, while those interventions are being undertaken to reassure the American people that the domestic risk, for all the reasons that we spoke of earlier, remains low for the general U.S. population.
For the second question, I'll turn it over to Dr. Asher.
20:14
Dr. Asher
Yes, thank you.
We did not specifically model exactly how many scenarios exceeded the size of the 2014-2016 Ebola outbreak in West Africa. But as the data I was presenting earlier shows, in more... in about two-thirds of the simulations within the next three months, under the scenario in which only 20% of cases isolate, are isolated within 2 days, it exceeds 20,000 cases over the next 3 months. So those would be substantially very large outbreaks, and there are simulations that do exceed that over a longer period of time.
21:03
Mr. Haynes
Sophie Gardner, you have the next question.
21:07
Sophie Gardner, Politico
Hi, thanks for taking my question. I was just looking at the Notes From the Field, and I noticed there doesn't seem to be a suspected, a case count or death count, and I'm wondering if that's information that we have. Thank you.
21:26
Dr. Pillai
In DRC, they ... in the Democratic Republic of Congo, they have been reporting on suspect cases, and all this data is available through the Ministry of Health websites, and so I would encourage you to visit their websites, as well as the CDC websites, for the latest, numbers for confirmed and suspect cases. Issues regarding ongoing review of the cases, diagnostic testing of individuals that were suspected and then are either confirmed to have Ebola, or then confirmed not to have Ebola, does result in the numbers changing, over time.
Mr. Haynes
Celine, you have the next question.
22:16
Dr. Céline Gounder, CBS News
Yeah, this is Dr. Celine Gounder with CBS News.
Are we seeing evidence of community transmission in Kampala, or do all the cases still trace back to importations from the DRC? And secondly, you had WHO and Africa CDC that are launching a $518 million joint response plan. The U.S. has withdrawn from WHO; will U.S. money flow into that WHO-led plan? And will the U.S. or CDC be coordinating with that plan?
22:51
Dr. Pillai
To the first question, from the information that we have gathered and that has been released by the Ministry of Health and in our ongoing engagements with them, there's no evidence of community transmission, in that all the cases have a link to travel from the Democratic Republic of Congo or are related to said travelers.
Regarding coordination, CDC, works across the United States government, and we're partnering wit, international organizations and, and particularly with our Ministry of Health colleagues who are our key partners in the countries in which these outbreaks are unfolding.
And CDC will continue to work within the United States government to ensure that the resources that we have are going towards controlling and containing the outbreaks in the affected countries.
Mr. Haynes
And our last question will come from Erika Edwards from NBC.
23:55
Erika Edwards, NBC News
Hey, thanks so much for taking the question. I'm curious, with the WHO downgrading the number of suspected Ebola cases significantly this week, does that modeling take that into account? Thank you.
24:07
Dr. Pillai
So I'll turn to Jason, and then I can add if there's anything additional.
24:15
Dr. Asher
Yes, thank you for the question. So, the uncertainty that you talked about was specifically part of the design of our study. That is why we considered different candidate scenarios for the possible number of deaths that had occurred as of May 24th, so that's why we considered that range, to bracket the uncertainty about the true number of deaths as of that date.
24:40
Mr. Haynes
Nothing to add? OK.
Once again, thank you all for joining us today. The MMWRs that we spoke about are posted online at www.cdc.gov/mmwr, and we will have the transcript and recording on the CDC media site later today.