For many Americans, Ebola has always seemed like a terrifying disease that happens “somewhere else.” We picture remote villages in Africa, health care workers in moon-suit protective gear, and frightening television images of quarantine tents. But modern medicine and public health experts are increasingly asking a difficult question:

What happens if Ebola, or a virus like it, becomes harder to contain?

The Ebola virus still represents one of the deadliest infectious diseases on Earth. In some outbreaks, mortality rates approached 90 percent. Even with modern treatment, many patients still die. 

While Ebola is not as easily transmitted as influenza or COVID-19, the virus presents enormous challenges because of globalization, international travel, unstable health care systems in some countries, and increasing distrust of vaccines and science.

The reality is simple: viruses do not need passports.

Every day, hundreds of thousands of people travel internationally. Someone exposed to Ebola overseas could board a plane during the incubation period when they feel healthy and show no symptoms. The incubation period for Ebola ranges from 2 to 21 days. That means an infected traveler could arrive in New York, Chicago, Miami or Los Angeles before anyone realizes they are carrying the virus.

Fortunately, Ebola is not airborne like measles or COVID-19. It spreads through direct contact with bodily fluids, including blood, vomit, saliva, diarrhea, sweat, urine and contaminated medical equipment. That makes it harder to spread casually in public places. You are not likely to catch Ebola from simply sitting next to someone in a restaurant or supermarket.

However, “harder to spread” does not mean “impossible to spread.”

The 2014 West African outbreak proved how quickly Ebola can spiral out of control when health care systems become overwhelmed. More than 28,000 people became infected and over 11,000 died. Several infected individuals traveled internationally, including cases diagnosed in the United States. Hospitals suddenly had to confront a disease many doctors had only read about in textbooks.

The frightening truth is that future outbreaks could look very different.

Viruses constantly mutate. Most mutations are meaningless, but occasionally a virus becomes better at infecting humans or surviving in new environments. Scientists closely monitor Ebola strains because even small changes in transmissibility could create enormous global danger. We recently witnessed this with hantavirus.

Climate change, deforestation and expanding human contact with wildlife may also increase the likelihood of new outbreaks. Fruit bats,  believed to be natural hosts for Ebola,  are increasingly interacting with human populations as habitats shrink.

So where do vaccines fit into all this?

Quite frankly, it’s a proven fact that vaccines are the firewall standing between humanity and catastrophe.

The Ebola vaccine Ervebo has already saved countless lives in Africa. During outbreaks, health care workers use a “ring vaccination” strategy, vaccinating everyone who had contact with infected patients. This method has successfully helped contain several outbreaks before they exploded into international disasters.

Yet despite clear scientific success, vaccine skepticism continues to grow worldwide.

That presents a dangerous problem.

Many people today have never witnessed diseases that once devastated entire populations. Smallpox killed millions before vaccines eliminated it. Polio crippled children every summer until vaccination campaigns nearly eradicated it globally. Measles, once common, resurged in some communities because vaccination rates dropped.

Ebola serves as another warning that nature never stops testing humanity.

Public health experts worry that vaccine fatigue following the COVID-19 pandemic has left many societies vulnerable. Misinformation spreads faster than viruses on social media. Conspiracy theories often drown out science. Unfortunately, viruses do not care about politics, ideology or internet rumors.

Could Ebola ever reach epidemic proportions in the United States?

At the moment, experts believe the risk remains low. America has advanced hospitals, isolation procedures, infection-control training, laboratory testing and emergency-response systems. The Centers for Disease Control and Prevention (CDC) carefully monitors travelers and outbreak zones around the world.

But “low risk” is not “no risk.”

Health care systems can become overwhelmed. Human error occurs. Delayed diagnosis happens. During the early COVID-19 pandemic, Americans learned how rapidly hospitals, supply chains and emergency services could come under pressure.

An Ebola epidemic in the United States is unlikely today, but preparedness cannot wait until after a crisis begins.

The lesson is broader than Ebola itself. The next major viral threat may not even exist yet. Scientists have identified numerous dangerous viruses circulating in animal populations worldwide. Some could eventually jump to humans.

Vaccines remain one of the most powerful medical tools ever developed. They prevent suffering, reduce deaths, protect health care systems, and help stop outbreaks before they become global disasters.

Ebola is not merely an African problem. It is a reminder that in an interconnected world, public health anywhere affects public health everywhere.

And perhaps the biggest question facing society today is not whether viruses will continue to emerge.

They will.

The real question is whether humanity will choose science, preparation and vaccination before the next deadly outbreak arrives.

Michael Kossove is professor emeritus and an adjunct professor of microbiology at Touro University’s School of Health Sciences. He is a polio researcher, international polio lecturer and polio survivor, and writes opinion columns for the River Reporter. He can be reached at Professormike2@aol.com.