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The management of Victoria’s suspected Ebola case last week shows the best infectious disease responses are the ones you never hear about. A patient arrives, precautions are taken, tests are run, and a threat is ruled out. The system works, then disappears back into the background.
That should reassure Australians, but it should also prompt a more difficult question. If Ebola lands in Australia tomorrow, what will happen next?
The Bundibugyo strain in the current outbreak, which is spreading rapidly in the Democratic Republic of Congo and neighbouring Uganda, has no approved vaccines or treatments, but we have enough experience with Ebola viruses to suggest that it would be unlikely to gain a foothold here.
Health Minister Mark Butler was right in describing it as “deeply concerning” on Monday, but we’re also reminded that Australia has a strong health system, sophisticated laboratories, experienced public health teams and specialist services well-placed to manage a small number of cases.
Ebola can be contracted via bodily fluids such as vomit, blood or semen. The disease it causes is rare, but severe and often fatal. It is not easily spread through casual contact, and the likelihood of a large outbreak here remains low. But low risk is not the same as no risk, and like any infectious disease new to humans, there are uncertainties and things can change rapidly.
With global travel, a disease that began far away can quickly become a test of systems here, and the first 24 hours would matter enormously.
A person with symptoms arrives at an emergency department, a GP clinic or calls an ambulance. Someone has to ask the right questions: where have they travelled, who have they been in contact with, have they been in an outbreak zone? The case has to be recognised quickly, isolated safely and notified to public health authorities. Staff need the right protective equipment, and they need to know how to use it. Ambulance, hospital, laboratory and public health teams must move as one.
Thankfully, Australians are vastly more aware of the threats of infectious diseases than we were before 2020. Through COVID-19, the public took a crash course in once unfamiliar disciplines as epidemiology and immunology. That experience has brought disadvantages, including waning trust in authorities, but this advancement in public knowledge stands us in good stead.
Australia also now has a national Centre for Disease Control, formally established on January 1 this year, to better co-ordinate surveillance, advice and response across jurisdictions. However, readiness erodes in ways that are easy to miss. Staff move on. Skills fade. Stockpiles expire. Supply chains shift, protocols become dated, and public trust can decline. By the time a threat arrives, the gap is no longer theoretical, and public health workforces are already stretched by the daily pressures of the health system.
No country is protected by the strength of its best hospital alone. What matters is whether the whole chain holds. A clinician in regional Victoria or a remote community faces the same obligation to take a travel history as someone in a major city but may have less support and a longer path to specialist backup. The chain runs through every emergency department, every GP clinic and ambulance crew, wherever they are.
This matters now because the conditions that allow outbreaks to emerge and spread are intensifying; conflict, displacement, fragile health systems, climate change, vaccine hesitancy, food insecurity, closer contact between humans and animals, and the spillover of zoonotic diseases are all on the increase. Making matters worse, international co-operation is under strain, exemplified by the United States’ withdrawal from the World Health Organisation.
The best way to protect Australians from Ebola, or from any new infectious disease, is not to wait until it reaches our shores, but to help stop outbreaks at their source by supporting global surveillance systems, rapid response teams, laboratory testing and vaccination where available.
Australia’s immediate challenge is not Ebola. It is staying ready for new diseases; familiar vaccine-preventable infections, seasonal viruses and the unknown pathogen we are not yet watching. That work matters most in the quiet periods, when there is no sense of emergency and no public demand for action.
The real test is not whether we could respond to one suspected case, it’s whether we are willing to keep maintaining the systems that made that response possible, long after the headlines have moved on.
Ebola is not so much a threat to Australia as it is a message: new infectious disease threats are now more likely than ever and whatever comes next will be different from what we’ve experienced before.
Professor Brendan Crabb is the Burnet Institute’s director and CEO.
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