American hospitals are far better placed to respond to a potential Ebola case during this summer’s World Cup than they were a decade ago, infectious disease experts say, even as they acknowledge that the threat – while low – has not entirely disappeared.
Past failures that spurred change
The gap in readiness is stark when measured against the response to the 2014 West African Ebola outbreak. That year, Thomas Eric Duncan, a Liberian man, was initially turned away from a Dallas hospital despite showing symptoms of the virus. He was admitted later but subsequently died. Two nurses who cared for him contracted Ebola and survived. The incident exposed critical weaknesses in the United States’ ability to identify, isolate and treat patients with highly dangerous pathogens.
A $260m investment in preparedness
The Dallas failure prompted a $260m (£204m) investment in U.S. Ebola preparedness, which funded training, response capabilities and the creation of 13 specialised treatment centres. The initiative was launched in 2015 as a collaboration between Emory University in Atlanta, the University of Nebraska Medical Center in Omaha, and NYC Health + Hospitals/Bellevue in New York City – institutions that had been at the forefront of caring for Ebola patients during the West African outbreak, the largest ever recorded.
Dr Gavin Harris, an expert in serious communicable diseases at Emory University – one of 11 U.S. host cities for the tournament – said: “There was a recognition that we had a duty to train other facilities to recognise potential patients who might be exposed or sick with something like Ebola.” Since then, thousands of healthcare workers have received training to identify and treat patients with Ebola and other severe pathogens. Nationwide training exercises have been conducted, including simulations of a potential MERS (Middle East respiratory syndrome) outbreak. Guidance has also been developed for physicians, raising awareness of illnesses uncommon in their home cities, such as malaria, dengue and chikungunya – mosquito-borne diseases that could be brought in by travellers.
World Cup scale and risk assessment
The 2026 World Cup, which runs for 39 days and features 104 matches across the United States, Mexico and Canada, is expected to draw 6.5 million travelling fans. Public health officials and hospitals in U.S. host cities have been preparing for a spectrum of infectious disease threats. The U.S. Centers for Disease Control and Prevention (CDC), the Pan American Health Organization (PAHO) and the World Health Organization (WHO) all categorise the risk of Ebola to World Cup host countries as low. They identify measles, COVID-19 and influenza – more common at large crowd gatherings – as more probable threats.
However, the ongoing Ebola outbreak in the Democratic Republic of Congo (DRC) remains a significant concern. Declared on 15 May 2026 and caused by the Bundibugyo virus – a strain for which no vaccine or specific treatment is currently available – the outbreak has so far resulted in 695 confirmed cases and 138 deaths across the DRC and Uganda as of 13 June 2026. The case fatality rate in the DRC is approximately 20.1%, though that figure is likely an underestimate because deaths before the official declaration remain under investigation. The WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC) on 17 May, assessing the risk as very high nationally in the DRC, high regionally and low globally. The outbreak is unfolding in a challenging context of humanitarian crisis, insecurity and densely populated areas with high population mobility. There is particular concern about potential spread within displacement camps, which house large numbers of people in cramped and unsanitary conditions. UNICEF has also voiced concern about the impact on children, as household transmission may increase.
Low risk, not zero
Dr Tom Frieden, chief executive of Resolve to Save Lives and a former director of the CDC, stressed: “The risk of Ebola to anyone at the World Cup is extremely low. Ebola isn’t airborne and doesn’t spread through casual contact – it requires direct contact with the body fluids of someone who is ill.” He added a crucial caveat: “But low isn’t zero, and it won’t be zero until the outbreak is stopped at its source in DRC.”
Dr Harris echoed the point: “We’re not going to be able to prevent 100% of infections, but we certainly are the most prepared that we have ever been.”
Travel restrictions, screening and local planning
To mitigate risk, the United States, Mexico and Canada have implemented airport screening and travel bans, restricting entry for non-citizens who have recently travelled to countries affected by the outbreak. The U.S. has also urged European nations to adopt similar restrictions. In a notable instance, the DRC national soccer team left the country in May to train in Belgium before traveling to the United States, in compliance with U.S. restrictions. Dr Harris believes these measures are likely to reduce the chances of Ebola reaching World Cup venues.
In each host city, FIFA, local public health officials and hospital systems have established medical committees. These committees are conducting comprehensive assessments of infectious disease threats, taking into account the teams playing in their cities, prevalent diseases in their home countries, visa restrictions and stadium logistics, according to Dr Harris. Some regions are exploring the supply of disease-specific treatments or protective gear to venues and are using surveillance tools such as wastewater monitoring, air quality data and electronic medical records to detect unusual clusters of illness. FIFA has confirmed that medical-related risks are continuously assessed as part of overall tournament planning and that it is maintaining contact with sporting and health authorities in the DRC and the three host countries.
Independent monitoring and coordination
Georgetown University, in collaboration with MedStar Health, launched an independent Health Security Operations Center (HSOC) on 1 June 2026. The centre, which is not an official FIFA programme, provides daily situation reports to more than 700 state and local health authorities, approximately 60 federal partners, FIFA and the CDC. It monitors infectious disease transmission and aims to mitigate global health risks during the World Cup. Dr Michael Osterholm, an infectious disease expert at the University of Minnesota, noted that planning for mass gatherings in the U.S. is not new: “State and local health departments working in conjunction with CDC have for many years been at the forefront of individuals coming into this country.”
Broader challenges and resource strains
Despite these preparations, significant challenges remain. The U.S. is currently grappling with the largest measles outbreak in decades, with 1,952 cases confirmed by the CDC as of 22 May 2026 and 30 outbreaks reported. The vast majority of cases – 92% – are in unvaccinated individuals, and the outbreak is straining state and local health departments. At the same time, the U.S. withdrew from the WHO in January 2026, a move that experts say weakens global health security by reducing access to real-time disease surveillance, technical advice and early warnings. The U.S. has effectively lost its “library card” to the WHO’s global network of laboratories that detect and sequence flu strains.
Staff reductions at the CDC, overseen by Health Secretary Robert F. Kennedy Jr.’s administration, have contributed to an exodus from government agencies. The cuts have also affected the National Institutes of Health (NIH), impacting research grants and programmes. Dr Frieden voiced his primary concern: “My biggest concern is whether a CDC that’s lost thousands of staff has the capacity, support, and mandate to move fast enough – both here and in DRC.” The U.S. Department of Health and Human Services, which oversees the CDC, did not respond to a request for comment.
The federal government allocated $625m for World Cup security but none specifically for public health, raising concerns about whether hospitals have received additional resources for the tournament. Jeanne Marrazzo, chief executive of the Infectious Diseases Society of America, noted that cuts to public health have contributed to the exodus from government agencies. “Nonetheless, we know the people who are still there are working around the clock in many cases to try to keep us safe,” she said in a briefing.