5 FAQs: Ebola Outbreaks and the Challenge of Public Trust

The 17th Ebola outbreak caused by the Bundibugyo virus was declared a public health emergency of international concern by the World Health Organization on May 17, affecting the Democratic Republic of the Congo (DRC) and Uganda, but less than a week later, residents attacked and burned treatment facilities in the Ituri Province.¹

The attacks were fueled by mistrust in public health officials, disinformation about the Ebola virus, and emergency response efforts disrupting cultural practices, according to an NPR interview with an aid worker at the center. But the motive for these actions is not entirely different from that of global reservations towards vaccines, infectious disease outbreaks, and public health officials’ responses.

Here are 5 frequently asked questions on why individuals are hesitant to believe public health organizations in the midst of viral disease outbreaks, the diseases themselves, vaccines, treatments, and aid.

1. Why is mistrust of Ebola response efforts prevalent in Ituri Province?

Conspiracy theories surrounding the Ebola outbreak are spreading online, almost as quickly as the virus itself. Amani Serubungo Bienfiat, a native aid worker, said in an interview with NPR that the individuals who burned down the treatment center don’t believe the virus is real, as early symptoms are often similar to those of malaria and typhoid. They also think aid workers are solely there to make money by collecting donations intended to serve the outbreak’s response efforts.¹

“What you see sometimes is conspiracy theories or rumors provide a rationale that makes sense to people that helps reduce their fear, even if they don't necessarily align with the facts or with scientific information,” Amy Bucher, PhD, chief behavioral officer at Lirio and expert in social relationships and their impact on well-being, said in an interview with The American Journal of Managed Care^® (AJMC^®).

Although only a minority believes these rumors, those who don’t are still concerned. Many questioned why there is no treatment or vaccine for the Bundibugyo virus responsible for the current outbreak spreading throughout the Northeast region of the DRC.

They also believe that wealthier nations are hoarding resources, leaving locals “left to die.”¹

“They're certainly experiencing uncertainty, and in those cases, we search for narratives that make sense, that can create meaning in an uncertain world,” Bucher said.

2. How does distrust of emergency responders affect Ebola outbreak control?

Fear is a prominent factor in the distrust of public health officials, especially during an outbreak, as people fear harm to themselves or their loved ones, Bucher said.

Because the Ebola virus is still contagious after death, families haven’t been able to see their loved ones who died in treatment centers. Preparing the body of the deceased is part of traditional burial practices in that region, but it increases the risk of infection for those involved.² Thus, another reason individuals might question emergency response efforts, especially those who lost loved ones to the disease.

“Burial is really a deep cultural flashpoint, and I think the more that public service professionals can help people figure out ways to maintain their practices as much as possible, but in a safer way that will help them adopt safer practices,” Bucher said.

As of Sunday, June 7, 2026, there were 550 confirmed cases and 101 deaths due to the Ebola virus.³ Gaps in communication among health officials in the area can also erode trust, as these gaps cause delays for important infection risk mitigation strategies like testing, treatment, and contact tracing.

“All of those things require a really quick response from community organizations and the individuals who work for them, but if the communication is broken down…all of that will affect the speed of the response,” she said. “[And] continue to erode the trust of the people who live there, because what…they're hearing isn't matching the behavior that they're seeing from the public health officials… [who] should be helping to keep them safe.”

3. What factors shape public perceptions of health interventions during outbreaks?

In addition to the attacks on treatment clinics, there is ongoing armed conflict in the region involving local militia groups and other armed groups, delaying and complicating public health and humanitarian response efforts.²

Years of militia violence and insecurity in the Ituri province and surrounding region influenced and reinforced mistrust of outside authority.²

“When you're looking at an area that has fracturing and political unrest, that cooperation [between public health systems] is inherently not there, so there's likely low institutional trust among the people who live in the province,” Bucher explained. “They likely already believe that things that the government is telling them are not true or politically motivated in some way.”

Public mistrust has also contributed to the lengthy response efforts to stop prior outbreaks, as the last Ebola outbreak in 2018 took nearly 2 years to quell.²

Individuals who have not personally experienced the disease are more likely to question health messaging and government responses, Bucher said.

“If people are not experiencing anything personally with any given outbreak, it can feel like a very politically motivated story,” Bucher said. “People [who] haven't seen Ebola before personally…don't necessarily trust the response or what the government is asking them to do is actually accurate or called for.”

4. Why are some individuals more susceptible to vaccine and outbreak misinformation?

Public reactions to the Ebola outbreak from citizens, particularly online discussions, mirror challenges seen during other public health emergencies, including the COVID-19 pandemic, such as the spread of misinformation, distrust of authorities, and growing vaccine hesitancy.

Through her research at Lirio, Bucher emphasized that individual comfort is a major decision factor regarding vaccines and trusting public health behaviors. But you can’t assume why an individual may be uncomfortable. Many people aren’t completely pro-vaccine or anti-vaccine but somewhere in the middle, she said, which opens the floor for conversation.

Another factor is susceptibility risk.

“If you don't feel like you are likely to get a particular condition, you're just not going to be very motivated to take action to prevent it,” Bucher said.

Patient awareness also plays a role, in which the responsibility to inform patients often falls on their primary care provider. However, because of time constraints, she said many doctors don’t often address vaccines in healthy adults.

“Having that trusted health care [provider], actually talking to somebody about it goes a long way, and we have found that the pharmacist can often play that role,” she said.

Gaps in awareness, however, aren’t solely the responsibility of clinicians. Successful vaccination programs have reduced public exposure to many vaccine-preventable diseases, which may lower perceived susceptibility and diminish the urgency some individuals feel toward preventative measures.

“Most of the public and even the scientific community haven’t seen some of these diseases because they've been eliminated, and so everyone has selective amnesia and forgets the horrors of these diseases,” Jamie R. Felzer, MD, MPH, epidemiologist and assistant professor of medicine at Emory University School of Medicine, said in an interview with AJMC.

Returning to standard practice, guidelines, schedules, vaccination practices, and communication with patients is important to rebuilding trust between patients and health care systems, Felzer said.

“Mistrust and vaccine hesitancy have been something that has been growing for a long time…and this has been predating COVID,” Felzer said. “And bringing it back to the basics, vaccination, hand hygiene, and basic sanitation practices...is really important.”

5. How can public health leaders build trust during infectious disease emergencies?

Engaging communities and building trust should be a continuous effort from public health officials, Bucher said.

“These relationships need to pre-exist a crisis. [Health officials] need to have been part of the community [and] understanding the community so [they’re] already positioned as a trusted partner when something happens,” she said.

Developing a consistent public health infrastructure to continually engage communities and actively address everyday health and well-being could make a significant difference in public trust when health crises, like the Ebola virus and SARS-CoV-2, arise.

Additionally, Felzer recommended that clinicians and policymakers make vaccine guidance clear and digestible for the general population.

“We need to make our guidelines simple and clear. We need to continue to have these conversations with not only our colleagues but also our patients and our communities because we need to build back trust in the scientific community.”

References

1. Emanuel G. Fighting suspicion and mistrust about ebola. NPR. June 4, 2026. Accessed June 10, 2026. https://www.npr.org/2026/06/04/nx-s1-5845086/fighting-suspicion-and-mistrust-about-ebola

2. McKay B. Ebola outbreak is now third largest in history. Here’s what to know. The Wall Street Journal. May 26, 2026. Accessed June10, 2026. https://www.wsj.com/world/africa/ebola-outbreak-explained-4ab4414f

3. Assadu C, Kabumba J. Congo’s Ebola outbreak rises to over 100 deaths out of 550 cases as conflict slows response. AP News. June 9, 2026. Accessed June 10, 2026. https://apnews.com/article/congo-ebola-outbreak-bundibugyo-virus-392dced7e0da091699eeb980a4b54147