ST. LOUIS — An Ebola outbreak that originated in the Democratic Republic of the Congo has spread into neighboring Uganda. Jennifer Layden, associate dean for practice and professor at the Bursky School of Public Health at Washington University in St. Louis, assessed the response challenges.

"Stopping an Ebola outbreak requires extensive effort, and this instance is complicated by delayed detection and the geographic spread of the outbreak prior to official reporting," Layden said. "There also are tensions and conflicts within the affected regions, likely underdiagnosis of cases and the absence of an approved therapeutic or vaccine for the strain involved."

"An on-the-ground response to an outbreak like this requires both scientific protocols including case identification, contact tracing, isolation, and community education, and communication strategies to earn community support," Layden said. She previously served as the state epidemiologist and chief medical officer for Illinois and founded the Centers for Disease Control and Prevention's Office of Public Health Data, Surveillance and Technology.

"Right now, the risk to Americans who have not traveled or been in the impacted regions recently is very low," Layden said. "Ebola is not something that naturally occurs in the U.S.," she said. "People contract Ebola through direct contact with body fluids of someone with symptomatic Ebola, or through contaminated objects."

Current U.S. public health protocols include travel restrictions, screening for returning travelers, and monitoring individuals with known exposure. U.S. public health surveillance includes tracking patterns in emergency department and urgent care visits and monitoring traditional and social media for disease indicators. Many infectious diseases are legally required to be reported to state and local health departments for continuous monitoring.