Doesn't sound like an exposure, but a customs issue.

Air France boarded a passenger from the Democratic Republic of Congo in error on a flight to the United States," U.S. Customs and Border Protection said in a statement to Free Press Wednesday evening. "Due to entry restrictions put in place to reduce the risk of the Ebola virus, the passenger should not have boarded the plane. CBP took decisive action and prohibited the flight carrying that traveler from landing at Detroit Metropolitan Wayne County Airport, and instead, diverted to Montreal, Canada."

906-patient facial dog bite study just published. Breed and severity data both collected. Never cross-tabulated. Not once.

Rothka et al., OTO Open, 2026. DOI: 10.1002/oto2.70233. Open access, Penn State Hershey, Level 1 trauma centre, 906 patients, 11 years.

The chart review captured all of this:

• Breed (68 breeds, reported for 686 patients)
• Hospital admission yes/no
• Operative vs bedside vs conservative management
• Anatomical location (15 facial subunits)
• Number of injuries per patient
• IV vs oral antibiotics
• Provocation type
• Family dog vs other

Breed appears once, as a raw count in Table 3. After that it vanishes from the analysis. The paper never asks whether breed predicts severity. Not in the results. Not in the discussion. Not in a supplementary table.

What Table 3 actually shows

Top of the breed list:

Breed	n	%
Pitbull	154	22.4
Labrador	72	10.5
German Shepherd	48	7.0
Rottweiler	24	3.5
Husky	23	3.4
Golden Retriever	23	3.4
Bulldog	22	3.2
Poodle	20	2.9
Mastiff	19	2.8
Doberman	18	2.6

Pitbull is more than double the next breed. The discussion brushes this aside with "it is intuitive that the most common breeds are most commonly involved in dog bites" and points at AKC popularity rankings. Two paragraphs later, the same discussion notes the AKC doesn't recognise the Pitbull as a breed. The popularity argument is applied to a breed the cited authority doesn't recognise.

No population denominator is provided anywhere.

The five tables that should exist and don't

1. Operative repair by breed. 16.9% overall went to theatre under GA. Was the rate the same for every breed? The paper doesn't say. The data is in the chart review.

2. Admission by breed. 17.0% overall admitted. Their own admission rate runs higher than published comparators (9.7–13.2%). They don't ask whether that's driven by which breeds attended.

3. Injuries per patient by breed. 906 patients, 2,061 injuries. That's 2.27 wounds per patient on average. Multi-site injury is a known severity marker. Breed-stratified version: never reported.

4. Anatomical distribution by breed. Table 4 breaks 1,535 injuries across 15 facial subunits across 12 years. Beautiful table. No version of it by breed.

5. IV vs oral antibiotics by breed. Ampicillin-sulbactam (IV, 17.5%) implies inpatient or severe. Amoxicillin-clavulanate (oral, 62.7%) is the outpatient default. The IV ratio by breed isn't reported.

Every one of these is a single column in the spreadsheet they already had.

What replaces the analysis

Three moves, repeated:

>"it is intuitive that the most common breeds are most commonly involved in dog bites"

No denominator. Argument from intuition, not data.

>"Given there is no consensus in what breeds bite most often, it is important to educate patients on how to engage with dogs."A 906-patient series is one of the larger contributions you can make to that consensus. Citing the lack of consensus as a reason not to add to it is circular.

A 906-patient series is one of the larger contributions you can make to that consensus. Citing the lack of consensus as a reason not to add to it is circular.

>

There are more than a dozen medical studies showing exactly that.
WHY THE OMISSION?

Paper's open access. Tables 1, 3, 4, 5. Discussion starts page 4.
Read it yourself and tell me what I'm missing.

Link: https://www.researchgate.net/publication/403995604_Evaluating_Dog_Bite-Induced_Facial_Trauma_A_Study_From_a_Single_Tertiary_Care_Center

Hi, I'm looking for experiences of trans people working in public health. Specifically, I am likely FTM (egg cracked a few months ago).

I'm afraid about the impact of medical transition on my future working life and employability. Trans rights are going backwards almost everywhere.

I'm not in the US/UK but am in the anglosphere. I'm an MD.

Any trans people, trans men and POC in particular, able to share their experiences? Are you stealth or open about being trans? How are your colleagues?

I am in uni for a few years to come.

I'm from the middle east and have no plans of living in either country long term. I want to attain an MPH though so I can use it for my country. US MPH degrees sound more prestigious, but UK ones are much cheaper. Should I just go for the latter?

I work for a state government based public health department. We have recently gone through (and are still going through) some major restructuring. With this restructure, portfolios and work streams have been completely realigned. The fiscal environment is pretty gross and funding for a lot of services has been minimised or cut.

A few new higher-ups have been hired, mostly all with big private entity experience. Their views and way of handling everything very much align with that experience.

Long story short - I have reached a point where work is leaving me emotionally drained. The new directions that are being taken do not act on the data and evidence available. My personal belief and understanding is that the long term ramifications will be significant, in a really bad way.

I believe it is our duty as public health professionals to stand up for what is right, based on the quality evidence available. Yet whenever I do this, or ask questions, I get high level waffle back or no response at all. It’s making me feel absolutely crazy.

What do you do when faced with situations such as this?

So much in me wants to fight hard, as I’m incredibly passionate about the space that I work in. Though it’s not healthy to be feeling this way all the time. That makes me want to give up, as I feel like nothing is in my control anyway and I might as well just focus on what I can do for my family.

Have you been through this? What did you do?

Genuinely asking because I might be misreading the room here.

The NCD-RisC paper is technically using "plateau" correctly. It says that prevalence stopped accelerating in the US, UK, Canada around the early 2000s.

Ref: NCD Risk Factor Collaboration (NCD-RisC). Obesity rise plateaus in developed nations and accelerates in developing nations. Nature (2026).

The US plateaued at 23% childhood obesity in boys. France plateaued at 3-4%. Both get labelled plateaued. That's not the same phenomenon according to me. That's two completely different baselines that both stopped moving. A plateau at 40% isn't a plateau.

And in GI specifically, a plateau in prevalence doesn't do anything for the downstream queue. The 20-year lag between obesity onset and MASLD cirrhosis, Barrett's progression, colorectal cancer - that cohort that plateaued in 2005 is who I'm scoping right now.

The LMIC framing bothers me more though. Several of those trajectories aren't "catching up to Western levels". Maybe I'm reading too much into language. But words matter when they reach health ministers and hospital planners.

Is anyone else noticed this framing in how the paper's being discussed?

A young girl washing her hands at an Ebola prevention checkpoint supported by UK aid at a Ugandan border crossing point with the Democratic Republic of the Congo, August 2019. Photo: DFID/Anna Dubuis via Wikimedia Commons, CC BY 2.0.

The ongoing Ebola outbreak in eastern Democratic Republic of the Congo and Uganda is a regional emergency with public number still catching up to the real picture in the field. The WHO has declared the outbreak a “Public Health Emergency of International Concern” and Africa’s CDC declared a similar public health emergency. Despite both of those declarations, we still are likely well behind the curve in terms of confirmed case counts.

The US CDC’s May 17^(th) update had listed 10 confirmed cases in the DRC, 336 confirmed cases, with 88 deaths and two imported cases confirmed in Uganda. Today’s update from Africa’s CDC had increased the death count to 106 and 395 suspected cases across the affected areas of the DRC like Bunia, Goma, Mongwalu, Butembo, and Nyakunde and Kampala, Uganda. The Associated Press reports that one of the infected is an American doctor and medical missionary in Bunia. The numbers are likely to be higher by morning (I’ll be keeping this post up to date with important new information on the outbreak). None of this is to say this should be treated like a COVID-level threat with the WHO noting it does not yet meet the definition of a pandemic emergency. The threat to the average person outside of the region is low. Heightened risk currently sits with the families, health workers, burial teams, patients, drivers, contact tracers, and whoever else can be pulled into the chain of transmission.

What’s causing the outbreak?

Before getting further into the current outbreak, it is worth remembering how and when Ebola entered the official record in the first place. WHO describes Ebola disease as first appearing in 1976 in two near-simultaneous outbreaks, one of the Sudan virus disease in Nzara, in what is now South Sudan, and the other of Ebola virus disease in Yambuku, in what is now the Democratic Republic of the Congo. The Yambuku outbreak, near the Ebola River, is the one that gave the disease its name. CDC’s outbreak history lists the 1976 DRC outbreak at 318 cases and 280 deaths (a fatality rate of 88%). The index case was treated at Yambuku Mission Hospital with an injection for possible malaria, and subsequent transmission followed through contaminated needles and syringes at the hospital and nearby clinics, as well as close personal contact.

This is Bundibugyo ebolavirus, as opposed to the better-known Zaire ebolavirus. Species is important here; I say that because when most people hear about Ebola, they’re likely to think of the West Africa outbreak or the 2018-2020 outbreak in North Kivu and Ituri. Those were Zaire ebolavirus outbreaks, and thankfully our modern response toolkit to combat Zaire ebolavirus now has a vaccine. Bundibugyo is different, most importantly in that there is no vaccine and no treatment beyond supportive care such as fluids, electrolytes, oxygen, constant monitoring, watching for secondary infections, and clinical hygiene. That puts an added strain on the already lean control machinery like isolation of cases, tracing contacts for 21 days, protecting health care workers with adequate PPE, and crucially, handling burials safely.

Why tracing an outbreak early is difficult

In an early epidemic, we often end up with a denominator problem in that counts of cases often lag behind the actual epidemic curve. This happens for a variety of reasons: people get sick before being tested, families bury someone before samples can be collected, healthcare workers get exposed before a disease even has a name, patients move closer to hospitals, contacts move around before tracing is even known to be needed, and any other reason imaginable for why a case may be missed. With Africa CDC already describing hundreds of suspected cases and over 100 deaths into the public phase of the outbreak, it seems that the response is working to reconstruct something that may have been moving around for quite some time, with late April being thought to be a decent starting point with a healthcare worker being identified as an early case. So while the confirmed numbers are useful, they’re almost always going to be underestimates the day they’re released.

How does this compare to 2014?

The 2014 comparison is useful, but it is not perfect. Seven days after announcement is not the same thing as seven days after spillover. One outbreak can burn quietly for weeks before being recognized, while another can be identified faster because the surveillance system is already primed. So the comparison should not be treated as a clean clock-to-clock match. What we can compare is the early public surveillance snapshot: what officials knew, what they were still chasing, and what kinds of warning signs were already visible.

WHO’s first public notice on March 23, 2014, described 49 cases and 29 deaths in Guinea, a 59% case fatality ratio. By March 27, WHO was reporting 103 suspected and confirmed cases, 66 deaths, four laboratory-confirmed cases in Conakry, four health-worker deaths, and suspected cases with deaths in Liberia and Sierra Leone among people who had traveled from Guinea. ECDC’s March 27 update described the outbreak as rapidly evolving and noted that supplies and logistics were still being mobilized.

So while the variant is different, the early shape of the current epidemic is not exactly more reassuring than previous outbreaks as we see high deaths relative to reported cases, health-worker deaths, funeral exposure, city involvement, border risk, and contact tracing trying to catch up to events that have already happened. That along with the fact that the current outbreak is Bundibugyo, with no licensed vaccine or treatment, makes me more concerned for those in the region.

Politics are not irrelevant

In 2014, the outbreak occurred while USAID and the CDC were still at a working capacity with regards to combating infectious diseases like Ebola. Even then, the response was late, messy, and inadequate. This outbreak is happening after DOGE spent most of 2025 cutting into USAID and US international health response capacity. Obviously that didn’t cause the outbreak, but it certainly changed the response environment for the worse. Especially having nerfed our Ebola research capacity. High-containment labs have incredibly harsh safety standards, and with Bundibugyo having no licensed vaccine and no specific therapeutic, shutting down one of the rare labs capable of doing safe work on Ebola is working in the wrong direction to say the least.

Where the outbreak could be going.

I had seen a story on twitter regarding a case in Kinshasa but I haven’t been able to confirm anything other than a person who tested negative. Goma and Kampala likely matter more at the moment. Goma is a large, mobile city on the Rwandan border, and it is currently under the control of the Rwanda-backed paramilitary group M23 movement. AFP-linked reporting says a confirmed case in Goma involved the wife of a man who died of Ebola in Bunia. She traveled to Goma after his death while already infected leading to the closure of some Goma-Gisenyi border crossings after the case was reported.

Uganda has reported two imported confirmed cases among people who traveled from the DRC, with no local transmission identified at the time of WHO’s report. One imported case is a warning. Two imported cases that do not obviously sit in one neat chain make me wonder what the DRC side has not reconstructed yet.

CDC is now trying to put some of its machinery back in motion as their May 18 briefing, confirmed the American case linked to work in the DRC, evacuation of other American and high-risk contacts to a quarantine facility Germany, enhanced screening and traveler monitoring for arrivals from DRC, Uganda, and South Sudan, and entry restrictions for non-U.S. passport holders who had been in those countries during the previous 21 days. The risk to the American public remains low.

What to watch out for

Over the next few days, I’ll be watching whether cases keep appearing in Goma, Butembo, Bunia, or other cities. Isolated introductions are one thing. Multiple urban chains are different. There’s also a need to keep an eye on Uganda for local transmission. Some imported cases are expected when people move across borders for care, work, or family reasons but any local spread in Kampala would change the story for the worse.

I’ll also be watching out for the gap between suspected cases, deaths, and confirmed cases to either widen or start to narrow depending on how much suspected cases outpace confirmatory testing. The count is supposed to move as testing catches up, but a widening gap would be a bad sign. I’ll be watching to see whether international support moves faster than the virus. Early signs are good with the ECDC having activated the EU Health Task Force, the IRC launched an emergency response in eastern DRC, and Africa CDC says it is working with partners to assess medical countermeasures and accelerate the necessary operational research.

Hey everyone! I'm u/Animoma, a founding moderator of r/PrevMedDoctors.

Welcome to a community for residents, fellows, and attending physicians in Preventive Medicine and Occupational Medicine. This subreddit is a place to discuss residency training, board preparation, career opportunities, research, public health, workplace medicine, and the evolving role of our specialty in healthcare. Members are encouraged to share experiences, resources, clinical insights, career advice, and educational materials related to Preventive and Occupational Medicine.

Together, let's make r/PrevMedDoctors amazing.

I am reading the most recent WH release “2026 National Drug Control Strategy” for work and notice many of the administrations priorities focus on public health domains (evidence based treatment, public health data collection, etc) to combat the drug crisis.

My question is if Public Health is such a a need why did the administration categorize it under the non professional degrees? I do understand the economical logic behind the decision: loan amounts capped, universities will be forced to bring down their costs) but is that the only reason?!

I’m in public health and have been wanting to get my MPH degree for awhile and this decision deterred me big time because I don’t want to get into debt but reading this release, I realize it is a need and a priority!

Trying to converse about this with someone who may have some knowledge to what this administration is doing lol

I’m trying to get better at translating health guidance into language normal people will actually act on.

Not asking for patient-specific examples or proprietary campaign details. I’m more interested in patterns.

In your experience, what message, framing, or format genuinely changed behavior in a community you know well? Could be screening uptake, vaccine uptake, STI testing, smoking cessation, heat safety, air quality, follow-up visits, or something else.

And on the flip side: what sounded smart to professionals but landed badly with the public?

My working theory is that people often do not need more facts first. They need fewer decisions, a clearer next step, and a reason the action feels worth doing today.