Two rare disease outbreaks within two weeks – Andes hantavirus and Bundibugyo Ebola – have caused deaths and triggered costly international responses. Together they expose a gap not in our ability to respond, but in our willingness to anticipate, prevent and use precaution.

The hantavirus outbreak on a cruise expedition in the south Atlantic played out slowly. Three weeks passed between the death of one passenger on 11 April and the linkage to hantavirus on 2 May. In that time, passengers onboard the MV Hondius continued their itinerary, having been advised that the man had probably died of natural causes. They toured remote islands and ate together at the same tables. More than 30 passengers disembarked at St Helena and flew in different directions.

From 27 April, the picture worsened on the ship. A passenger was medevaced from Ascension, several others fell ill and one woman died.

A remote adventure cruise became a costly international health event, requiring World Health Organization coordination, the intervention of the Spanish prime minister and governments chartering planes to bring their nationals home from Tenerife for weeks of isolation. Cases may still emerge.

The second outbreak was immediately alarming. An Africa Centres for Disease Control and Prevention report last Friday cited 65 deaths and more than 260 cases of Ebola in the Democratic Republic of the Congo, concentrated in the remote province of Ituri, bordering Uganda and South Sudan. As it is endemic in the DRC, Ebola is usually picked up early – even one or two deaths have been notified to the WHO. This outbreak had been spreading for weeks before confirmation. When it was finally identified as the rare Bundibugyo strain, Africa CDC and the WHO alerted the world promptly.