As eastern Congo battles the fastest-growing Ebola outbreak on record — with nearly 3,800 confirmed cases and more than 1,700 deaths — health officials are confronting another public health crisis: fear of health facilities. Their work highlights a broader public health lesson: An outbreak’s success depends not only on controlling the disease but also on maintaining enough trust in the health system that people continue seeking essential care. Here, Seff and Stark explain how fear and mistrust can undermine outbreak response; why women and girls are disproportionately affected; and what public health leaders can do to reduce those risks. SeffHow can fear become a public health risk during an outbreak? The worst part is that the mistrust that arises from one poorly designed public health response can carry over to the next emergency.