Interim Guidance for Public Health Assessment and Management of Travelers from Countries Affected by the 2026 Ebola Outbreak

Overview

An outbreak of Bundibugyo virus disease (BVD) is occurring in the Democratic Republic of the Congo (DRC).

BVD is a type of Ebola disease (a viral hemorrhagic fever [VHF]) caused by infection with the Bundibugyo virus. BVD is a serious and often deadly disease. No vaccines or specific treatments have been approved to prevent or treat BVD. Early supportive care improves the chance of survival. Local health authorities in DRC are conducting public health investigations to identify people with Ebola and their contacts. The goal of these activities is to prevent further transmission and educate communities and the public about the risks of the disease and actions they can take to protect themselves and their loved ones. As part of domestic response to the BVD outbreak in DRC, CDC is providing this interim guidance to state, tribal, local, and territorial health departments with recommendations for post-arrival management of travelers to the United States who have been in an affected country in the past 21 days, including Ebola exposure assessment, education, and monitoring. As of August 6, 2026, DRC is the primary country affected by this outbreak.

To reduce the risk of Ebola importation into the United States, U.S. entry is temporarily restricted for travelers who were recently in DRC. Travelers, including Americans, who have been in DRC within 21 days of their flight will not be allowed to board commercial flights with U.S. destinations. All U.S. citizens and U.S. nationals who have been in DRC should plan to remain outside DRC for 21 days before entering the United States. This includes all passengers with an intermediate stop in the DRC or on multi-stop itineraries via the DRC regardless of whether they disembarked or stayed on the airplane. CDC will also be notified by U.S. Customs and Border Protection about American citizens and nationals who arrive at a U.S. port of entry (airport, seaport, or land border) within 21 days after leaving DRC so CDC can conduct an initial public health assessment and coordinate subsequent public health management with federal partners and state, tribal, local, and territorial health departments, as appropriate.

State, tribal, local, and territorial jurisdictions may choose, consistent with their authorities, to use more stringent public health measures than are recommended in this guidance.

Definitions

Affected countries

• DRC
• South Sudan
• Uganda

Specific areas of concern for the purpose of this response (as of August 6, 2026)

• DRC: Entire country
• South Sudan: No specific area of concern identified; travelers from South Sudan are included in this interim guidance because it neighbors DRC with a high-volume of travel across a porous shared border.
  
• Uganda: No current area of concern; as of August 6, 2026, more than 21 days have passed since the last patient with BVD in Uganda was discharged from the hospital after two negative tests. Furthermore, more than 42 days have passed since that patient was isolated which is highly suggestive that community transmission is not occurring in Uganda.

Outbreak provinces

• DRC: Haut-Uélé, Ituri, Nord-Kivu (North Kivu), Sud-Kivu (South Kivu) and Tshopo provinces
• South Sudan: None
• Uganda: None

High-risk exposures

Refer to detailed definition in Public Health Management of People with Suspected or Confirmed VHF or High-Risk Exposures

Situations with exposure potential

The following situations have potential for unrecognized exposure to BVD and should be considered in the assessment of people without reported high-risk exposures who have been in an area of concern during the previous 21 days.

Nonoccupational

• Exposure to a person with acute febrile illness
• Visiting a health care facility or traditional healer
• Attending a funeral or burial
• Contact with bats or non-human primates; contact with blood, fluids, or raw meat from these animals; or entry into areas known to be inhabited by bats (e.g., caves, mines)

OccupationalA

• Providing health care, performing environmental cleaning, or handling of waste in an Ebola treatment unit (ETU), or for patients with BVD in any clinical setting
• Entry into a patient care area of an ETU for any reason
• Providing health care to patients not known to have BVD
• Environmental cleaning or handling of waste in a regular healthcare facility
• Clinical laboratory work associated with a treatment unit or other health care setting
• Burial work

Traveler assessment and education

Air passengers arriving from or transiting (on a connecting flight) through affected countries are being redirected to a U.S. airport designated for public health entry screening. At screening, federal public health staff will conduct an initial assessment. The CDC assessments will be accessible to health departments of jurisdiction in CDC's One CDC Data Platform (1CDP).

Health departments should also establish communication with travelers arriving in their jurisdictions from an affected country to conduct an initial assessment, provide health education, conduct symptom monitoring if recommended (as described below), and track overall success in monitoring incoming travelers, based on resources available in the jurisdiction. For travelers who were screened at a U.S. port of entry, health departments may choose to defer to CDC's assessment of the traveler; however, health departments should still interact with travelers shortly after their arrival to conduct education as described below.

The initial health department encounter should occur as soon as feasible, ideally within 24 hours of receiving CDC's notification about the traveler's arrival. Priority should be given to travelers reporting situations with exposure potential and those who have been in an outbreak province in DRC.

A summary of these recommendations is provided in the table below.

Traveler contact information

CDC will provide contact information for travelers arriving from an affected country to the appropriate health departments daily through 1CDP.

Initial assessment

If a jurisdiction chooses to conduct its own exposure assessment, the assessment should include whether the traveler:

• had any potential high-risk exposures
• was present in an area of concern
• had any epidemiologic risk factors for exposure to Bundibugyo virus, i.e., situations with exposure potential (see definition above)
• used personal protective equipment and other recommended infection control measures during any situation with potential for exposure to Bundibugyo virus
• had any potential zoonotic exposures (as described above)

Refer to the definitions above for high-risk exposures and situations with other exposure potential and to help guide traveler assessment. Travelers should also be assessed for signs and symptoms compatible with BVD during the initial assessment.

A sample exposure screening and assessment tool is available here.

Health education

Health departments should help all travelers who have been in an affected country understand:

• possible signs and symptoms of BVD and how to self-monitor
• the need to self-isolate immediately and contact their health department if symptoms develop
  • Health departments should assist travelers in identifying a suitable location within their homes to self-isolate, ideally with access to a dedicated private bathroom
• how to reach the health department 24/7 if symptoms develop
• recommendations regarding domestic, international, or cruise ship travel during the 21 days after leaving an affected country, as specified below
• the need for advance notification to the health department if travel outside the jurisdiction is planned

CDC has posted Information for Travelers Returning from Ebola-Affected Areas. Health departments may choose to use this resource as part of their health education activities.

Monitoring and other interventions

During the current outbreak, in-person monitoring is recommended for travelers who have been in or transited through DRC. For travelers from Uganda or South Sudan, symptom monitoring while they are in the United States can be conducted by phone, video conferencing, other electronic means (e.g., text message, email, app, web form), or in person, according to resources available in that jurisdiction. The frequency of monitoring is guided by the results of the exposure assessment and travel history, as specified below.

Travelers with high-risk exposures

Refer to guidance available in Public Health Management of People with Suspected or Confirmed VHF or High-Risk Exposures.

Travelers who were in, or transited through an airport in, DRC and had no high-risk exposures

All travelers who have been in DRC should be advised to self-monitor (including daily temperature measurement) and notify their health department if they develop symptoms within 21 days after leaving the area of concern.

Health departments should monitor these travelers twice daily in person.

Travelers should be advised to stay home and avoid others, and to delay nonurgent medical or dental care.

Travel should be limited to essential purposes, such as obtaining urgent health care. It should occur by noncommercial means (private vehicle or private chartered flight), and be coordinated by health authorities at the travel departure area and destination.

Travelers who were in, or transited through an airport in, South Sudan or Uganda

These travelers should be advised to watch their health until 21 days after departing or transiting through an airport in South Sudan or Uganda. If they develop symptoms, they should take their temperature and notify their health department.

After the initial encounter with the traveler, health departments may consider an additional check-in during or at the end of the 21-day period.

If these individuals intend to travel outside their jurisdiction, they should notify the jurisdiction's health department. For domestic travel, the health department could choose to coordinate with the health department in the jurisdiction where the traveler is going or retain responsibility for the traveler. CDC does not have a recommendation for international notification for this group of travelers if they depart the United States; however, travelers should reconsider international travel and cruise ship travel because of uncertainty about restrictions and access to health care in destination countries.

Table—Asymptomatic Travelers

Symptomatic travelers

If a traveler is identified as being symptomatic within 21 days after arriving from an affected country, health department personnel should reassess the person's travel and potential exposure history in the context of their reported signs/symptoms to determine the likelihood that their illness is caused by Bundibugyo virus (i.e., whether the clinical case definition for a suspected case is met), in consultation with CDC subject matter experts.

The purpose of having health departments reassess symptomatic travelers is so that public health officials at the state, tribal, local, and territorial levels can:

• Have immediate situational awareness if a traveler from an affected country develops symptoms and avoid symptomatic travelers' presenting at a healthcare facility without advance notification
• Make recommendations, in consultation with CDC, regarding the need a symptomatic traveler to seek medical evaluation and care immediately versus careful observation and in-home isolation
• Identify the appropriate type of treatment center for the person if medical evaluation and care are recommended, based on whether or not BVD is suspected
• Communicate their assessment to emergency medical services, healthcare facilities, and others, as needed, in coordinating the transport and management of symptomatic people for whom medical evaluation and care are recommended

By assuming a coordinating role in the management of symptomatic travelers, health departments will have the opportunity to:

• Avoid unnecessary testing of people whose signs/symptoms and exposure history do not meet the definition for a suspected case of BVD
• Address potential concerns of healthcare or medical transport personnel in situations where symptomatic travelers have no known epidemiologic risk factors and testing is not recommended
• Minimize potential unintended consequences of managing a symptomatic traveler with no known epidemiologic risk factors as a suspected case-patient. These include unnecessary implementation of infection prevention and control precautions suitable for VHF or delayed recognition and management of other more common and potentially life-threatening conditions (e.g., malaria, typhoid) while ruling out BVD (see Guidance on Performing Routine Diagnostic Testing for Patients with Suspected VHFs or Other High-Consequence Disease)
• For any patient whose illness and exposure history meet the definition of suspected case of BVD:
  • Designate an appropriate healthcare facility that has capacity to provide an appropriate level of care for and safely manage a patient with suspected VHF
  • Communicate in advance with emergency medical services and the healthcare facility to allow appropriate infection control precautions to be in place during transport and at the healthcare facility