US Issues Title 42 Order Suspending Entry from Ebola-Affected Countries in Central Africa

CENTRAL AFRICA — The Centers for Disease Control and Prevention issued an order on May 18 suspending the right to introduce covered aliens, a legal term that refers to foreign nationals who are neither U.S. citizens nor lawful permanent residents (green card holders) and who have departed from or were present in the Democratic Republic of the Congo, Uganda, or South Sudan during the preceding 21 days, into the United States for 30 days.

The order applies regardless of the person’s country of origin. The Department of Homeland Security and Customs and Border Protection direct all affected U.S.-bound travelers, including American citizens and lawful permanent residents, to designated airports for enhanced public health screening.

The State Department simultaneously raised travel advisories to Level 4 Do Not Travel for the three countries, temporarily paused visa operations at U.S. embassies in Juba, Kinshasa, and Kampala effective May 18, and committed to funding up to 50 treatment clinics in affected regions.

These coordinated measures took effect within days of laboratory confirmation and prioritize protection of Americans and the American homeland per the May 19 State Department statement.

The order remains subject to ongoing comprehensive public health risk assessment and allows time for strengthened surveillance, diagnostic capacity, and mitigation planning.

No suspected, probable, or confirmed cases linked to this outbreak have been reported in the United States as of May 22.

Public Health Response Measures

The CDC order, issued under Sections 362 and 365 of the Public Health Service Act and 42 CFR 71.40, targets the serious risk of introduction of Bundibugyo virus disease (BVD), caused by the Bundibugyo ebolavirus.

It explicitly covers covered aliens present in the Democratic Republic of the Congo, Uganda, or South Sudan within the last 21 days and remains in effect for 30 days from May 18.

The Department of State is implementing the order across consular and travel operations while coordinating with the Department of Homeland Security on any future quarantine or isolation guidance.

Enhanced screening requirements direct all U.S.-bound passengers who were present in the three countries within 21 days to route exclusively through Washington Dulles International Airport beginning 11:59 p.m. on May 21, with phased addition of Hartfield-Jackson Atlanta International Airport from 11:59 p.m. on May 22 and George Bush Intercontinental Airport in Houston from 11:59 p.m. on May 26.

Centers for Disease Control and Prevention and Customs and Border Protection personnel conduct the screenings and collect contact information for recommended public health follow-up. Travelers must confirm flights with airlines and expect possible disruptions.

Effective May 18, the U.S. Embassies in Juba, Kinshasa, and Kampala temporarily paused all visa services, including immigrant and non-immigrant categories, due to the outbreak. Affected applicants received direct notification.

The pause upholds public health and safety standards while the situation evolves. The State Department updated all three countries to Level 4 Do Not Travel advisories, stating that no American citizens or permanent residents should travel to the Democratic Republic of the Congo, Uganda, or South Sudan for any reason.

U.S. government employees face mission-critical restrictions only. The State Department committed to funding up to 50 treatment clinics in affected regions.

Clinics will provide emergency Ebola screening, triage, and isolation capacity, implemented primarily through United Nations OCHA to accelerate containment and expand access to care.

Epidemiological Update and Outbreak Scope

On May 15 the Ministry of Health of the Democratic Republic of the Congo confirmed an outbreak of Ebola disease in Ituri Province in northeastern Democratic Republic of the Congo.

Patients presented with fever, generalized body pain, weakness, vomiting, and in some cases bleeding, with several deteriorating rapidly.

On May 21 the Democratic Republic of the Congo and Uganda Ministries of Health reported a total of 575 suspected cases, 51 confirmed cases, and 148 suspected deaths across both countries, including 2 confirmed cases with 1 death in Uganda among individuals who traveled from the Democratic Republic of the Congo.

As of May 22 a total of 744 suspected cases, 83 confirmed cases and 176 suspected deaths had been reported.

Laboratory analysis conducted by the National Institute of Biomedical Research in Kinshasa confirmed Bundibugyo virus infection in 8 of 13 samples collected from suspected cases associated with clusters of severe illness and deaths in the Mongbwalu and Rwampara health zones.

The outbreak has expanded to 11 health zones in Ituri and Nord-Kivu provinces. No further local spread has been reported in Uganda. This marks the Democratic Republic of the Congo’s 17th Ebola virus outbreak since 1976 and its second involving the Bundibugyo species.

Previous Bundibugyo outbreaks occurred in Uganda in 2007 with a 25 percent case-fatality rate and in the Democratic Republic of the Congo in 2012 with a 50 percent case-fatality rate.

The outbreak is occurring in areas affected by insecurity, population displacement, mining-related movement, and frequent cross-border travel, all of which increase transmission risk.

The incubation period for Bundibugyo virus disease ranges from 2 to 21 days. There are currently no FDA-approved vaccines or therapeutics specific to the Bundibugyo species.

An American national working in the Democratic Republic of the Congo tested positive for Bundibugyo virus and was transferred to Germany for care; a second high-risk American contact was transferred to the Czech Republic.

What to Watch

• CDC Health Alert Network and situation-summary pages for updated case counts, laboratory confirmations, and any adjustments to the 30-day order (expected within 72 hours).

• State Department travel.state.gov advisories and embassy alerts for revisions to Level 4 designations, visa operations, or clinic implementation timelines (expected within 7-10 days).

• WHO IHR Emergency Committee temporary recommendations and risk assessments for additional international measures (next update expected within 7 days).

• Department of Homeland Security Federal Register notices for any expansion of designated screening airports (expected within 48-72 hours).

• Official State Department or UN OCHA implementation update on the 50 treatment clinics (expected within 7-10 days).

• DRC Ministry of Health or WHO consolidated contact-tracing report for Ituri and Nord-Kivu (expected within 72 hours).

• WHO R&D Blueprint or Africa CDC announcement on monoclonal antibody and obeldesivir trial initiation (expected within 14 days).

• Security incident reports from Ituri and North Kivu provinces for impact on clinic operations (ongoing monitoring).

Official Statements

• U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, CENTERS FOR DISEASE CONTROL AND PREVENTION (May 18 Order): “The Centers for Disease Control and Prevention (CDC), a component of the U.S. Department of Health and Human Services (HHS), issues this Order pursuant to Sections 362 and 365 of the Public Health Service (PHS) Act, 42 U.S.C. §§ 265, 268, and their implementing regulations. This Order suspends the right to introduce ‘covered aliens,’ as defined herein, into the United States for a period of thirty days, subject to the outcome of an ongoing comprehensive public health risk assessment. This Order is necessary to protect the health of the United States from the serious risk posed by the introduction of Ebola disease into the United States by covered aliens based on the emergent outbreak of Ebola disease caused by the Bundibugyo virus strain confirmed present in Democratic Republic of the Congo (DRC) and Uganda. This suspension Order applies to covered aliens who have departed from, or were otherwise present within, DRC, Uganda, or South Sudan during the last 21 days (regardless of their country of origin). This order is time-limited and shall be in effect for 30 days from the date of issuance.”

• U.S. DEPARTMENT OF STATE, OFFICE OF THE SPOKESPERSON (May 19 Ebola Response Update and Clinic Funding): “The Department of State, in close coordination with the Centers for Disease Control and Prevention (CDC), the lead agency for the U.S. Government response, is actively responding to the Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda. The Department’s first priority is the protection of Americans and the American homeland. The Department has issued updated Level 4 travel advisories for all three countries: no American citizens or permanent residents should travel to the DRC, Uganda, or South Sudan for any reason. Americans should remain vigilant of CDC guidelines on isolation and quarantine if they are departing the region. Over the weekend, the Department mobilized an initial $23 million in bilateral foreign assistance to immediately bolster each country’s own response, supporting surveillance, laboratory capacity, risk communication, safe burials, entry and exit screening, and clinical case management. Today, the United States announced a broad commitment to rapidly support the response by funding up to 50 treatment clinics, and associated frontline costs being established in Ebola-affected regions of the DRC and Uganda. Clinics will provide emergency Ebola screening, triage, and isolation capacity. This U.S. funding commitment will accelerate the delivery of frontline medical care, life-saving humanitarian assistance, and critical outbreak response capabilities to communities at greatest risk.”

• U.S. DEPARTMENT OF STATE (May 18 Temporary Pause of Visa Operations): “Effective May 18, 2026, the U.S. Embassies in Juba, South Sudan; Kinshasa, Democratic Republic of the Congo; and Kampala, Uganda have temporarily paused all visa services. This pause includes applications for immigrant visas as well as nonimmigrant visas for tourists, business travelers, students, exchange visitors, and all other nonimmigrant categories. Affected visa applicants have been notified. We will update our website when appointment scheduling resumes and inform applicants whose appointments were rescheduled.”

• CENTERS FOR DISEASE CONTROL AND PREVENTION HEALTH ALERT NETWORK AND FAQ (May 19-21 Update): “On May 15, 2026, the Ministry of Health of the Democratic Republic of the Congo (DRC) confirmed an outbreak of Ebola disease in Ituri Province in northeastern DRC. As of May 16, 2026, a total of 246 suspected cases and 80 deaths have been reported. Laboratory analysis conducted by the National Institute of Biomedical Research (INRB) confirmed the cause as Bundibugyo virus infection in 8 of 13 samples collected from suspected cases associated with clusters of severe illness and deaths in the Mongbwalu and Rwampara health zones in Ituri Province. As of May 21, the DRC and Uganda Ministries of Health report the following: A total of 575 suspected cases, 51 confirmed cases, and 148 suspected deaths. These numbers include 2 confirmed cases including 1 death in Uganda in people who traveled from DRC. No further spread has been reported. This is a rapidly evolving situation, and case counts are subject to change. There have only been 2 previous outbreaks of the Bundibugyo species of Ebola virus, 1 in Uganda, and 1 in DRC, with death rates of 25% and 50%, respectively.”

• TRAVELGOV (May 22 Health Alert): “Health Alert: Worldwide Caution – Updated Public Health Arrival Restrictions and Enhanced Ebola Screening – May 22, 2026. Event: U.S.-bound American citizens and lawful permanent residents (LPRs) who have been present in the Democratic Republic of the Congo, Uganda, or South Sudan within 21 days of arrival in the United States must only enter through the following airports for enhanced screening: Washington Dulles International Airport (IAD) for flights after 11:59 PM on May 21, 2026; Hartfield-Jackson Atlanta International Airport (ATL) for flights after 11:59 PM on May 22, 2026; George Bush Intercontinental Airport (IAH), Houston, for flights departing after 11:59 PM on May 26, 2026. The U.S. Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security’s (DHS) Customs and Border Protection (CBP) will apply enhanced public health screening at IAD in response to the Ebola outbreak. This requirement applies to all passengers, including U.S. citizens and LPRs, who were present in those countries. Please be prepared for flight changes or cancellations.”

• WORLD HEALTH ORGANIZATION (May 22 IHR Emergency Committee Temporary Recommendations): “On 19 May 2026, the Director-General convened the first meeting of the IHR Emergency Committee regarding the epidemic of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda. Temporary recommendations are issued to all IHR States Parties to respond to and prepare to respond to the epidemic, according to the public health risk they face. As of 22 May 2026, the WHO Secretariat assessed the risk for these States Parties as ‘Very high’ for the DRC and as ‘High’ for Uganda.”

• CDC OFFICIAL ACCOUNT (May 18): “CDC and federal partners are implementing proactive public health measures to help prevent the introduction of Ebola disease caused by Bundibugyo virus (BDBV) into the United States. These actions include enhanced traveler screening and monitoring, coordination with airlines and ports of entry, strengthened hospital and laboratory readiness, and continued deployment of CDC teams to support outbreak response efforts abroad. Effective immediately, additional entry restrictions will apply to non-U.S. passport holders who have traveled through affected areas in Uganda, the DRC, or South Sudan within the past 21 days. CDC assesses the risk to the general U.S. public as low.”