On May 18, 2026, the Centers for Disease Control and Prevention CDC, a component of the Department of Health and Human Services HHS, issued an Order under Sections 362 and 365 of the Public Health Service PHS Act. This directive temporarily suspends the right of certain persons to enter the United States from countries experiencing a communicable disease outbreak. The immediate trigger for this action is an emergent outbreak of Ebola disease caused by the Bundibugyo virus strain, primarily confirmed in the Democratic Republic of the Congo DRC and Uganda, with South Sudan identified as being at high risk. This measure, effective for 30 days, is designed to safeguard U.S. public health by preventing the introduction of the virus while federal agencies conduct a thorough risk assessment and formulate a comprehensive response.
The Scope of the Suspension
The CDC's Order specifically targets what it terms "covered aliens" who have departed from, or were present within, the Democratic Republic of the Congo, Uganda, or South Sudan during the 21 days prior to seeking entry into the United States. This restriction applies regardless of the individual's country of origin. The 30-day duration of the order is deemed the minimum time necessary for the CDC to complete its evaluation, implement surveillance, enhance diagnostic capabilities, initiate contact tracing protocols, and develop a robust mitigation and containment plan in collaboration with various stakeholders.
Exemptions to the Order
Crucially, the order includes several exemptions to ensure it does not unduly impact specific populations or essential government operations. Those not subject to the suspension include:
- U.S. citizens, U.S. nationals, and lawful permanent residents.
- Members of the U.S. armed forces and associated personnel, along with U.S. government personnel serving overseas, their associated personnel, and their spouses and children, provided required assurances are met.
- Individuals whom customs officers, with supervisory approval, determine should be excepted based on a holistic assessment of significant law enforcement, officer and public safety, humanitarian, and public health interests. The Department of Homeland Security DHS will consult with CDC on the standards for these exceptions.
- Noncitizens who would otherwise fall under the order but are permitted entry into the United States as part of a DHS-approved process. This process must be documented, shared with the CDC, and incorporate appropriate mitigation protocols consistent with CDC guidance.
Authority and Purpose
The legal foundation for this CDC Order stems from Sections 362 and 365 of the PHS Act, specifically 42 U.S.C. 265 and 268, along with their implementing regulations under 42 CFR part 71. These statutes empower the CDC Director to suspend the introduction of persons into the United States when a quarantinable communicable disease in a foreign country poses a serious danger to U.S. public health, and the introduction of persons from that country exacerbates this danger.
The stated purpose of the order is two-fold. First, it aims to immediately reduce the number of individuals entering the U.S. from affected regions who may be exposed to Ebola, thereby lowering the risk of disease introduction. Second, it provides a critical window for a comprehensive assessment of the public health risks associated with the current Ebola outbreak, enabling informed decisions on future restrictions and the formulation of a detailed response strategy.
Understanding the Bundibugyo Ebola Outbreak
Ebola virus disease EVD is a severe and often fatal viral hemorrhagic fever. The current outbreak involves the Bundibugyo virus strain, a rarer form of Ebola first identified in Uganda in 2007. Symptoms are typical of other Ebola strains, including fever, weakness, vomiting, diarrhea, and in severe cases, hemorrhagic complications and organ failure. Transmission occurs through direct contact with infected bodily fluids or contaminated materials. The incubation period typically ranges from 2 to 21 days, with symptoms usually appearing within 4 to 10 days post-exposure. Crucially, infected individuals are not contagious until symptoms manifest.
Screening for Bundibugyo virus disease involves identifying symptoms and exposure history, such as recent travel to affected areas. Diagnosis is confirmed through specialized laboratory tests like PCR. Public health measures emphasize early detection, rapid isolation, stringent infection prevention, and contact tracing. Currently, there are no widely approved vaccines or specific antiviral treatments for the Bundibugyo strain, making supportive care critical for improving survival rates.
The Current Outbreak Situation
The ongoing outbreak is concentrated in eastern DRC's Ituri Province, where hundreds of suspected cases and dozens of deaths have been reported. Containment efforts are severely hampered by persistent conflict, inadequate health infrastructure, and porous borders in the region. Uganda has confirmed imported cases linked to travel from the DRC, including a case detected in Kampala, which underscores the cross-border transmission risk. Ugandan authorities have reactivated emergency response systems and intensified surveillance and screening at borders and health facilities. Uganda's experience with the 2025 Sudan virus strain outbreak has reportedly bolstered its preparedness and response capacity.
While South Sudan has not yet reported confirmed cases in the current outbreak, it is considered highly vulnerable. Its close proximity to affected areas in DRC and Uganda, coupled with limited healthcare resources and significant cross-border population movement, places it at substantial risk. Regional and international organizations, including the World Health Organization WHO and Africa CDC, are actively supporting preparedness measures, surveillance, and coordination across the three nations.
Despite these efforts, a significant concern remains the potential for the virus to spread beyond these countries, potentially reaching the United States. This risk is primarily linked to international travel by infected individuals during the asymptomatic incubation period. Travelers moving between affected regions and major global transit hubs such as Addis Ababa, Nairobi, Doha, Dubai, and Istanbul, which have extensive connectivity to U.S. gateway airports, could unknowingly transport the virus.
