Credit CDC
#19,168
While the full extent of the Ebola outbreak in the DRC and neighboring countries remains unclear, we are already seeing numbers that suggest this virus is spreading rapidly in the community.
The latest CDC update reads:
New developments
- On May 17, an American who was exposed as part of their work caring for patients in DRC tested positive for Ebola Bundibugyo disease.
- The person developed symptoms over the weekend and tested positive late on Sunday.
- CDC is working hand-in-hand with the U.S. Department of State to move the patient to Germany for treatment and care. In addition to being a shorter flight time, Germany has previous experience caring for Ebola patients.
- High-risk contacts associated with this exposure are also being moved to Germany.
- As of May 19, the DRC and Uganda Ministries of Health report the following:
- A total of 536 suspected cases, 105 probable cases, 34 confirmed cases, and 134 deaths
- In the last 24 to 48 hours, 26 new confirmed cases and 143 new suspected cases were identified,
- These numbers include 2 confirmed cases including 1 death in Uganda in people who traveled from DRC. No further spread has been reported.
- On May 18, CDC, the Department of Homeland Security, and other appropriate federal agencies took proactive public health measures to prevent Ebola from entering the United States.
- This is a rapidly evolving situation, and case counts are subject to change.
- More information about enhanced travel security measures is forthcoming.
Late yesterday afternoon the CDC issued the following lengthy HAN Advisory. I've only posted some excerpts. Those with specific interests (clinicians, public health workers, lab techs, etc.) will want to read the advisory in its entirety.
I'll have a brief postscript after the break.
Ebola Disease Outbreak in the Democratic Republic of the Congo and Uganda
May 19, 2026
Distributed via the CDC Health Alert Network
May 19, 2026
CDCHAN-00530
Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert clinicians, public health practitioners, and travelers about a new outbreak of Ebola disease in the Democratic Republic of the Congo (DRC) and Uganda caused by the Bundibugyo virus (species Orthoebolavirus bundibugyoense).
The risk of spread to the United States is considered low at this time. As a precaution, this Health Advisory summarizes CDC recommendations for U.S. health departments, clinical laboratories, and healthcare workers about potential Ebola disease case identification, testing, and biosafety considerations in clinical laboratories.
Background
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. Patients presented with symptoms including fever, generalized body pain, weakness, vomiting, and in some cases bleeding. Several patients reportedly deteriorated rapidly and died. The outbreak is occurring in areas affected by insecurity, population displacement, mining-related population movement, and frequent cross-border travel, all of which may increase the risk of further transmission. In neighboring Uganda, health authorities confirmed Bundibugyo virus disease (BVD) in a patient who had traveled from DRC and later died while receiving care. Ugandan authorities have activated surveillance, screening, and response measures.
On May 15, 2026, CDC issued a Level 1 Travel Health Notice for people traveling to Uganda and a Level 3 Travel Health Notice for people traveling to DRC. On May 17, the World Health Organization determined this outbreak to be a public health emergency of international concern. As of May 18, no suspected, probable, or confirmed Ebola cases related to this outbreak have been reported in the United States.
This is the 17th recorded Ebola outbreak in DRC since the virus was first identified in 1976. The previous Ebola outbreak in DRC ended in December 2025. The Bundibugyo species of Ebola virus was first identified in Uganda in 2007 and has historically been associated with somewhat lower case fatality rates than other species of Ebola virus disease, though severe disease and death can still occur. Previous outbreaks of BVD have had mortality rates of approximately 25%-50%.
CDC is working through its country offices and partners in DRC and Uganda to provide technical assistance with disease tracking and contact tracing, laboratory sample collection and testing, virus sequencing, infection prevention and control (IPC) efforts, border health screening, and coordination with affected countries and international public health partners. Case numbers are subject to change as the situation evolves.
The risk of spread to the United States is considered low at this time. However, it is possible for travelers from affected areas in DRC or Uganda to enter the United States. Therefore, as an additional precaution, CDC is working to raise awareness of this outbreak among travelers, public health departments, public health and clinical laboratories, and healthcare workers in the United States.
Ebola disease is caused by a group of viruses known as orthoebolaviruses (formerly ebolavirus). Ebola disease most commonly affects humans and nonhuman primates, such as monkeys, chimpanzees, and gorillas. Four orthoebolaviruses cause illness in people, presenting as clinically similar disease:
The incubation period for BVD ranges from 2 to 21 days after exposure. A person infected with an orthoebolavirus is not considered contagious until after symptoms appear. Early "dry" symptoms include fever, aches, pains, and fatigue and later "wet" symptoms include diarrhea, vomiting, and unexplained bleeding. Ebola disease is spread through direct contact (through broken skin or mucous membranes) with the body fluids (e.g., blood, urine, feces, saliva, semen, or other secretions) of a person who is sick with or has died from Ebola disease. Ebola disease can also be transmitted to humans from infected animals, or through contact with objects like needles that are contaminated with the virus. Ebola disease is not spread through airborne transmission.
- Ebola virus (species Orthoebolavirus zairense) causes Ebola virus disease.
- Sudan virus (species Orthoebolavirus sudanense) causes Sudan virus disease.
- Taï Forest virus (species Orthoebolavirus taiense) causes Taï Forest virus disease.
- Bundibugyo virus (species Orthoebolavirus bundibugyoense) causes Bundibugyo virus disease.
In the absence of early diagnosis and appropriate supportive care, Ebola disease has a high mortality rate. There is currently no Food and Drug Administration (FDA)-licensed or authorized vaccine to protect against Bundibugyo virus infection. The Ebola vaccine licensed in the United States (ERVEBO®) is indicated for preventing Ebola disease due to a different species of Ebola virus (species Orthoebolavirus zairense) only, and based on studies in animals, this vaccine is not expected to protect against Bundibugyo virus or other orthoebolaviruses. There is currently no FDA-approved or authorized treatment for BVD, but there are therapies that have shown some efficacy in animal models. With intense supportive care and fluid replacement, mortality rates may be lowered.
CDC has developed recommendations for U.S.-based organizations (e.g., nongovernmental, faith-based, academic, or aid organizations) with staff working in affected areas: Recommendations for Organizations Sending U.S.-based Personnel to Areas with VHF Outbreaks.
Recommendations for Clinicians
Recommendations for Public Health Departments
Recommendations for Clinical Laboratory Biosafety
Recommendations for U.S. Travelers
CDC recommends avoiding nonessential travel to Ituri and Nord-Kivu provinces in DRC. If they travel to DRC, travelers should take precautions as described in CDC's level 3 Travel Health Notice, including taking steps to avoid possible exposure to BVD and monitoring themselves for symptoms while in DRC and for 21 days after leaving. Travelers who develop symptoms during this time should self-isolate and contact local health authorities or a clinician.
Travelers to Uganda are recommended to follow recommendations in CDC's level 1 Travel Health Notice including taking steps to avoid possible exposure to BVD and monitoring themselves for symptoms while in Uganda and for 21 days after leaving. Travelers who develop symptoms during this time should self-isolate and contact local health authorities or a clinician.
Recommendations for the Public
- Protect yourself and prevent the spread of BVD when living in or traveling to a region where Bundibugyo virus is potentially present or that is currently experiencing an outbreak.
- In affected areas, take the following actions to protect yourself:
- Avoid contact with sick people who have symptoms such as fever, muscle pain, and rash.
- Avoid contact with blood and other body fluids.
- Avoid materials possibly contaminated with blood or other body fluids of people who are sick.
- Avoid semen from men who have recovered from BVD until testing shows that the virus is no longer in the semen.
- Avoid visiting healthcare facilities for nonurgent medical care or for nonmedical reasons.
- Avoid visiting traditional healers.
- Do not participate in funeral or burial practices that involve touching the body of someone who died.
- Keep away from bats, forest antelopes, non-human primates (e.g., monkeys, chimpanzees, gorillas), and avoid contact with blood, fluids, or raw meat from these or unknown animals.
- Do not enter areas where bats live, such as mines or caves.
- Monitor your health while you are in, and for 21 days after you return from, an area experiencing a BVD outbreak.
- If you develop any symptoms of BVD during this time, isolate (separate) yourself immediately from others, do not travel, and contact local health authorities or a healthcare facility for advice.
- Before you enter a healthcare facility, alert the healthcare providers of your recent presence in a BVD-affected area.
Over the past 3 weeks we've seen 2 viral outbreaks (hantavirus & Ebola) emerge from out of left field - and while I believe both will be contained - it is a reminder of how quickly the viral landscape can change.
The next pandemic virus is likely already out there, in a bat, a mouse, or a bird; just looking for the right opportunity (or evolutionary change) to enable it to jump species and begin its world tour.
Meanwhile we continue to dismantle our global surveillance and reporting systems, we resist aggressive testing of livestock, and we've cut funding for both basic research and public health systems.
But at least when next pandemic crisis invariably does appear, our leaders will be able to shake their heads and honestly say; `No one saw it coming.'
