The United States has elevated its travel advisory to the highest level, urging Americans to avoid all travel to several provinces in the Democratic Republic of the Congo (DRC) where a deadly Ebola outbreak has claimed thousands of lives. The Centers for Disease Control and Prevention (CDC) issued a Level 4 travel health notice for the Ituri and Nord-Kivu provinces, escalating from a previous Level 2 advisory.
A Level 3 warning, advising reconsideration of non-essential travel, has been issued for the Haut-Uélé and Tshopo provinces, with enhanced precautions recommended for all other areas of the DRC. These advisories come as the outbreak, caused by the Bundibugyo virus—a rare strain of Ebola with a historically high fatality rate of 25 to 50 percent—strains local healthcare infrastructure and raises concerns about international spread.
The Bundibugyo virus causes viral hemorrhagic fever, a severe and often fatal illness characterized by symptoms such as fever, headache, muscle pain, weakness, diarrhea, vomiting, stomach pain, and in later stages, bleeding or bruising. Currently, there is no approved vaccine or specific treatment for this strain of Ebola.
In response to the escalating crisis, the U.S. has also implemented temporary travel restrictions. Travelers, including U.S. citizens, who have been in the DRC within the past 21 days are barred from boarding commercial flights to the United States. American citizens and nationals returning from the DRC must travel to another country for 21 days before entering the U.S. For individuals arriving from neighboring Uganda or South Sudan, which have confirmed cases linked to the DRC outbreak but are not experiencing widespread independent outbreaks, entry into the U.S. is restricted to four designated airports with enhanced screening protocols.
As of August 9, data from the CDC and World Health Organization indicate over 4,381 confirmed cases and 2,011 confirmed deaths in the DRC. Uganda has reported 20 confirmed cases and two deaths, bringing the combined total to more than 4,400 cases and over 2,000 deaths linked to the Bundibugyo virus. These figures are subject to challenges in surveillance and reporting in conflict-affected regions.
Health officials have noted that retrospective investigations suggest transmission began in early April 2026, circulating undetected for approximately six weeks before the outbreak was officially declared on May 15. The provinces of Ituri and Nord-Kivu have been particularly affected, with healthcare facilities struggling to contain the virus amid ongoing insecurity and community resistance.
Early supportive care is crucial for improving survival chances, though the absence of approved medical countermeasures complicates containment efforts. This contrasts with other Ebola strains where vaccines and therapies have been successfully deployed.
Ebola is transmitted through direct contact with the blood or bodily fluids of infected individuals and contact with contaminated objects. It can also spread through contact with infected animals or the bodies of deceased individuals. Traditional burial practices, which often involve direct contact with the deceased, pose a significant risk of transmission.
The CDC has outlined strict precautions for individuals who must travel to affected provinces. These include reviewing health information, securing travel insurance with medical evacuation coverage, and avoiding contact with symptomatic individuals, bodily fluids, contaminated objects, healthcare facilities, traditional healers, and deceased individuals. Participation in burial practices involving contact with the deceased is strongly discouraged, as is contact with semen from recovered individuals until testing confirms the absence of the virus.
Travelers are also advised to avoid contact with bats, nonhuman primates, and any associated animal fluids or raw meat, as well as avoiding areas where bats reside, such as mines or caves. Individuals in the DRC are urged to monitor themselves for symptoms for 21 days after departure and to isolate immediately if symptoms develop, contacting local health authorities before seeking medical care.
The 21-day incubation period for Ebola means that individuals can be contagious without showing symptoms. This has led to stringent U.S. entry requirements and screening measures. The overlapping early symptoms of Ebola and malaria, which is prevalent in the DRC, can complicate diagnosis, although Ebola symptoms typically worsen rapidly, while malaria is identifiable through a blood test. The State Department encourages all U.S. citizens in the DRC to register with the U.S. Embassy for assistance and updates as the country navigates this complex public health emergency.