State of California—Health and Human Services Agency
California Department of Public Health

Health Update

To: Healthcare Providers

Ebola Disease Outbreak in the Democratic Republic of the Congo and Uganda Update

6/17/2026

Key Messages

On May 15, 2026, the Democratic Republic of Congo (DRC) and the Republic of Uganda officially declared an outbreak of Bundibugyo virus disease (BVD), a type of Ebola disease caused by Bundibugyo virus. WHO has declared the Ebola disease outbreaks in DRC and Uganda to be a public health emergency of international concern.
As of June 15, DRC has reported 808 confirmed cases and 192 deaths; Uganda has reported 19 confirmed cases, 2 confirmed deaths, and one probable death.
No suspected, probable, or confirmed cases related to these outbreaks have been reported within the United States or California. Further, there are no returned travelers in California who are high-risk exposures. At this time, CDC and CDPH assess the immediate risk to the general US public as low.
CDC has issued travel monitoring guidance to state and local health departments for individuals returning to the United States from affected countries. All travelers returning from DRC, Uganda and South Sudan must return to the US through designated arrival airports and undergo risk and symptom screening before continuing to their final destination.
CDPH is notifying local health departments (LHDs) of travelers returning to their jurisdictions and providing guidance on monitoring and management of travelers who develop symptoms.
Healthcare facilities should have protocols in place to identify and triage persons with relevant Ebola exposure history and signs or symptoms of Ebola.
Clinicians who suspect BVD in a returning traveler should immediately take infection prevention and control precautions specific to Ebola disease, including isolating the patient, using appropriate personal protective equipment (PPE), and notifying their local health department (LHD).

Background

The California Department of Public Health (CDPH) is closely monitoring an outbreak of Bundibugyo virus disease (BVD), a type of Ebola disease caused by Bundibugyo virus, in the Democratic Republic of Congo (DRC) and Uganda. To date, no cases of BVD related to these outbreaks have been reported in the United States or other countries outside of DRC and Uganda. At this time, the CDC assesses the risk to the general U.S. public as low.

The Centers for Disease Control and Prevention (CDC) and Department of Homeland Security (DHS) issued travel restrictions in response to this outbreak, including entry restrictions on non-U.S. passport holders who have traveled in affected countries. On June 5, CDC issued travel monitoring guidance to state and local health departments for individuals returning to the United States after travel in affected countries. At this time, all persons with recent travel to DRC, Uganda, and South Sudan will have their air travel re-routed to arrive at Washington-Dulles International Airport (IAD), Atlanta Hartsfield-Jackson International Airport (ATL), George Bush Intercontinental Airport (IAH), or John F. Kennedy International Airport (JFK). These travelers will undergo exposure risk assessment and a symptom screen before continuing to their final destinations.

CDC has issued a Level 3 travel advisory (reconsider non-essential travel) for affected provinces in DRC and a Level 2 travel advisory (practice enhanced precautions) for DRC outside of the affected provinces and Uganda. No cases of BVD have been identified in South Sudan; however, travelers from South Sudan are included in this interim guidance due to the large numbers of people who travel freely between the neighboring countries of South Sudan and DRC.

About BVD

BVD is a type of Ebola disease. Symptoms of Ebola disease typically begin 8 to 10 days after exposure (range: 2–21 days) and initially include nonspecific “dry” symptoms such as fever, severe headache, muscle and joint aches, fatigue, and sore throat. After 4 to 5 days, illness progresses to more severe “wet” symptoms, including diarrhea, vomiting, and abdominal pain, which can be accompanied by bleeding/bruising and other complications. Case fatality rates in the past two Ebola Disease outbreaks caused by Bundibugyo virus have ranged from 30% to 50%. Like Ebola virus, Bundibugyo virus spreads through contact with the bodily fluids of an infected sick or dead person. There are no licensed vaccines or specific therapeutics against BVD, though early supportive case can be lifesaving.

Recommendations for Clinicians

Healthcare facilities should implement routine triage evaluation for internationa travel for all patients presenting with potientially infectious symptoms.

Clinicians should suspect Ebola disease caused by Bundibugyo virus in a patient who has traveled to DRC or Uganda in the last 21 days, AND who has compatible signs and symptoms (e.g., fever, headache, muscle and joint pain, fatigue, loss of appetite, gastrointestinal symptoms, or unexplained bleeding), AND has reporting epidemiologically compatible risk factors within the 21 days before symptom onset.

If Ebola is suspected, immediately isolate the patient and inform your hospital infection prevention and control team and your local health department (LHD). Follow recommended protocols for patient assessment. CDPH and CDC can assist in healthcare providers and LHDs with evaluation of symptomatic returned travelers.

The decision to test for Ebola must be made in conjunction with the patient's clinical care team, the LHD, CDPH, and CDC's Viral Special Pathogens Branch. CDPH is available to consult on collecting, packaging, and shipping specimens including which laboratory should receive the samples.
The specimen stype required for the test that is available (i.e., the BioFire Defense Global Fever Special Pathogens Panel) is EDTA whole blood (two 5 mL vials are requested). The BioFire Defense Global Fever Special Pathogens Panel can detect multiple viral hemorrhagic fever viruses as well as other bacterial and protozoa. It is currently available at five public health laboratories in California. For more information, see CDPH's Ebola Testing page.

When caring for patients with exposure risks and symptoms compatible with BVD, healthcare facilities should follow CDC's Infection Prevention and Control Recommendations for Patients in U.S. Hospitals who are Suspected or Confirmed to have Selected Viral Hemorrhagic Fevers and CDPH's PPE guidance during patient evaluation and while BVD test results are pending.

If a patient tests positive, they will be transferred to a Regional Emerging Special Pathogens Treatment Center (RESPTC) or another appropriate facility in coordination with the LHD, CDPH and CDC. Cedars-Sinai Medical Center is the RESPTC for HHS Region IX which includes California.
If a patient tests positive, be prepared to implement a waste management plan for Category A waste.

All febrile travelers with recent travel to these countries should be tested for malaria. Other common diagnoses such as COVID-19 and influenza should also be considered, as well as other common causes of gastrointestinal and febrile illnesses in patients with recent travel to these countries. The possibility of co-infections with BVD should also be considered.
Travel to or from DRC or Uganda in the past 21 days should not be a reason to defer routine laboratory testing or other measures necessary for standard patient care.
All California hospitals are expected to be able to serve as National Special Pathogen System (NSPS) Level 4 facilities (formally referred to as "frontline hospitals"). All California hospitals should be able to identify and isolate suspect Ebola patients and inform their local health department of the suspect patient. Healthcare facilities should initiate stabilizing medical care for a suspect Ebola patient, protect staff, and work with the local health department to arrange timely patient transport.
Counsel healthcare workers traveling to BVD outbreak-affected countries for work in clinical settings of their potential increased risk of Bundibugyo virus exposure, the importance of following recommended infection prevention and control precautions, and the possibility of symptom monitoring and work-restrictions after their return to California depending on their exposure risk and public helath recommendations at the time of their return to California.

See Recommendations for Organizations Sending U.S.-based Personnel to Areas with VHF Outbreaks.

Recommendations for Infection Prevention and Control Measures in Hospitals

Employ recommended infection prevention and control measures to prevent transmission of Ebola disease in hospitals. These infection prevention and control measures include, but are not limited to:

Isolating patients in a private room with a private bathroom or covered bedside toilet if Ebola disease is suspected and limiting the number of personnel who enter the room for clinical evaluation and management. Dedicated medical equipment (preferably disposible, when possible) should be sued for the provision of patient care.
Following CDPH-recommended PPE guidance for managing clinically stable and clinically unstable patients.
Maintaining a log of all people entering the patient's room.
Enguring that healthcare personnel caring for patients with BVD have received comprehensive training and demonstrated competency in performing Ebola-related infection prevention and control practices and procedures, including donning an especially doffing PPE. Specific areas should be designated and managed for PPE donning and doffing.
Having an onsite manager supervise personnel providing care to these patients at all times. A trained observer must also supervise each step of every PPE donning/doffing procedure to ensure established PPE protocols are completed correctly.
Safely handling of Ebola-related medical waste. CDPH has developed guidance for medical waste management.

Healthcare personnel can be exposed through contact with a patient's body fluids, contaminated medical supplies and equipment, or contaminated environmental surfaces. Splashes to unprotected mucous membranes (e.g., the eyes, nose or mouth) are particularly hazardous.

Minimize procedures that increase environmental contamination with infectious material, involve handling of potentially contaminated needles or other sharps, or create aerosols.