Public Health Guidance for Ebola Disease

Travel screening and entry restrictions guidance for Bundibugyo virus outbreak that began in May 2026

On May 18, 2026, CDC and DHS began implementing enhanced travel screening, entry restrictions, and public health measures to prevent Ebola virus from entering the United States amid outbreaks in the Democratic Republic of the Congo and Uganda.

Planning guidance

During an outbreak of a viral hemorrhagic fever (VHF) like Ebola or other high-consequence infectious disease (HCID), public health departments must be equipped with comprehensive planning tools to guide their response to a suspected or confirmed VHF case and potential exposures within the community.

Key partnerships for an Ebola response

Ebola preparedness involves building and sustaining strong partnerships across healthcare and emergency response. Proactively engaging with the following partners can build trust, clarify roles, and improve coordination:

• Healthcare facilities (hospitals, emergency departments, inpatient and outpatient healthcare, primary and urgent care clinician practices)
• Emergency Medical Services (EMS)
• State and local public health departments and/or agencies
• Laboratory Response Network for Biological Threats (LRN-B)
• Healthcare coalitions
• National Emerging Special Pathogens Training and Education Center (NETEC)
• National Special Pathogen System (NSPS)
• State and local emergency management.
• Organizations responsible for sending U.S.-based personnel to areas with VHF outbreaks

Public health recommendations for VHF/Ebola planning and response

Recommendations

These recommendations can help strengthen health department and laboratory response planning for VHF outbreaks. Review these resources frequently as information may change over time.

Maintain situational awareness of VHF outbreaks using event-based surveillance and CDC resources.

• Sign up for CDC's free email subscription service for notifications through the Health Alert Network.
• Laboratories can sign up for the Laboratory Outreach Communication System (LOCS).
• Routinely review CDC updates regarding the status of outbreaks and VHF basics.
• Routinely review CDC Travel Health Notices.
• Engage travel health clinics, clinical and public health partners, and/or public health surveillance news sources (e.g., BEACON)

Ensure workforce readiness; implement public health response measures

• Know who to contact within the health department (e.g., laboratory, emergency response, communications) to get support during an Ebola outbreak
  
• Familiarize key staff with the processes for evaluating and managing a patient with suspected VHF like Ebola.
  
• Ensure Healthcare Infection Prevention and Control Recommendations for VHFs are in place:
  • Guidance for Personal Protective Equipment (PPE)
  • NETEC: Personal Protective Equipment (PPE) Feature Resources
  • Disinfectants for Emerging Viral Pathogens including VHFs
  • Disinfectants for Emerging Viral Pathogens (EVPs): List Q (EPA)
  • EPA's Registered Antimicrobial Products Effective Against Ebola Virus - List L (EPA)
• Identify and engage any NSPS Level 4 facilities and EMS providers with the capability to transfer and manage a patient with suspected VHF.

Assess minimum capabilities of healthcare facilities in your jurisdiction

• Identify existing designated treatment and assessment facilities (NSPS levels 2 and 3) within the jurisdiction as well as your region's RESPTC point of contact. If no designated facilities are identified, work with the relevant RESPTC partner to identify potential future designation opportunities to support patient assessment and referral.
• Provide facilities with information regarding the minimum capabilities for their designated NSPS level.
  • NSPS Minimum Capabilities – National Special Pathogen System (NSPS)
  • NETEC Education and Training
  • Joint Commission Standards and Elements of Performance – National Performance Goals: NPG.05.02.01
• Promote preparedness training for healthcare facilities to identify, assess, treat, manage, transport, and transfer high-risk patients. Consulting with partners, including Hospital Preparedness Program leads, hospital coalitions, and other related associations.
  • Clinical Screening and Diagnosis for VHFs | Viral Hemorrhagic Fevers (VHFs)
  • Exercise Templates | NETEC Exercise Templates | NETEC Resource Library
  • CDC Yellow Book: Post-Travel Evaluation to Rule Out Viral Special Pathogen Infection
  • NETEC Webinar Series: Ebola: Clinical Evaluation, Treatment, and Infection Control for Clinicians and Healthcare Staff
  • NETEC Infection Prevention Learning Journey
  • Health Care Facility Viral Hemorrhagic Fever (VHF) Preparedness Checklist
• Promote guidance to support hospitals in managing persons with suspected VHF.
• Ensure healthcare facilities know who to contact if there is concern for a VHF or other high-consequence infection during the differential diagnosis of an ill patient.
  • Remind them to contact your health department immediately (via the 24-hour Epi-On-Call contact list) and follow jurisdictional protocols.

Review and update public health department response plans

• Coordinate with the jurisdictional Public Health Emergency Preparedness (PHEP) Director or designee to review a VHF response activation scenario within the department's Emergency Operation Plan.
• Maintain a current operational VHF response plan, including hazard-specific criteria for IMS/ICS activation based on epidemiological risk, available resources, and coordination needs.
• Collaborate with regional, state health departments, and RESPTC partners to ensure the jurisdictional response plan is actionable and interoperable with regional response capabilities.
• Pre-identify key personnel and partners across health systems and agencies.
• Develop job action sheets and define occupational health and safety requirements depending on the expected hazards.
• Ensure the ICS organizational chart reflects the full scope of VHF response activities, including but not limited to:
  • Surveillance
  • Laboratory coordination
  • Infection prevention and control
  • Case management
  • Biosafety/biosecurity, including waste management, EMS transportation, and emergency management coordination
  • Risk communication and community engagement
• Integrate a VHF response scenario into your discussion-based or functional exercise workplan to test response plan readiness.

Review, update protocols for evaluating and managing patients

Epidemiologic investigation

• Ensure epidemiology and surveillance capacity at local and state levels is adequate to support timely detection and response to suspected VHF cases.
  • This includes contact tracing and active monitoring, access to standardized forms or tools, and the presence of reliable notification and reporting systems.
• Develop plans for potentially exposed healthcare providers and community members.
• Identify roles for public health staff who would be involved in contact tracing and monitoring.
• Develop Just-in-Time (JIT) training for each of the identified roles, including clear criteria on when to notify others within the health department (e.g., medical epidemiologists) of a potential VHF concern.

Travelers' health

• Identify a point of contact at the CDC port health station responsible for your jurisdiction.
• Ensure processes are in place:
  • To assess traveler exposure risks and ensure ability to identify and classify high-risk exposures.
  • To make quarantine and wraparound services available for travelers with high-risk exposures who are visiting the jurisdiction or are unable to quarantine safely at home.
  • For assessing symptomatic travelers to determine need for medical evaluation and possible hospital isolation.
  • For preventing use of commercial/public transport by a person with a suspected or confirmed VHF or a high-risk exposure.
• Review CDC JIT recommendations on traveler post-arrival risk assessment and management.
• Identify which staff should be involved in monitoring and the type of training needed, including who is responsible when the health department cannot directly monitor the traveler, if monitoring by a health department is recommended, etc.
• Ensure a 24/7 contact number for the health department is in place for travelers who develop symptoms to immediately notify the health department.
• Incorporate a system to automate traveler monitoring (e.g., 1CDP, automated traveler texting).
• Develop template educational materials for travelers recommended to self-monitor post-arrival (e.g., through text messaging) that include what to do if symptoms develop and your 24/7 contact information.
• Identify a health department point-of-contact for timely communication from CDC about NGOs, other organizations, or agencies with staff in VHF-endemic areas or that send responders to an outbreak.
• CDC's VHF listserv shares information with healthcare providers working abroad with alerts when an outbreak is declared.

Laboratory capacity and support

• Know the laboratory and VHF specimen-handling capacity of facilities within your jurisdiction and which agreements are currently in place.
• Contact your state public health laboratory for assistance with packing and shipping Category A pathogens.
  • Packaging and Shipping (APHL)
  • Packing and Shipping Infectious Substances Training Requirements Job Aid (APHL)
• Review safe specimen handling procedures (VHF and routine diagnostic testing) and verify that personnel are trained in specimen collection and Category A packing and shipping.
  • VHF Clinical Specimen Packaging and Shipping
  • Laboratory Testing for Patients with a Suspected VHF or High-Consequence Disease
  • Guidance on Performing Routine Diagnostic Testing for Patients with Suspected VHFs or Other High-Consequence Disease
  • CDC's Rapid Education and Capacity-building Hub (REACH)
  • BMBL 6th Edition Updates: Clinical Laboratory Biosafety Recommendations | OneLab REACH
  • Fundamentals of Laboratory Safety | OneLab REACH
  • Introduction to Laboratory Risk Management (LRM) | OneLab REACH
  • Resources and Tools to Strengthen Biosafety Practices
  • Biosafety in Microbiological and Biomedical Laboratories (BMBL)
  • Biological Risk Assessment (page 9)
  • Appendix N-Clinical Laboratories (pages 529-543)
  • OSHA Bloodborne Pathogens Standard Course
  • Safe Use of Biological Safety Cabinets
  • Checklist for Safe Use of Biological Safety Cabinets
  • Fundamentals of PPE
• Promote training for laboratory and clinical personnel responsible for performing Point-of-Care Testing, including Clinical Laboratory Improvement Amendments (CLIA)-waived tests.
  • Considerations for Waived Testing
  • Recommended Practices for Performing Patient Testing (under CLIA Certificate of Waiver)
  • Self-Assessment Checklist for Good Testing Practices
    

Patient transfer

• Ensure all partners are aware of dispatch and responder actions, including a screening algorithm, precaution types, and special considerations for transporting patients.
  • EMS Infectious Disease Playbook, Version 2.0
  • EMS Biosafety: Identify, Isolate, Inform
  • Interim Guidance for Emergency Services
  • NETEC Training Course: EMS Biosafety Transport for Operators
• Ensure awareness of the regional concept of operations (CONOPS) for transport of patients with suspected or confirmed VHF and be familiar with roles and responsibilities.
• Contact RESPTC for more information.

Communication and risk communications

• Ensure information-sharing protocols are in place between the health department, healthcare facilities, and the community.
• Determine which information-sharing materials are needed for risk communication messaging and develop templates for healthcare staff and the public if a patient with suspected or confirmed VHF is identified, considering background resources such as CDC's Health Alert Network (HAN) when you put them together.
• Include general information on VHF, risk to the public, traveler recommendations, transmission risk, protective measures, and health department contact information for clinicians if VHF is initially suspected.
• Identify translation resources that can be rapidly mobilized to support effective communication with the community and travelers.
• Encourage healthcare providers to sign up for jurisdictional and CDC notifications.
  • Health Alert Network (HAN)
  • Clinician Outreach and Communication Activity (COCA)
• Consider taking CDC's Crisis & Emergency Risk Communication (CERC) training.

Managing Category A VHF-associated solid waste

• Be familiar with State, Department of Transportation (DOT), and Pipeline and Hazardous Materials Safety Administration (PHMSA) requirements.
  • Planning Guidance for Handling Category A Solid Waste (USDOT)
  • Links to Hazardous Waste Programs and U.S. State Environmental Agencies
• Ensure that protocols are in place to safely and compliantly handle, package, and store Category A VHF-associated waste from a person with suspected VHF until testing is completed.
• Once status is confirmed, ensure proper disposal protocols are in place.
• Identify a designated waste management center that can receive Category A VHF-associated waste in the event of a confirmed case.
• Ensure required contracts and permits (e.g., DOT-SP16279) are in place to transport waste material from the point of origin to the point of final disposal.
• Ensure treatment centers, acute hospitals, frontline hospitals, and EMS have:
  • Compliant arrangements (autoclave or approved contractor/permits) d
  • Disinfectant protocols for non-porous surfaces
  • Documentation demonstrating adherence to applicable federal and state laws for Category A VHF-associated waste management.

Decedent management

• Coordinate with your medical examiner to ensure that healthcare and mortuary partners have guidance resources related to decedent management. Consider collaboration with jurisdictional Disaster Mortuary Operational Response Teams (DMORT) to offer fatality management expertise, as well as partnerships with associations such as Funeral Home Director Associations and Coroners and Medical Examiners' Associations.
  • Safe Handling of Human Remains of VHF Patients in U.S. Hospitals and Mortuaries
  • Decedent Management Considerations for Confirmed or Suspected Viral Hemorrhagic Fever (VHF) (NETEC)

Resources

From CDC

Patient management

• Public Health Management of People with Suspected or Confirmed VHF or High-Risk Exposures
• Clinical Screening and Diagnosis for VHFs
• Guide for Clinicians Evaluating an Ill Person for VHF or Other High-Consequence Disease
• Guidance on Performing Routine Diagnostic Testing for Patients with Suspected VHFs or Other High-Consequence Disease
• Infection Prevention and Control Recommendations for Patients in U.S. Hospitals who are Suspected or Confirmed to have Selected Viral Hemorrhagic Fevers (VHF)
  

Planning and response

• Public Health Guidance for VHF Response Planning
• Interim Guidance for U.S. Emergency Services
• Recommendations for organizations sending U.S.-based healthcare or emergency response personnel to areas with viral hemorrhagic fever (VHF) outbreaks

NETEC

• National Emerging Special Pathogens Training & Education Center