Travel warning upgraded to highest level amid thousands of deaths in Ebola outbreak… ‘avoid all travel’

The US has issued its highest travel warning, urging Americans to avoid multiple African provinces as a deadly Ebola outbreak has already claimed thousands of lives. 

The CDC issued a Level 4 travel health notice for Ituri and Nord-Kivu provinces in the Democratic Republic of the Congo, urging Americans to avoid all travel to the region, an escalation from its first advisory, which was a Level 2 on May 18.

The agency also issued a Level 3 warning for Haut-Uélé and Tshopo provinces, also in the DRC, urging travelers to reconsider non-essential visits, and recommending enhanced precautions for all other parts of the country.

The outbreak, caused by the Bundibugyo virus – a rare strain of Ebola with a case fatality rate that historically can range from 25 percent to 50 percent – has overwhelmed local healthcare systems and sparked fears of international spread. 

The virus, for which there is no vaccine or treatment, causes viral hemorrhagic fever, a severe and often fatal illness that damages blood vessels, with symptoms including fever, headache, muscle pain, weakness, diarrhea, vomiting, stomach pain and late-stage bleeding or bruising. 

In addition to the travel advisories, the US has also imposed temporary travel restrictions barring travelers, including American citizens, who have been in the DRC within 21 days from boarding commercial flights to the US.

All US citizens and nationals who have been in the DRC must plan to travel to another country for 21 days before entering the United States.

For those who have been in neighboring Uganda or South Sudan – both of which have confirmed Ebola cases linked to the DRC outbreak but are not experiencing a widespread, independent outbreak – entry into the US is only permitted through four designated airports that have enhanced screening measures in place.  

As of August 9, CDC and WHO data show 4,381 confirmed cases and 2,011 confirmed deaths in the DRC, plus 20 confirmed cases and two deaths in Uganda, bringing the combined outbreak total to more than 4,400 confirmed cases and over 2,000 confirmed deaths linked to the Bundibugyo virus. 

Exact figures remain difficult to confirm, however, due to challenges in surveillance and reporting in conflict-affected regions. 

And health officials have warned that the virus was spreading for weeks before it was detected. 

A Lancet study cited by WHO found that retrospective investigations suggest transmission began in early April 2026, meaning the virus circulated undetected for roughly six weeks before the outbreak was officially declared on May 15. 

Ituri and Nord-Kivu provinces in the DRC have been particularly hard-hit, with healthcare facilities struggling to contain the virus amid ongoing insecurity and community resistance.

Health officials have stressed that early supportive care improves the chance of survival, though there are currently no vaccines or specific treatments approved to prevent or treat Bundibugyo virus disease.

This stands in contrast to other Ebola strains, where vaccines and therapies have been deployed successfully in recent outbreaks.

The lack of approved medical countermeasures has made containment efforts more challenging and has heightened the urgency of travel restrictions.

Ebola is spread through direct contact with the blood or bodily fluids of infected individuals, as well as through contact with contaminated objects such as clothing, bedding, needles and medical equipment.

The virus can also be transmitted through contact with infected animals, including bats and nonhuman primates, or through contact with the bodies of those who have died from the infection.

Traditional burial practices, which often involve washing and preparing the dead, pose a particularly high risk of transmission, experts warn.

For those who must travel to Ituri or Nord-Kivu provinces despite the Level 4 advisory, the CDC has issued a series of strict precautions.

Travelers are advised to review health information for the DRC, consider purchasing travel insurance including health and medical evacuation coverage and avoid all contact with people who have symptoms such as fever, muscle pain and rash.

They should also avoid contact with blood and other bodily fluids, contaminated objects, healthcare facilities, traditional healers and dead bodies.

Travelers should not participate in funeral or burial practices that involve touching the deceased, nor should they have contact with semen from men who have recovered from BVD until testing confirms the virus is no longer present.

Additionally, the CDC advises avoiding contact with bats, forest antelopes, nonhuman primates and any blood, fluids or raw meat from these or unknown animals.

Travelers should stay out of areas where bats live, such as mines or caves.

Anyone in the DRC must monitor themselves for symptoms for 21 days after leaving and should immediately isolate themselves if they develop fever, headache, muscle pain, weakness, diarrhea, vomiting, stomach pain or unexplained bleeding or bruising.

They should not travel and should contact local health authorities or a healthcare facility for advice, calling ahead before visiting any medical facility.

The incubation period for Ebola is up to 21 days, meaning travelers could carry the virus without showing symptoms for weeks.

This has prompted the US to implement strict entry requirements and screening measures at designated airports for travelers arriving from affected regions.

Malaria, which is widespread in the DRC, can cause similar early symptoms such as fever, headache, and muscle pain, making diagnosis difficult in the early stages.

Ebola symptoms tend to worsen rapidly, while malaria can be confirmed with a simple blood test.

The State Department is urging all US citizens in the DRC to register with the US Embassy for assistance and updates.

For now, the outbreak remains largely contained to the eastern provinces, but health officials around the world are watching closely as the country battles what has become a deadly and complex public health emergency.