Idaho Health Advisory: Ebola Outbreak Update – International Situation Awareness

May 22, 2026

Key Points for Providers

• Ebola (Bundibugyo virus) outbreak is reported in DRC and Uganda
• Low likelihood of U.S. importation at this time
• Evaluate patients with compatible illness and recent travel/exposure history (=21 days)
• Early recognition and isolation remain key, though risk is minimal

An outbreak of Bundibugyo virus disease (BVD), caused by the Bundibugyo virus (Orthoebolavirus bundibugyoense), was confirmed in the Democratic Republic of the Congo (DRC) on May 15, 2026, with additional cases in Uganda. This virus is one of a group of related viruses that cause similar illnesses, collectively referred to as Ebola diseases. An American healthcare worker caring for patients in the DRC has tested positive for BVD and has been transferred to Germany for care. High-risk contacts are being relocated to Germany or the Czech Republic for monitoring. At this time, the risk of spread to the U.S. is considered low. For updates: https://www.cdc.gov/ebola/situation-summary/index.html

Clinical Overview

BVD is clinically similar to other diseases caused by orthoebolaviruses (e.g., Ebola virus disease). The incubation period for BVD ranges from 2 to 21 days. A person is not considered infectious until after symptom onset. BVD has a high case fatality rate without early diagnosis and supportive care.

BVD is spread through direct contact (via broken skin or mucous membranes) with body fluids (e.g., blood, urine, feces, saliva, semen, or other secretions) of a person who is sick with or has died from BVD. BVD can also be transmitted to humans from infected animals, or through contact with objects like contaminated needles. BVD is not spread through airborne transmission.

There is 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 only for preventing disease caused by the related virus Orthoebolavirus zairense. Based on studies in animals, this vaccine is not expected to protect against BVD. There is no FDA-approved or authorized treatment for BVD; therapies have shown some efficacy in animal models.

Clinical Recommendations

• Systematically assess patients with compatible symptoms (e.g., fever, headache, muscle and joint pain, fatigue, loss of appetite, gastrointestinal symptoms, or unexplained bleeding). See https://www.cdc.gov/ebola/signs-symptoms/index.html for exposure risk and possibility of BVD.
• Exposure Risk Factors: Within 21 days before symptom onset has any of the following:
  • Had direct contact with a symptomatic or deceased person with suspected or confirmed BVD, or with any objects contaminated by their body fluids.
  • Experienced a breach in infection prevention and control precautions that resulted in potential contact with body fluids of a patient with suspected or confirmed BVD.
  • In an area with an active BVD outbreak:
    • Had contact with someone who was sick or died, or with any objects contaminated by their body fluids.
    • Attended or participated in funeral rituals, including preparing bodies.
    • Visited or worked in a healthcare facility or laboratory.
    • Had contact with bats.

• If BVD is Suspected:
  • Immediately isolate and hospitalize patients who have symptoms compatible with BVD AND exposure risk until receiving a negative BVD test result on a specimen collected =72 hours after symptom onset.
  • Consider and perform testing for more common diagnoses and concurrent infections such as malaria, COVID-19, influenza, or other common causes of gastrointestinal and febrile illnesses in an acutely ill patient with recent international travel. A history of being in the DRC or Uganda during the past 21 days should not be a reason to defer routine laboratory testing or other measures necessary for standard patient care. See https://www.cdc.gov/viral-hemorrhagic-fevers/php/laboratories/guidance-on-performing-routine-diagnostic-testing-for-patients-with-suspected-vhfs-or-other.html.
  • Pursue routine laboratory testing to monitor the patient’s clinical status and diagnostic testing to assess other potential causes of the patient’s illness while BVD testing is underway.
  • Do not delay BVD diagnostic testing while awaiting results of other diagnostic testing.
  • If a specimen collected <72 hours after symptom onset is negative for BVD, keep the patient isolated in the healthcare facility and test a new specimen taken =72 hours after symptom onset.

If BVD is suspected: Report Immediately:

• Central District Health: 208-327-8625
• IDHW Epidemiology: 208-334-5939
• After hours and on weekends: 800-632-8000

Infection Prevention

• Be prepared to 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” at https://www.cdc.gov/viral-hemorrhagic-fevers/hcp/infection-control/index.html.
• Place patients in isolation at their presenting medical facility and use recommended infection control precautions while BVD test results are pending. Ensure patient care personnel are trained on and wear?appropriate personal protective equipment (PPE) (see https://www.cdc.gov/viral-hemorrhagic-fevers/hcp/guidance/ppe-clinically-unstable.html).

• Working with Idaho public health agencies, arrange to transfer patients with a positive BVD test result to the Regional Emerging Special Pathogens Treatment Centers at Providence Sacred Heart Medical Center in Spokane, WA. https://www.providence.org/locations/wa/sacred-heart-medical-center/special-pathogens-program.

Traveler Counseling

• Counsel patients with planned travel to a BVD outbreak-affected area on ways to prevent exposure during their travel (see https://wwwnc.cdc.gov/travel/notices/level3/ebola-democratic-republic-of-the-congo).
• Counsel healthcare workers traveling to the DRC or Uganda for clinical work about their increased risk of exposure to BVD and the importance of following recommended infection prevention and control precautions and monitoring themselves for symptoms of BVD during and after their travel. See https://www.cdc.gov/viral-hemorrhagic-fevers/php/partners/recommendations-for-vhf-outbreaks.html.

Health Record System Readiness

A travel flag in electronic or other available health records is crucial for quickly identifying patients who have recently been in areas with VHF outbreaks, enabling timely detection and infection control.

Additional Resources from CDC

• Yellow Book, “Post-Travel Evaluation to Rule Out Viral Special Pathogen Infection,” https://www.cdc.gov/yellow-book/hcp/post-travel-evaluation/post-travel-evaluation-to-rule-out-viral-special-pathogen-infection.html
• Clinical Guidance for Ebola Disease: https://www.cdc.gov/ebola/hcp/clinical-guidance/index.html
• Healthcare Provider Trainings on Ebola Disease: https://www.cdc.gov/ebola/hcp/training/index.html