The Ebola outbreak spreading across the Democratic Republic of the Congo and Uganda has become one of the most serious in recorded history, and the United States government is responding at its highest level of emergency activation.
On June 26, 2026, the CDC elevated its Ebola response to a Level One activation, the most intensive emergency response classification in the agency's incident management system. The announcement came as the DRC Ministry of Health confirmed the outbreak has surpassed 1,100 cases and 300 deaths across DRC and Uganda, making it the third-largest Ebola outbreak ever documented, behind only the 2014–2016 West Africa epidemic and the 2018–2020 DRC outbreak.
"This is now the second largest Ebola outbreak ever recorded in DRC and the third largest Ebola outbreak documented globally," CDC announced Thursday. "Therefore, as of today, CDC is raising our Ebola response to a Level One activation, which represents the highest level of response at CDC."
Why This Matters
The Level One activation does not mean Ebola is spreading in the United States — it is not. The CDC assessment of risk to the American public remains low, and no U.S. cases have been confirmed. But the escalation reflects the scale and trajectory of the outbreak, which is growing faster than any prior Ebola outbreak in recorded history.
The Bundibugyo strain driving this outbreak — unlike the Zaire strain that caused the 2014–2016 West Africa epidemic — has no approved vaccine and no approved treatment. Management consists entirely of supportive care. That absence of medical countermeasures makes rapid case identification, isolation, and contact tracing the only tools for containment.
CDC modeling published in MMWR in June 2026 estimated that if only 20 percent of cases enter isolation, there is a 65 percent probability the outbreak will exceed 20,000 cases within three months. If 70 percent of cases are isolated rapidly, that probability drops to 5 percent.
What We Know So Far
The ECDC's June 26, 2026 update confirmed 1,155 cases, including 304 deaths and 385 hospitalized in isolation as of June 24, with 37 new confirmed cases and five new deaths in the previous two days. Ituri province remains most affected, with 1,054 of the confirmed cases from 22 health zones. North Kivu has recorded 98 cases, and South Kivu has reported 3 cases.
The outbreak has now spread to two additional provinces beyond its origin in northeastern DRC. Cases in Uganda have been confined to the capital Kampala. The ECDC notes that contact tracing coverage in DRC has reached only 55 percent, leaving more than 35,000 contacts untraced. Armed conflict by the Allied Democratic Force continues to cut off access to affected villages. Patient zero has not been identified.
A single imported case has also been confirmed in France — a humanitarian physician who was working in the DRC. French authorities confirmed they were notified immediately upon the physician's arrival and that isolation and contact tracing began immediately. The ECDC assessed the likelihood of infection for people living in the EU as very low.
What the U.S. Is Doing
The United States government has committed more than $162 million in foreign assistance to support the response in DRC, Uganda, and neighboring countries. This has funded six dedicated Ebola response clinics, laboratory capacity expansion, contact tracing training, and community engagement efforts.
Domestically, the CDC's Level One activation brings additional resources to coordination, staffing, and operational needs. As CDC Acting Director Jay Bhattacharya noted in the June 26 press transcript, the agency has nearly 100 staff in both country offices in DRC and Uganda, with approximately 400 total either in the Emergency Operations Center or domestically deployed.
For Americans entering the United States, the following protocols remain in effect:
- A 30-day entry restriction on non-U.S. nationals who have been in DRC, Uganda, or South Sudan within the previous 21 days was renewed on June 21, 2026.
- U.S. citizens and permanent residents who have been in these countries may return but must enter through one of four designated screening airports: JFK (New York), Dulles (Washington D.C.), Hartsfield-Jackson (Atlanta), or Bush Intercontinental (Houston).
- All travelers through these designated airports who have been in affected countries receive mandatory public health screening and are enrolled in a 21-day monitoring program with their state health department.
The Bundibugyo Strain: Why This Outbreak Is Different
According to the CDC, both approved Ebola vaccines — Ervebo and the Mvabea/Zabdeno regimen — target the Zaire strain of Ebola. Neither provides protection against Bundibugyo virus. This is the third outbreak ever caused by Bundibugyo virus, following outbreaks in Uganda in 2007 and DRC in 2012. Previous Bundibugyo outbreaks had case fatality rates of approximately 32 percent and 55 percent, respectively.
WHO is working with researchers to evaluate candidate treatments and vaccines for Bundibugyo, but none are currently approved or available at scale. The CDC has confirmed that experimental work on potential Bundibugyo countermeasures is accelerating, but it cannot be meaningfully deployed in the current outbreak timeline.
What Doctors and Experts Say
CAPT Satish Pillai, CDC's incident manager for the Ebola response, addressed the scale directly during the June 26 press briefing: "This outbreak requires an aggressive, multi-pronged approach focused on rapidly identifying and isolating cases, supporting testing, strengthening infection prevention and control, tracing contacts, facilitating safe and dignified burials, and working with communities to reduce transmission."
The CDC's MMWR modeling report, presented by Dr. Jason Asher of the Center for Forecasting and Outbreak Analytics, was equally direct: the trajectory of the current outbreak, if contact tracing and isolation do not improve rapidly, has the potential to rival the 2014–2016 West Africa outbreak, which killed more than 11,000 people.
Who Faces the Greatest Risk?
For Americans, the groups most directly at risk are:
- Health workers and humanitarian aid personnel who have recently worked in Ituri, North Kivu, or South Kivu provinces of the DRC or in Uganda
- U.S. citizens who have traveled to affected countries within the past 21 days
- Family members who were in close contact with travelers returning from these areas who develop symptoms
- Anyone who was in direct proximity to a confirmed Ebola patient
The general American public — particularly those who have not traveled to the affected region — faces very low risk. Ebola is not airborne and is not transmitted through casual contact. Transmission requires direct contact with the blood or bodily fluids of a person who is ill with or has died from Ebola.
Symptoms and Warning Signs to Watch For
People who have recently traveled from DRC, Uganda, or South Sudan should monitor themselves for the following symptoms for 21 days after their departure date:
- Fever (temperature at or above 101.5°F)
- Severe headache
- Muscle pain and weakness
- Fatigue
- Diarrhea and vomiting
- Stomach pain
- Unexplained hemorrhage or bruising
If you develop any of these symptoms within 21 days of returning from an affected country, do not go directly to a hospital or clinic. Call 911 or your state health department first and disclose your travel history. This allows responders to prepare appropriate isolation before you arrive.
What You Can Do Now
- If you have recently returned from DRC, Uganda, or South Sudan, monitor your symptoms every day for 21 days after your departure. If you were screened at a designated airport, your state health department will be in contact.
- If symptoms develop, call 911 immediately and disclose your travel history — do not drive yourself to a medical facility.
- Avoid non-essential travel to DRC and Uganda, which are currently under Level 3 and Level 1 travel health notices from the CDC, respectively.
- Health workers who have been deployed to DRC or Uganda or who are planning to go should consult the CDC's updated guidance for health care workers in affected areas.
- Check CDC.gov/ebola for daily updates, as the situation is evolving rapidly.
What Happens Next
The CDC's Level One activation allows the agency to deploy additional resources and personnel to support containment in DRC and Uganda and to strengthen U.S. preparedness. The 30-day entry restriction on non-U.S. nationals from DRC, Uganda, and South Sudan is next due for review in mid-July. MedicalDaily will continue reporting on case counts, CDC modeling updates, and any changes to travel or screening policies.
The Bottom Line
Ebola has now exceeded 1,100 cases in the DRC and Uganda; the CDC has activated its highest-level emergency response, and the outbreak is growing faster than any prior Ebola event in history. The risk to the American public is currently low. But the situation is serious and changing rapidly, and the absence of an approved vaccine or treatment for the Bundibugyo strain means speed of containment is everything. Travelers with recent or planned visits to the affected region should follow CDC screening and monitoring protocols carefully.
