Notice2026-10157
Notice of Order Under Sections 362 and 365 of the Public Health Service Act Suspending Introduction of Certain Persons From Countries Where a Communicable Disease Exists
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Published
May 21, 2026
Effective
May 18, 2026
Issuing agencies
Health and Human Services DepartmentCenters for Disease Control and Prevention
Abstract
The Centers for Disease Control and Prevention (CDC), a component of the Department of Health and Human Services (HHS), announces the issuance of an Order under Section 362 and 365 of the Public Health Service Act that suspends the introduction of certain persons from countries where an outbreak of a communicable disease exists for a period of 30 days. The Order was issued on May 18, 2026.
Full Text
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<title>Federal Register, Volume 91 Issue 98 (Thursday, May 21, 2026)</title>
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[Federal Register Volume 91, Number 98 (Thursday, May 21, 2026)]
[Notices]
[Pages 29961-29964]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-10157]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Docket No. CDC-2026-0892]
Notice of Order Under Sections 362 and 365 of the Public Health
Service Act Suspending Introduction of Certain Persons From Countries
Where a Communicable Disease Exists
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice with comment period.
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SUMMARY: The Centers for Disease Control and Prevention (CDC), a
component of the Department of Health and Human Services (HHS),
announces the issuance of an Order under Section 362 and 365 of the
Public Health Service Act that suspends the introduction of certain
persons from countries where an outbreak of a communicable disease
exists for a period of 30 days. The Order was issued on May 18, 2026.
DATES: This action took effect May 18, 2026.
Written comments must be received on or before June 22, 2026.
ADDRESSES: You may submit comments, identified by Docket No. CDC-2026-
0892 by either of the methods listed below. Do not submit comments by
email. CDC does not accept comments by email.
<bullet> Federal eRulemaking Portal: <a href="http://www.regulations.gov">http://www.regulations.gov</a>.
Follow the instructions for submitting comments.
<bullet> Mail: Division of Global Migration Health, Centers for
Disease Control and Prevention, 1600 Clifton Road NE, MS H16-4,
Atlanta, GA 30329.
Instructions: All submissions received must include the agency name
and Docket Number. All relevant comments received will be posted
without change to <a href="http://regulations.gov">http://regulations.gov</a>, including any personal
information provided. For access to the docket to read background
documents or comments received, go to <a href="http://www.regulations.gov">http://www.regulations.gov</a>.
FOR FURTHER INFORMATION CONTACT: Matthew J. Buzzelli, Chief of Staff,
Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS
V18-2, Atlanta, GA 30329. Phone: 404-639-7000. Email:
<a href="/cdn-cgi/l/email-protection#30535453425557455c5144595f5e43705354531e575f46"><span class="__cf_email__" data-cfemail="5a393e39283f3d2f363b2e333534291a393e39743d352c">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: On May 18, 2026, the Senior Official
Carrying out the Delegable Duties of the Director of the Centers for
Disease Control and Prevention issued the following Order prohibiting
the introduction of certain persons who have departed from, or were
otherwise present within, specified countries during the last 21 days.
The order is effective for a period of 30 days.
A copy of the order is provided below and a copy of the signed
order can be found at <a href="https://www.cdc.gov/ebola/situation-summary/index.html">https://www.cdc.gov/ebola/situation-summary/index.html</a>.
U.S. Department of Health and Human Services Centers for Disease
Control and Prevention (CDC)
Order Under Sections 362 & 365 of the Public Health Service Act
(42 U.S.C. 265, 268) and 42 CFR 71.40
Order Suspending the Right To Introduce Certain Persons From Countries
Where a Quarantinable Communicable Disease Exists
I. Executive Summary
The Centers for Disease Control and Prevention (CDC), a
component of the U.S. Department of Health and Human Services (HHS),
issues this Order pursuant to Sections 362 and 365 of the Public
Health Service (PHS) Act, 42 U.S.C. 265, 268, and their implementing
regulations. This Order suspends the right to introduce ``covered
aliens,'' as defined herein, into the United States for a period of
thirty days, subject to the outcome of an ongoing comprehensive
public health risk assessment. This Order is necessary to protect
the health of the United States from the serious risk posed by the
introduction of Ebola disease into the United States by covered
aliens based on the emergent outbreak of Ebola disease caused by the
Bundibugyo virus strain confirmed present in Democratic Republic of
the Congo (DRC) and Uganda.
This suspension Order applies to covered aliens who have
departed from, or were otherwise present within, DRC, Uganda, or
South Sudan during the last 21 days (regardless of their country of
origin). This Order is based on an assessment of the most recently
available data and current conditions regarding the Ebola disease
outbreak.
This order is time-limited and shall be in effect for 30 days
from the date of issuance. This Order is intended to address the
serious risk of introduction of Ebola disease into the United
States, while allowing the U.S. Government the time necessary to
conduct a full assessment of the unique public health risks posed by
Ebola disease, assist with implementing surveillance, diagnostic
capabilities and contact tracing, and develop a comprehensive
mitigation and containment strategy in consultation with other
stakeholders.
II. Authority, Scope, and Purpose
I issue this Order pursuant to Sections 362 and 365 of the
Public Health Service (PHS) Act, 42 U.S.C. 265, 268, and their
implementing regulations under 42 CFR part 71,\1\ which authorize
the CDC Director to suspend the right to introduce \2\ persons into
the United States when the Director determines that the existence of
a quarantinable communicable disease in a foreign country or place
creates a serious danger of the introduction of such disease into
the United States and the danger is so increased by the introduction
of persons from the foreign country or place that a temporary
suspension of the right of such introduction is necessary to protect
public health.
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\1\ Control of Communicable Diseases; Foreign Quarantine:
Suspension of the Right to Introduce and Prohibition of Introduction
of Persons into United States from Designated Foreign Countries or
Places for Public Health Purposes, 85 FR 56424 (Sept. 11, 2020); 42
CFR 71.40.
\2\ Suspension of the right to introduce means to cause the
temporary cessation of the effect of any law, rule, decree, order,
or settlement agreement pursuant to which a person might otherwise
have the right to be introduced or seek introduction into the United
States. 42 CFR 71.40(b)(5).
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This Order applies to persons who have departed from, or were
otherwise present within, Democratic Republic of Congo, Uganda, and
South Sudan during the last 21 days (regardless of their country of
origin), subject to the exceptions detailed below. For purposes of
this Order, I refer to persons covered by the Order as ``covered
aliens.''
This Order does not apply to the following:
[[Page 29962]]
<bullet> U.S. citizens, U.S. nationals, and lawful permanent
residents; \3\
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\3\ 42 CFR 71.40(f).
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<bullet> Members of the armed forces of the United States and
associated personnel, U.S. government personnel serving overseas,
associated personnel, and their spouses and children, subject to
required assurances; \4\
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\4\ 42 CFR 71.40(e)(1) and (3).
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<bullet> Persons whom customs officers determine, with approval
from a supervisor, should be excepted from this Order based on the
totality of the circumstances, including consideration of
significant law enforcement, officer and public safety,
humanitarian, and public health interests. The U.S. Department of
Homeland Security (DHS) will consult with CDC regarding the
standards for such exceptions to help ensure consistency with
current CDC guidance and public health recommendations; and
<bullet> Noncitizens who would otherwise be subject to this
Order, who are permitted to enter the United States as part of a
DHS-approved process, where the process approved by DHS has been
documented and shared with CDC, and includes appropriate mitigation
protocols, per CDC guidance.
The purpose of this order is two-fold. First, this Order aims to
immediately minimize the number of covered aliens entering the
United States who have been within countries experiencing a known or
suspected outbreak of Ebola disease and thereby reduce the risk of
introduction of Ebola disease into the United States. Second, this
Order is intended to facilitate a thorough assessment and complete
understanding of the full public health risk profile associated with
the Ebola disease outbreak. Thirty days is the minimum amount of
time necessary for CDC to conduct the assessment, which will enable
the acting CDC Director to make an informed determination regarding
what restrictions are necessary going forward and provide the
opportunity for the development of a comprehensive mitigation and
containment plan in consultation with other stakeholders.
III. Factual Basis
A. Ebola Disease
Viral hemorrhagic fever refers to a group of severe illnesses
caused by certain viruses that damage the body's blood vessels and
affect the ability of the blood to clot properly. Viral hemorrhagic
fevers include diseases such as Ebola, Marburg, Lassa fever, and
dengue hemorrhagic fever.
Ebola virus disease (EVD) is a severe and often fatal illness
caused by viruses in the Ebola family. Ebola disease outbreaks occur
mainly in parts of sub-Saharan Africa and can spread rapidly in
communities with limited healthcare resources. Ebola disease caused
by the Bundibugyo virus is a rare form of Ebola first identified
during an outbreak in Bundibugyo District, Uganda, in 2007.
Bundibugyo virus is one of several species within the
orthoebolavirus family and causes symptoms similar to other forms of
Ebola, including fever, weakness, vomiting, diarrhea, and, in severe
cases, hemorrhagic complications and organ failure. The disease
spreads through direct contact with infected bodily fluids or
contaminated materials.
The incubation period for Ebola virus disease caused by the
Bundibugyo virus is typically between 2 and 21 days, with most
people developing symptoms within 4 to 10 days after exposure.
During this incubation period, infected individuals do not spread
the virus until symptoms begin.
Screening for Bundibugyo virus disease focuses on identifying
symptoms and possible exposure history, such as recent travel to
affected areas or contact with infected individuals. Suspected
patients are evaluated for symptoms including fever, weakness,
vomiting, diarrhea, and bleeding, and laboratory confirmation is
performed using specialized tests such as PCR (polymerase chain
reaction) to detect the virus in blood and other body fluid samples.
Health authorities also use temperature checks, contact tracing, and
isolation procedures to prevent transmission.
There are currently no widely approved vaccines or specific
antiviral treatments for the Bundibugyo strain of Ebola disease.
Treatment mainly consists of supportive care, including intravenous
fluids, electrolyte replacement, oxygen support, pain and fever
management, and treatment of secondary infections. Early medical
care significantly improves survival chances. Robust public health
measures such as early detection, rapid isolation, strong infection
prevention measures (i.e., use of personal protective equipment
(PPE)), and monitoring of contacts are critical to controlling
outbreaks and reducing deaths.
B. Ongoing Bundibugyo Virus Disease Outbreak
Presently, there is a confirmed ongoing outbreak of Ebola
disease caused by the Bundibugyo virus in DRC and Uganda. The
current outbreak is centered in eastern DRC's Ituri Province, where
hundreds of suspected cases and dozens of deaths have been reported.
Conflict, weak health infrastructure, and relatively porous borders
in the region are complicating containment efforts.
Uganda has confirmed imported cases linked to travel from DRC,
including one case detected in Kampala, imported from a traveler
from DRC. Ugandan authorities have activated emergency response
systems, expanded surveillance, and strengthened screening at
borders and health facilities. Uganda has significant prior
experience managing Ebola disease outbreaks, including the Sudan
virus strain outbreak in 2025, which improved preparedness and
response capacity.
South Sudan has not reported confirmed cases in the current
outbreak, but it is considered at high risk because of its close
border with affected areas in eastern DRC and Uganda, limited
healthcare infrastructure, and cross-border population movement.
Regional and international agencies, including WHO and Africa CDC,
are supporting preparedness measures, surveillance, and coordination
among the three countries to prevent wider spread. Despite these
efforts there is a risk that the outbreak could spread beyond these
three countries, and ultimately reach the United States, through
international travel by infected individuals during the virus's
incubation period, when they have been exposed but are not yet
showing symptoms. Travelers moving between affected countries and
major international transit hubs could unknowingly carry the virus
before becoming ill.
DRC, Uganda, and South Sudan are connected to the global
aviation network through a series of regional and international
transit hubs that provide pathways into the United States. Travelers
departing from outbreak-affected regions frequently transit through
densely populated metropolitan airports such as Addis Ababa Bole
International Airport (ADD), Jomo Kenyatta International Airport
(NBO) in Nairobi, Hamad International Airport (DOH) in Doha, Dubai
International Airport (DXB), and Istanbul Airport (IST), all of
which maintain extensive passenger connectivity to major U.S.
gateway airports including John F. Kennedy International Airport
(JFK), Washington Dulles International Airport (IAD), Hartsfield-
Jackson Atlanta International Airport (ATL), Chicago O'Hare
International Airport (ORD), and Los Angeles International Airport
(LAX). These international transportation corridors support
continuous movement of travelers between Central and East Africa and
major U.S. metropolitan centers, increasing the likelihood that
individuals exposed to Ebola virus disease could enter the United
States before symptoms become apparent. Complex multi-leg
itineraries and the rapid pace of international travel create
substantial challenges for identifying potentially infected
travelers before arrival.
The risk of Bundibugyo virus disease introduction into the
United States is heightened by the virus's incubation period, which
can extend up to 21 days, allowing infected individuals to travel
internationally while asymptomatic and therefore unlikely to be
detected through routine symptom-based screening measures. A
traveler infected in outbreak regions of DRC and Uganda may transit
through multiple countries and major international airports before
developing fever or other clinical signs of disease. Upon arrival in
major U.S. metropolitan areas, travelers who become symptomatic
could interact with crowded airport environments, domestic
transportation systems, healthcare facilities, hotels, or community
settings prior to diagnosis and isolation. Because modern aviation
networks enable rapid movement from outbreak zones to the United
States within one to two days, even a limited number of infected
travelers could create significant public health response demands,
particularly if exposure events occur in high-density urban
environments. The interconnected nature of global air travel
therefore presents a credible pathway for Bundibugyo virus disease
importation into the United States, underscoring the importance of
aggressive surveillance, traveler monitoring, airport screening,
healthcare preparedness, and rapid containment capabilities.
Travelers utilizing air transit pathways originating in or
passing through DRC,
[[Page 29963]]
Uganda, and South Sudan include non-U.S. citizens, including
regional migrants, foreign contract workers, humanitarian personnel,
business travelers, students, refugees, and third-country nationals
moving through international aviation hubs in Africa, the Middle
East, and Europe. Many travelers entering U.S.-bound itineraries
from these pathways may do so under temporary visas, refugee or
asylum processing mechanisms, international organizational travel,
or multi-country itineraries that obscure their original point of
departure. As a result, public health screening and border security
systems face heightened operational complexity in identifying
travelers with recent exposure histories linked to Ebola-affected
regions, particularly when travelers originate from or transit
through multiple jurisdictions prior to arrival at major U.S.
metropolitan airports.
Restricting entry of non-U.S. citizens who originate from or
have recently traveled through DRC, Uganda, and South Sudan would
reduce the volume of higher-risk international arrivals requiring
public health monitoring and follow-up. Limiting the number of
potentially exposed travelers entering through major U.S. ports of
entry, federal, state, and local public health authorities could
concentrate finite surveillance, screening, contact tracing,
quarantine management, and medical monitoring resources on returning
U.S. citizens and lawful permanent residents. Such an approach would
reduce operational strain on airport screening systems, CDC
quarantine stations, public health laboratories, and healthcare
facilities responsible for evaluating suspected Bundibugyo virus
disease cases. It would also improve the ability of authorities to
conduct detailed exposure assessments, ensure compliance with
monitoring requirements during the 21-day incubation period, rapidly
identify symptomatic individuals, and allocate specialized isolation
and treatment capacity more effectively. In the context of a rapidly
evolving Bundibugyo virus disease outbreak with significant
international mobility, prioritizing surveillance efforts toward a
smaller and more traceable traveler population would strengthen the
overall effectiveness of U.S. disease containment and border health
security operations.
IV. Legal Basis for This Order Under Sections 362 and 365 of the Public
Health Service Act and 42 CFR 71.40
CDC is issuing this Order pursuant to sections 362 and 365 of
the Public Health Service Act (42 U.S.C. 265, 268) and the
implementing regulation at 42 CFR 71.40. In accordance with these
authorities, the CDC Director is permitted to prohibit, in whole or
in part, the introduction into the United States of persons from
designated foreign countries (or one or more political subdivisions
or regions thereof) or places, only for such period of time that the
Director deems necessary to avert the serious danger of the
introduction of a quarantinable communicable disease, by issuing an
Order in which the Director determines that:
(1) By reason of the existence of any quarantinable communicable
disease in a foreign country (or one or more political subdivisions
or regions thereof) or place there is serious danger of the
introduction of such quarantinable communicable disease into the
United States; and
(2) This danger is so increased by the introduction of persons
from such country (or one or more political subdivisions or regions
thereof) or place that a suspension of the right to introduce such
persons into the United States is required in the interest of public
health.\5\
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\5\ 42 U.S.C. 265; 42 CFR 71.40.
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Section 362 and the implementing regulation provide the Director
with a public health tool to suspend introduction of persons not
only to prevent the introduction of a quarantinable communicable
disease, but also to aide in continued efforts to mitigate spread of
that disease.\6\
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\6\ 85 FR 56424 at 56425-26.
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The term ``introduction into the United States'' is defined in
42 CFR 71.40 as ``the movement of a person from a foreign country
(or one or more political subdivisions or regions thereof) or place,
or series of foreign countries or places, into the United States so
as to bring the person into contact with persons or property in the
United States, in a manner that the Director determines to present a
risk of transmission of a quarantinable communicable disease to
persons, or a risk of contamination of property with a quarantinable
communicable disease.'' 42 CFR 71.40(b)(1). Similarly, the term
``serious danger of the introduction of such quarantinable
communicable disease into the United States'' is defined as, ``the
probable introduction of one or more persons capable of transmitting
the quarantinable communicable disease into the United States, even
if persons or property in the United States are already infected or
contaminated with the quarantinable communicable disease.'' 42 CFR
71.40(b)(3).
Section 71.40(b)(2) defines ``[p]rohibit, in whole or in part,
the introduction into the United States of persons'' in Section 362
to mean ``to prevent the introduction of persons into the United
States by suspending any right to introduce into the United States,
physically stopping or restricting movement into the United
States.'' See also 42 U.S.C. 265 (authorizing the prohibition when
the danger posed by the communicable disease ``is so increased by
the introduction of persons from such country . . . or place that a
suspension of the right to introduce such persons into the United
States is required in the interest of public health Pursuant to that
provision'').\7\
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\7\ Viral hemorrhagic fevers, which include Ebola, were added to
the U.S. federal list of quarantinable communicable diseases by
Executive Order 13295 on April 4, 2003.
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As stated in the Final Rule for 42 CFR 71.40, CDC ``may, in its
discretion, consider a wide array of facts and circumstances when
determining what is required in the interest of public health in a
particular situation . . . includ[ing]: the overall number of cases
of disease; any large increase in the number of cases over a short
period of time; the geographic distribution of cases; any sustained
(generational) transmission; the method of disease transmission;
morbidity and mortality associated with the disease; the
effectiveness of contact tracing; the adequacy of state and local
health care systems; and the effectiveness of state and local public
health systems and control measures.'' \8\
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\8\ Id. at 56444.
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As stated in 42 CFR 71.40, this Order does not apply to U.S.
citizens, U.S. nationals, lawful permanent residents, members of the
armed forces of the United States and associated personnel if the
Secretary of War provides assurance to the Director that the
Secretary of War has taken or will take measures such as quarantine
or isolation, or other measures maintaining control over such
individuals, to prevent the risk of transmission of the
quarantinable communicable disease into the United States, and
United States government employees or contractors on orders abroad,
or their accompanying family members who are on their orders or are
members of their household, if the Director receives assurances from
the relevant head of agency and determines that the head of the
agency or department has taken or will take measures such as
quarantine or isolation, to prevent the risk of transmission of a
quarantinable communicable disease into the United States.\9\
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\9\ 42 CFR 71.40(e) and (f).
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In addition, this Order does not apply to additional classes of
persons excepted by the CDC Director. Creating exceptions in the
Order is consistent with Section 362 and 42 CFR 71.40. Section 362
explicitly states that the prohibition of introduction into the
United States may be ``in whole or in part.'' This phrase is also
included in section 71.40(a) and, as explained in the Final Rule, is
intended to allow the Director to narrowly tailor the use of the
authority to what is required in the interest of public health.\10\
Pursuant to this capability, CDC is therefore excepting certain
categories of persons, as described herein.
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\10\ 85 FR 56424 at 56444.
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This Order will be in effect for 30 days to avert the serious
danger of the introduction, transmission, and spread of Ebola
disease into the United States. Finally, as directed by 42 CFR
71.40(c), the Order sets out the following:
(1) The foreign countries (or one or more political subdivisions
or regions thereof) or places from which the introduction of persons
is being prohibited;
(2) The period of time or circumstances under which the
introduction of any persons or class of persons into the United
States is being prohibited;
(3) The conditions under which that prohibition on introduction
will be effective, in whole or in part, including any relevant
exceptions that the Director determines are appropriate;
(4) The means by which the prohibition will be implemented; and
(5) The serious danger posed by the introduction of the
quarantinable communicable disease in the foreign country or
countries (or one or more political subdivisions or regions thereof)
or places from which the introduction of persons is being
prohibited.
[[Page 29964]]
V. Determination and Implementation
Based on the foregoing, I hereby determine that Ebola disease, a
highly transmissible quarantinable communicable disease, is
confirmed present in the DRC and Uganda. There is a material risk
that the outbreak will spread to South Sudan. I also determine that
the prevalence of Ebola disease in these foreign countries
constitutes a serious danger of the introduction of this disease
into the United States due to the limited screening and testing and
mitigation measures currently available. Finally, I determine that a
temporary 30-day suspension of the right to introduce covered aliens
is necessary to protect the public health from the serious danger of
the introduction of Ebola disease into the United States, pending
completion of a thorough public health assessment of the unique
public health risk profile posed by Ebola disease and the
development of a comprehensive mitigation and containment strategy
in consultation with other stakeholders.
I consulted with the Department of State, DHS, and other federal
departments as needed before I issued this Order and requested that
DHS aid in the enforcement of this Order because CDC does not have
the capability, resources, or personnel needed to do so.\11\ As part
of the consultation, DHS developed operational plans for
implementing this Order. These plans are consistent with the
language of this Order.
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\11\ 42 U.S.C. 268; 42 CFR 71.40(d).
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Although this Order is not a rule subject to notice and comment
under the Administrative Procedure Act (APA) and is issued with
immediate effect, in order to ensure that the forthcoming public
health risk assessment is informed by public input, the Order is
being issued with a simultaneous 30-day comment period.
* * * * *
In testimony whereof, the Senior Official carrying out the
delegable duties of the Director, Centers for Disease Control and
Prevention, U.S. Department of Health and Human Services, has
hereunto set his hand at Fairfax County, Virginia this 18th day of
May, 2026.
Public Participation
Interested persons or organizations are invited to participate by
submitting written views, recommendations, and data so that the public
can provide input that may inform the forthcoming public health risk
assessment and whether any subsequent exercise of this authority is
necessary.
Please note that comments received, including attachments and other
supporting materials, are part of the public record and are subject to
public disclosure. Comments will be posted on <a href="https://www.regulations.gov">https://www.regulations.gov</a>. Therefore, do not include any information in your
comment or supporting materials that you consider confidential or
inappropriate for public disclosure. If you include your name, contact
information, or other information that identifies you in the body of
your comments, that information will be on public display. CDC will
review all submissions and may choose to redact, or withhold,
submissions containing private or proprietary information such as
Social Security numbers, medical information, inappropriate language,
or duplicate/near duplicate examples of a mass-mail campaign. Do not
submit comments by email. CDC does not accept comment by email.
Authority
The authority for these orders is Sections 362 and 365 of the
Public Health Service Act (42 U.S.C. 265, 268).
Jay Bhattacharya,
Senior Official Carrying out the Delegable Duties of the Director,
Centers for Disease Control and Prevention.
[FR Doc. 2026-10157 Filed 5-19-26; 8:45 am]
BILLING CODE 4163-18-P
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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.