US Pauses Visa Issuance for Travelers Who Have Visited Ebola-Affected Countries

On May 18, 2026, the United States took a step no administration had taken during any previous Ebola outbreak — not during the 2014 West Africa crisis that killed over 11,000 people, not during the 2018 Kivu epidemic that infected more than 3,400. The State Department suspended all visa operations at its embassies in the Democratic Republic of the Congo, Uganda, and South Sudan [1]. The CDC simultaneously invoked Title 42 to bar entry for any foreign national who had set foot in those three countries within the preceding 21 days [2]. Four days later, the administration expanded the restrictions further, blocking visa issuance worldwide for anyone with recent travel to the affected region [3].

The trigger: an Ebola outbreak caused by the Bundibugyo virus that the WHO declared a public health emergency of international concern (PHEIC) on May 17 [4]. The outbreak had reached roughly 750 suspected cases and 177 deaths, with 51 confirmed cases in DRC's Ituri and North Kivu provinces and two confirmed cases in Uganda's capital, Kampala [5][6].

But the WHO's own Emergency Committee, meeting on May 22, issued temporary recommendations that explicitly stated the opposite of what the U.S. had done: "neither the suspension of flights from States Parties with documented BDBV detection, nor denial of entry to travellers and conveyances arriving from those States Parties, are recommended" [4].

The gap between those positions — and the consequences for thousands of visa applicants, humanitarian workers, and the outbreak response itself — is the central tension of this story.

The Outbreak: Bundibugyo Virus in a Conflict Zone

The current outbreak involves the Bundibugyo ebolavirus (BDBV), a strain first identified in western Uganda in 2007. Unlike the Zaire ebolavirus responsible for the 2014 West Africa catastrophe, Bundibugyo has no approved vaccine or specific antiviral treatment [5]. That makes containment — surveillance, contact tracing, isolation — the primary tool.

Source: WHO / CDC

Data as of May 23, 2026CSV

The outbreak's epicenter is Ituri Province in northeastern DRC, a region wracked by armed conflict involving multiple militia groups. Cases have been reported across 11 health zones in Ituri and have crossed into North Kivu Province [6]. Two confirmed cases appeared in Kampala, Uganda, in individuals who had traveled from DRC [5]. South Sudan, which shares a border with the affected area, has not reported confirmed cases but is considered at high risk.

Source: WHO / CDC

Data as of May 23, 2026CSV

By the numbers, the 2026 outbreak remains far smaller than the 2014-2016 West Africa epidemic, which produced 28,616 cases and 11,310 deaths across Guinea, Liberia, and Sierra Leone [6]. But the case fatality rate — roughly 24% among suspected cases — and the conflict-zone setting have alarmed epidemiologists. The WHO upgraded the regional risk assessment to "very high" [5].

A critical complication: the outbreak likely circulated undetected for weeks or months before the official declaration on May 15. Grace Tran, a former USAID Ebola preparedness officer, told NPR: "It's more the fact that it circulated for so long, and this thing is much bigger than we've realized" [7].

What the U.S. Actually Did

The U.S. response unfolded in three overlapping layers during a single week:

May 18: The State Department suspended all visa services — immigrant and nonimmigrant, including tourist, student, business, and exchange visitor categories — at embassies in Juba, Kinshasa, and Kampala [1]. The CDC issued a Title 42 order barring entry for "covered aliens" who had been present in DRC, Uganda, or South Sudan within the previous 21 days [2].

May 21: The Department of Homeland Security announced that all U.S. citizens and lawful permanent residents returning from the three countries must enter exclusively through Washington Dulles International Airport for enhanced CDC screening [8].

May 22: Internal State Department cables, reported by The Wall Street Journal, revealed the restrictions had been expanded: visa issuance was paused worldwide for any applicant who had traveled to the affected countries within 21 days, regardless of where they applied [3].

The Title 42 order is time-limited to 30 days [2]. The State Department has not provided a specific timeline for lifting the visa operations pause, saying only that it would "reach out to applicants with updates" [3].

The Legal Machinery: Title 42 Returns

The legal foundation for the entry restrictions is Title 42 of the U.S. Code, specifically Sections 362 and 365 of the Public Health Service Act, which authorize the CDC director to suspend entry of persons from countries where communicable diseases exist [2].

Title 42 was largely dormant for decades before the Trump administration invoked it during COVID-19 to expel migrants at the southern border — a use that generated years of litigation and accusations that public health law was being repurposed for immigration enforcement. The Biden administration ended that order in 2023 [9].

The current invocation differs from the COVID-era use in several ways that supporters cite as evidence of its legitimacy: it targets a specific disease with a known incubation period, applies a 21-day window corresponding to Ebola's maximum incubation, names specific countries with documented transmission, and carries a 30-day expiration [2].

But the order contains a logical tension that critics have seized on. The CDC's own order states that Bundibugyo virus "does not spread through the air, through respiratory droplets, or by sitting next to someone on a flight" and that "infected individuals do not spread the virus until symptoms begin" [10]. If asymptomatic travelers cannot transmit the disease, the rationale for blocking them at the visa stage — days or weeks before they would travel — becomes difficult to square with the epidemiology.

Dr. Céline Gounder, an infectious disease specialist and former COVID-19 advisor, noted the further inconsistency: if asymptomatic travelers genuinely pose a risk warranting a ban, exempting U.S. citizens and permanent residents from the entry restriction undermines the public health logic, since the virus does not distinguish by passport [10].

How the Rest of the World Responded

The U.S. approach stands largely alone among Western nations. The European Centre for Disease Prevention and Control (ECDC) assessed the risk of Ebola importation to the EU/EEA as "very low" and is not proposing travel restrictions [11]. The European Commission's Health Security Committee convened on May 20 to coordinate surveillance and deployed an expert to Africa CDC headquarters, but focused on screening and information-sharing rather than entry bans [12].

The United Kingdom has similarly not imposed travel restrictions, assessing its domestic risk as very low [11].

The WHO's Emergency Committee recommendations, issued May 22, drew a clear line: affected countries should screen travelers at exit points, prevent known cases and contacts from traveling internationally, and implement bilateral arrangements at ground crossings [4]. But for all other countries — including the U.S. — the Committee recommended preparing detection systems for travelers with unexplained fever, not suspending flights or denying entry [4].

During the 2013-2016 West Africa outbreak, a study published in the Bulletin of the WHO documented that many countries imposed travel restrictions against WHO recommendations, and research found those restrictions did not meaningfully slow international spread. A retrospective modeling study estimated that travel restrictions produced an absolute risk reduction of less than 1% and relative risk reductions of approximately 20%, concluding the restrictions "were not effective enough to expect the prevention of global spread" [13].

Who Bears the Cost

The visa suspension affects every category of nonimmigrant and immigrant visa applicant across three countries with a combined population exceeding 140 million people. The State Department has not disclosed how many applications are currently in limbo [3].

The categories of people caught in the freeze include:

Students: Congolese, Ugandan, and South Sudanese students admitted to U.S. universities for the fall 2026 semester face an uncertain timeline. Brown University's International Student and Scholar Services office issued guidance noting the restrictions but offering no clarity on exceptions [14].

Medical and humanitarian workers: The restrictions apply to all foreign nationals, including health workers who may need to rotate between the outbreak zone and the United States for training, resupply, or personal reasons. The State Department's own Ebola Response Update of May 19 pledged to "swiftly mobilize all available resources to assist frontline providers," but did not address how travel restrictions on those same providers would be handled [15].

Business travelers: The DRC is a major source of cobalt and other critical minerals. South Sudan's oil sector depends on international personnel movements. Uganda has a growing technology sector with ties to U.S. companies.

The exemptions that exist are narrow. U.S. citizens are exempt from the entry ban but must enter through Dulles for screening [8]. Lawful permanent residents were initially exempt but are now subject to the same Dulles-only entry requirement [9]. The Title 42 order allows DHS to grant individual exemptions, but the criteria and process for obtaining them remain undefined [2].

Source: UNHCR Population Data

Data as of Dec 31, 2025CSV

The affected countries already produce significant refugee and displacement populations. South Sudan is the fifth-largest refugee source country globally, with 2.4 million refugees, and the DRC is the seventh-largest, with 1.1 million [16]. The visa freeze adds another layer of restriction on populations already facing severe mobility constraints.

The Epidemiological Argument

The central public health question is whether blocking visas by travel history meaningfully reduces the risk of Ebola importation compared to symptom-based screening at ports of entry.

Ebola's transmission characteristics are well understood. The virus spreads through direct contact with bodily fluids — blood, vomit, feces — of a symptomatic person [2]. It does not spread through air, water, food, or casual contact. The incubation period is 2 to 21 days, and crucially, individuals are not infectious until they develop symptoms [10].

This means a visa applicant who visited DRC three weeks ago and is currently healthy poses no transmission risk at the time of their interview. A visa is not a boarding pass — it is adjudicated days or weeks before travel. By the time the traveler actually arrives in the United States, screening at the port of entry can detect symptoms that would have developed during the interval.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, characterized the risk to the broader U.S. public as low: "This is a horrible situation in affected areas of Africa. But for the world, it is not" [17].

Peter Hotez of Baylor College of Medicine emphasized that Ebola patients do not transmit the virus before developing symptoms, and early symptoms like fever do not spread through casual contact [17].

Amesh Adalja of the Johns Hopkins Center for Health Security was more direct: travel bans "are a favorite tool of politicians" but "make things worse by making it logistically more difficult to get resources to the outbreak zone" [17].

The Case for Caution

The counter-argument draws on institutional memory, specifically the 2014 case of Thomas Eric Duncan. Duncan, a Liberian citizen, arrived in Dallas on September 20, 2014, having helped transport an Ebola patient in Monrovia days earlier. He developed symptoms five days after arrival and visited the emergency room at Texas Health Presbyterian Hospital, where staff failed to connect his symptoms with his travel history and sent him home [18].

Duncan returned two days later by ambulance and was diagnosed with Ebola. He died on October 8. Two nurses who treated him — Nina Pham and Amber Vinson — contracted the virus, exposing gaps in hospital infection control protocols that shook public confidence in the U.S. health system's readiness [18].

Defenders of the current visa pause argue that the Duncan case demonstrated how a single undetected case can strain the domestic health system. The screening protocols that existed in 2014 failed at the point of entry (Dulles airport, where Duncan was not flagged) and at the hospital level (where travel history was not prioritized in the electronic medical record). A temporary pause, the argument goes, buys time to verify that the screening infrastructure at Dulles — now the mandatory entry point — is adequate.

The CDC has deployed enhanced screening at Dulles, including questionnaires about exposure history, temperature checks, and assessment by trained personnel [8]. Whether these measures are operationally ready to handle the volume of travelers from three countries has not been independently verified.

The Containment Paradox

The policy's most consequential risk may be its effect on the outbreak itself. Containing Ebola requires deploying trained personnel, medical supplies, and laboratory equipment to the affected area — and rotating those teams in and out. Restricting travel for foreign health workers who have recently been in the outbreak zone creates a practical barrier to that rotation.

The State Department pledged $23 million in bilateral foreign assistance and announced funding for up to 50 treatment clinics in affected regions [15]. But the U.S. government's capacity to support the response has already been weakened by prior decisions. USAID's humanitarian assistance to conflict areas like Ituri Province dropped from over $900 million in 2024 to $179 million during the current administration's first year [7].

The International Rescue Committee was forced to scale back from covering five health zones in Ituri to two, eliminating the surveillance capacity that might have detected the outbreak earlier [7]. Ana Bodipo-Mbuyamba, a former USAID health director in DRC, told NPR: "When you dismantle those programs, you no longer have your frontline eyes and ears on the ground that can alert you" [7].

Matthew Kavanagh, director of Georgetown University's Center for Global Health Policy, called the overall response "disappointing" and described travel bans as "more theatre than effective public health measures" [1].

The WHO's recommendations specifically urge countries not to restrict travel for health workers heading to the outbreak zone [4]. Whether the U.S. visa pause has created obstacles for American or international NGO personnel deploying to DRC and Uganda — or for Congolese and Ugandan health workers seeking training or coordination in the United States — is a question the State Department has not publicly addressed.

What Comes Next

The Title 42 order expires after 30 days — around June 17, 2026 — unless renewed [2]. The visa operations pause at the three embassies has no stated end date [3]. The outbreak, meanwhile, continues to grow. The gap between the roughly 750 suspected cases and 51 confirmed cases suggests significant underreporting, a consequence of limited laboratory capacity in a conflict zone where samples must travel more than 600 miles to reach Kinshasa for testing [7].

The policy confronts a tension that has recurred in every major infectious disease outbreak: the political pressure to "do something" visible at the border versus the epidemiological evidence about what actually reduces risk. During the 2014 outbreak, the Obama administration resisted calls for a travel ban despite intense congressional pressure, opting instead for exit screening in West Africa and enhanced monitoring at U.S. airports. No cases of Ebola were imported to the United States through air travel after the screening regime was implemented [18].

The current administration chose differently. Whether that choice protects the American public, disrupts the lives of thousands of visa applicants, hampers the outbreak response, or does all three simultaneously will become clearer as the 30-day clock runs down.