Ebola reaches a fifth country, Nigeria, and US-bound flights will need a signed attestation: Health risk update, Oct. 16–23, 2026

Between October 16 and 23, 2026, the CDC, the World Health Organization and the FDA moved eighteen items in front of US households, travelers and clinical teams. Nine of them carry a decision for someone reading this page.

The week's signal

The outbreak is Ebola disease caused by Bundibugyo virus, one of the Ebola viruses. No vaccine and no specific treatment is approved for it, so care is supportive. 1

WHO's notice of October 23 counted 9,704 confirmed cases and 4,687 deaths in the Democratic Republic of the Congo (the Congo) as of October 20, a crude case fatality ratio of 48.3%. 2

That is 976 more cases and 482 more deaths than the agency's October 8 update. Of those 482 deaths, 307 occurred in communities and 175 in treatment centres. 2

Cases have now been confirmed in 66 health zones across eight provinces. Nord-Ubangi, in the country's northwest, is the newest province, and Dakwa in Haut-Uélé the newest health zone. 2

WHO's African regional office, counting a day earlier, added 572 cases and 265 deaths since its previous weekly report. Its summary table listed one case in Nigeria beside nine in Kenya. 3

Nigeria confirmed an imported case in the Federal Capital Territory, Abuja, on October 20. The patient fell ill on October 7, four days after arriving from Uganda, and 44 contacts are being monitored. 2

Nigeria is the fifth country to report a case since the outbreak was declared on May 15, after the Congo, Uganda, France and Kenya. 2

Map of confirmed Bundibugyo virus disease cases by health zone across the eastern provinces of the Democratic Republic of the Congo — The Congo's confirmed cases by health zone, as of October 20, 2026. Each red circle is a reporting health zone, sized by case count, and Nord-Ubangi now appears at the top left alongside the seven provinces that were already affected. Source: WHO Disease Outbreak News, October 23, 2026.

Kenya's cluster grew from three cases to nine, with one death, as of October 20. All eight later patients were relatives or health workers who were already in quarantine when they fell ill. 2

Kenya has traced and quarantined all 135 contacts. By October 22 it had screened 709,093 travellers and tested 461 samples at five laboratories. 2

On October 19, CDC posted a Level 1 travel notice for Kenya, its least restrictive tier. Every Kenyan case has been in Nairobi, and the notice names no other part of the country. 1

Map of Kenya with the capital area shaded orange and a legend reading Ebola Bundibugyo Virus Disease Level 1 Travel Health Notice — CDC's map for the new Kenya notice shades one area: Nairobi, where the country's nine cases have been reported. The rest of Kenya stays outside the notice. Source: CDC Travelers' Health, reviewed October 19, 2026.

The United States is adding paperwork as well. From November 3, 2026, at 11:59 pm Eastern, every passenger boarding an international flight to the US must sign a statement that they were not in the Congo during the 21 days before the flight. 4

CDC's counts run a day later than WHO's and cover five countries: 9,735 confirmed cases and 4,690 deaths as of October 21. CDC still calls the risk to the American public low. 4

In the United States, measles passed 4,588 confirmed cases on October 22, up 178 in a week. CDC now counts three deaths, one more than a week ago, and 479 hospitalizations. 5

People under 20 make up 58% of this year's cases, and 16% of children under 5 have been hospitalized. Unvaccinated or unknown status covers 96% of cases. 5

Pennsylvania, the year's largest outbreak, reported 1,286 cases in 42 counties, 247 hospitalizations and five deaths on October 19, up 26 cases from October 16. 6

On the food and drug side, four recalls went up in the window: a Lidl house-brand gelato for Listeria, a WinCo hoagie roll that leaves sesame off the label, Natural Grocers mung beans with glass in the bag, and a nationwide veterinary pharmacy recall. 7 8 9 10

Actions for households, travelers, and clinical teams

Alert	Who should act	What to do now
US entry rules for the Congo, Uganda and South Sudan	Anyone booking or boarding a flight to the United States who has been in the region	Passengers who have been in the Congo within 21 days of their flight cannot board a commercial flight to the US, including on itineraries with a stop there. US citizens and nationals should plan to stay outside the Congo for 21 days before entering. Anyone who was only in Uganda or South Sudan must arrive through designated airports for screening. From November 3, 11:59 pm ET, every passenger boarding a US-bound international flight signs an attestation of no Congo presence in the prior 21 days. 4
Kenya, Level 1	Travelers to Nairobi or anywhere else in Kenya	CDC asks travelers to take usual precautions for Kenya. Avoid contact with people who have Ebola symptoms — fever, muscle pain, rash — or their body fluids. If fever, headache, muscle pain, weakness, diarrhea, vomiting, stomach pain or unexplained bleeding appears, isolate immediately, do not travel, and call a health facility before arriving. Watch for symptoms for 21 days after leaving. 1
Measles in Pennsylvania, including pregnancy guidance	Residents and visitors in the 42 affected counties, anyone with incomplete MMR records, and pregnant women	The state reported 1,286 cases, 247 hospitalizations and five deaths on October 19. Two documented MMR doses are the protection; infants aged 6 through 11 months in flagged counties can take an early dose and still need both routine doses later. MMR is not given during pregnancy, and pregnancy should be avoided for 28 days after the shot; non-immune pregnant women and exposed infants can receive immunoglobulin within six days. Call 877-PA-HEALTH (877-724-3258) before going to a clinic. 6
Measles in Wisconsin	Residents of Rock, Richland, Chippewa and Marathon counties, and of Grant, Iowa, Lafayette and Vernon counties	Wisconsin counted 310 cases on October 23. The southwest outbreak stands at 262 confirmed and 6 probable; Rock County has 5 probable cases with no source identified; Richland County added one confirmed case linked to the southwest outbreak; Chippewa County jumped to 28. Check immunity through the Wisconsin Immunization Registry or a provider. Measles was last detected in Green County wastewater on October 14. 11
Gelatelli coffee and vanilla gelato at Lidl	Anyone who shops at Lidl in Delaware, the District of Columbia, Georgia, Maryland, New Jersey, New York, North Carolina, Pennsylvania, South Carolina or Virginia	Do not eat the 16 fl oz (1 pt) tub of Gelatelli Coffee & Vanilla Gelato with Coffee Sauce & Cookie Pieces, UPC 4 0564897 22458, lot 085261, best by MAR/26/2028. Routine testing found Listeria monocytogenes; no illnesses have been reported. The product sold between July 19 and October 15. Return it to any Lidl for a full refund, no receipt needed. Questions: (844) 747-5435. 7
WinCo hoagie rolls	Sesame-allergic households in California, Idaho, Montana, Nevada, Oregon, Utah and Washington	Stop using WinCo Foods Brand Hoagie Rolls, 16 oz (1 lb) 454 g, UPC 2-70552-00649-2, with best-if-used-by dates from September 10 to November 3, 2026 (printed as "SEP 9" and similar). The manufacturer, United States Bakery, found sesame flour missing from the ingredient list and allergen statement. No illnesses reported. Return them to any WinCo store for a refund. Questions: 1-800-824-1706. 8
Natural Grocers organic mung beans	Anyone who bought the 2-pound bag in Arkansas, Arizona, Colorado, Iowa, Idaho, Kansas, Louisiana, Minnesota, Missouri, Montana, North Dakota, Nebraska, New Mexico, Nevada, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wisconsin or Wyoming	Stop using Natural Grocers Brand Organic 2-Pound Mung Beans, UPC 000080112600, if the pack date in the lower left corner reads 26-160, 26-173, 26-196, 26-224 or 26-258. Customers reported sharp glass fragments; glass can cut the mouth and throat or perforate the intestine. No injuries reported so far. Discard or return for a refund. Questions: 303-226-1434. 9
Cosmetic surgery abroad	Anyone considering a facelift or other cosmetic procedure in Mexico or elsewhere outside the US	Ask whether the facility is accredited and the surgeon certified, because those standards vary by country. Watch the surgical site for swelling, fluid pockets or drainage for up to four months after the operation, and tell any US provider you travelled for surgery — these infections need special cultures, not routine ones. 12

How to read this week's counts

The gap between 482 new deaths and 307 of them dying in the community is the number to watch. WHO reads that share as a sign that cases are being detected late and that care is arriving late. 2

Contact tracing is also behind target. Across six provinces, 79.7% of 30,130 contacts were seen in 24 hours against a 95% goal, with Nord-Kivu at 73.3%. 2

The two agencies' totals measure different things. WHO's 9,704 covers the Congo to October 20; CDC's 9,735 covers five countries to October 21. Compare one agency against itself from week to week. 2 4

State measles counts also move after publication. Pennsylvania's October 16 release listed 43 counties; the October 19 release lists 42. 6

CDC's national death count is explicitly provisional. It reads three while reviews continue, and CDC is still working with the Council of State and Territorial Epidemiologists on one death definition, so states count differently in the meantime. 5

Travel health: one new notice, and a rule that starts in November

Kenya's notice is new, and it is deliberately narrow. Level 1 asks travelers to take usual precautions; the Congo's affected provinces sit at Levels 4 and 3, and the rest of the Congo and Uganda at Level 2. 1 13

What has not changed: the Level 4 notice for Ituri and Nord-Kivu, the Level 3 notice for Haut-Uélé and Tshopo, and the Level 2 notice for the rest of the Congo and Uganda, all issued in August. 13

The two yellow fever notices reviewed on October 16 — Ghana's Upper West Region and Colombia — also stand unchanged, as do global polio from September 23 and global dengue from October 2. 13

The November 3 attestation is a US entry requirement. WHO's position, restated on October 23, is that travel and trade with the affected countries should continue unrestricted. 2

At the Congo's border with South Sudan, both countries are strengthening surveillance at the crossings. Health zones in Haut-Uélé counted 408 cases and 176 deaths by October 17. 14

A man speaks into a microphone to a seated group under a timber shelter, with thatched huts and brick buildings behind them — A community awareness session on Bundibugyo virus disease in the Aba health zone of Haut-Uélé province, about 18 kilometres from the South Sudan border, where more than 26,000 South Sudanese refugees live. Five of eleven planned border entry points are operating; the zone has no ambulance for suspected cases. Photo: WHO Regional Office for Africa, October 22, 2026.

Vaccine, clinical and alert notes

The US routine vaccination schedule is unchanged. CDC's ACIP page still lists no recommendation adopted since August 2025. 15

MMWR's October 22 issue described five US residents in four states who developed nontuberculous mycobacteria infections after facelift surgery by one surgeon at one hospital in Jalisco, Mexico. 12

Three of the isolates were the same Mycobacterium abscessus strain, and a February inspection found sterilization lapses. The operating area was closed and the surgeon's instruments confiscated. 12

Symptoms began a median of 33 days after surgery but in one case 112 days later, and cultures took a median of 76 days. No deaths were reported, and some patients are still under treatment. 12

The same issue carried a second report, on acute kidney injury among patients hospitalized with drug overdose between 2016 and 2025 — clinical material. 16

CDC's Health Alert Network added nothing this week. The newest notice in its archive is still the September 10 rabies post-exposure advisory, CDCHAN-00533. 17

WHO's only other notice in the past fortnight was a Middle East respiratory syndrome update for Saudi Arabia on October 15, which sits outside this window; CDC lists no MERS travel notice. 18

There is one piece of good news from the outbreak. A vaccine trial, TUMAINI, began enrolling its first participants in Bunia on October 23, testing candidates against Bundibugyo virus. 2

State measles picture

Pennsylvania's outbreak is now being modelled with federal help. A CDC Epidemic Intelligence Service officer joined the state on October 19 to work on nowcasting and vaccination-impact analysis. 6

Vaccination is running well above normal. Providers gave more than 56,000 MMR doses in September against a typical 25,000, and more than 23,000 in the first two weeks of October. 6

Most of Wisconsin's increase came from the north. Chippewa County went from 11 cases to 28 in a week, all tied to out-of-state travel, while the four-county southwest outbreak added four confirmed cases. 11

Rock County's five probable cases still have no identified source, and a single confirmed case in Richland County links back to the southwest outbreak. The state's total rose to 310. 11

Utah counted 527 cases for 2026 and has reported none in the past three weeks. About 9.4% of its confirmed cases have been in vaccinated people. 19

Because the risk is low there now, Utah is telling parents an early dose for infants under 12 months can wait until the routine schedule. 19

Food safety: what is still open

FDA's investigators started an inspection and sampling in a Listeria outbreak that has 46 cases and no product named yet. 20

A Salmonella Newport investigation rose from 116 to 119 cases and was then declared ended, and a Cyclospora investigation moved from 240 to 241. A separate 11-case Listeria investigation also ended. 20

Two investigations still carry consumer advice and were not updated this week. The raw-milk cheese outbreak stands at 13 illnesses, 8 hospitalizations and 3 cases of kidney failure across nine states. The sprout outbreak stands at 32 illnesses and 3 hospitalizations across six states. 21 22

The gelato recall covers nine states and the District of Columbia and reaches back to product sold in July, so check the freezer rather than the last grocery run. 7

Glass in beans is a physical hazard, and the affected bags shipped from June 10 onward to 22 states, so a pantry bought months ago can still be in scope. 9

Pet owners have a recall of their own. Wedgewood Pharmacy pulled compounded veterinary medications shipped between February 18 and October 6, 2026, after finding its laboratory's potency testing unreliable. 10

The company has logged 98 complaints, 7 of them serious. Stop the medication, keep the container, and call 866-562-5931 — the lot lookup is at wedgewood.com/recall-lookup. 10

This week's checklist

Flying to the US from the Congo, Uganda or South Sudan? Read the 21-day boarding rule now, and expect to sign an attestation from November 3.
Check the freezer for Gelatelli gelato, lot 085261, and the pantry for Natural Grocers mung beans with pack dates 26-160 through 26-258.
Shop at WinCo in California, Idaho, Montana, Nevada, Oregon, Utah or Washington? Check any hoagie rolls for UPC 2-70552-00649-2.
Bring MMR records up to date, especially in Pennsylvania and Wisconsin, where new cases are still being reported each week.
Pregnant or planning a pregnancy in an outbreak county? MMR goes before pregnancy, not during, and immunoglobulin exists for exposure within six days.
Giving a pet a compounded medication from Wedgewood? Check the lot list before the next dose.

References