U.S. warns against travel to Ebola-affected countries

The United States on May 18 imposed new Ebola-related travel restrictions and enhanced screening for people arriving from Uganda, the Democratic Republic of the Congo and South Sudan, as health officials responded to an outbreak centered in Central and East Africa. The Centers for Disease Control and Prevention said the measures took effect immediately and will last 30 days. The order includes entry restrictions for non-U.S. passport holders who have been in any of the three countries within the previous 21 days. U.S. officials said the immediate risk to the general American public remains low. ### What exactly did the U.S. government change this week? The CDC said on May 18 that it, the Department of Homeland Security and other federal agencies had implemented “enhanced travel screening, entry restrictions, and public health measures” to prevent Ebola disease from entering the United States. The agency said it would increase screening and traveler monitoring for people arriving from outbreak-affected areas and coordinate with airlines, international partners and port-of-entry officials. (cdc.gov) The State Department said it updated travel advisories and worked with the CDC on a May 18 Title 42 order prohibiting travel to the United States for foreign nationals who had visited the DRC, Uganda or South Sudan within the last 21 days. The department said embassies in the DRC, Rwanda, South Sudan and Uganda had set up monitoring groups to track developments and communicate with American citizens. (cdc.gov) ### Why is South Sudan included if the outbreak is in Congo and Uganda? South Sudan appeared in the U.S. measures as part of regional containment steps rather than because U.S. and WHO statements identified an active outbreak there. The CDC order names Uganda, DRC and South Sudan for screening and entry restrictions, while WHO’s May 15-16 outbreak notices described confirmed outbreaks in the DRC and Uganda. (state.gov) The U.S. Embassy in Juba told Americans on May 18 that WHO had declared the outbreak in the DRC and Uganda a public health emergency of international concern and advised travelers to monitor their health for 21 days after travel to outbreak areas. The embassy alert pointed readers to CDC travel health information and noted South Sudan’s own standing Level 4 “Do Not Travel” advisory for separate security and health reasons. (cdc.gov) ### What strain is involved, and why are officials treating it seriously? WHO said laboratory analysis in Kinshasa confirmed Bundibugyo virus disease in eight of 13 blood samples from Ituri Province on May 15. WHO said Bundibugyo virus is a species of Ebola and that no licensed vaccine or specific therapeutics are available for it, though early supportive care can save lives. (ss.usembassy.gov) CDC said the outbreak was first identified after a cluster of severe illnesses among healthcare workers in northeastern DRC. The agency said one imported case in Uganda involved a Congolese man who died in Kampala, and WHO said on May 16 that the outbreak in DRC and Uganda met the threshold for a public health emergency of international concern. (who.int) ### What do the case numbers look like right now? CDC said that as of May 18 there were reports of 11 confirmed cases and 336 suspected cases, including 88 deaths, in the DRC, and two confirmed cases including one death in Uganda. The agency said no cases linked to this outbreak had been confirmed in the United States. WHO’s May 15 outbreak notice described the situation as fast-moving and said response measures included rapid response teams, medical supplies, surveillance, laboratory confirmation, treatment centers and cross-border preparedness. (who.int) WHO also said countries had been issued advice on response steps. ### What are travelers and Americans in the region being told to do? (cdc.gov) CDC travel notices posted May 15 and May 18 said Uganda was under an Ebola Bundibugyo Virus Disease notice and that the DRC outbreak was concentrated in Ituri and North Kivu provinces. CDC said travelers should avoid nonessential travel to those affected Congolese provinces and follow local public health guidance. (who.int) The CDC order said people who traveled through affected countries should watch for fever, weakness, vomiting, diarrhea or unexplained bleeding and seek medical attention immediately if symptoms develop within 21 days. The State Department said it was also working with CDC, DHS and the U.S. military on possible repatriation of affected Americans based on exposure and health needs, and said it had mobilized an initial $13 million in foreign assistance within 48 hours. (wwwnc.cdc.gov) The CDC said the 30-day order took effect immediately on May 18, and both CDC and WHO said they would continue updating guidance as the outbreak evolves. (cdc.gov)