South Korea, US expand Ebola travel

South Korea widened its Ebola-related travel ban in the Democratic Republic of Congo on May 22, and the United States separately broadened entry restrictions tied to the same regional outbreak. Seoul added Ituri Province to areas already under its highest travel warning, while U.S. authorities moved to bar some lawful permanent residents who recently traveled through affected countries. The measures came after the World Health Organization said the outbreak involved the Bundibugyo strain of Ebola, for which there is no licensed vaccine or specific therapeutic. WHO on May 16 classified the event in Congo and Uganda as a public health emergency of international concern. ### Which places did South Korea add to its restrictions? South Korea’s foreign ministry said Friday, May 22, that Ituri Province would be placed under a Level 4 travel alert, the highest level in its four-tier system. The move expanded South Korea’s no-travel zones in Congo to three provinces: Ituri, North Kivu and South Kivu. The ministry said South Korean nationals who enter or remain in those areas without exceptional passport-use authorization could face penalties under the passport law. (en.yna.co.kr) It also kept a Level 3 alert, recommending departure, for areas within 50 kilometers of the border with the Central African Republic and for seven other Congolese provinces, including Bas-Uele and Haut-Uele. ### What exactly did the United States change? The U.S. Centers for Disease Control and Prevention said on May 22 that a Title 42 order would remain in effect for 30 days, effective immediately, as part of measures announced with the Department of Homeland Security and other agencies on May 18. The CDC said the order was intended to prevent Ebola disease caused by the Bundibugyo virus from entering the United States. (en.yna.co.kr) A legal analysis published by ClinchLaw said a new rule issued May 22 extended the U.S. Ebola travel ban to lawful permanent residents who had recently traveled to the Democratic Republic of Congo, Uganda or South Sudan. That report said the earlier May 18 order had exempted green card holders before the exemption was removed four days later. (cdc.gov) The CDC statement reviewed by Reuters did not spell out lawful permanent residents by category in the text shown on its public page, but it said CDC and DHS had implemented entry restrictions, enhanced screening and traveler monitoring tied to the outbreak. ### Why are governments reacting so quickly at the border? WHO said on May 15 that laboratory analysis in Kinshasa confirmed Bundibugyo virus disease in samples from Ituri Province, and the Democratic Republic of Congo declared its 17th Ebola outbreak the same day. (news.clinchlaw.com) Uganda also confirmed an outbreak after identifying an imported case from Congo in Kampala, WHO said. (cdc.gov) WHO said the Bundibugyo strain has produced case fatality rates of 30% to 50% in past outbreaks. The agency also said there is no licensed vaccine or specific therapeutic against Bundibugyo virus, though early supportive care can save lives. South Korea’s foreign ministry said Ebola infections in eastern Congo had been rising rapidly, with more than 160 suspected deaths cited in foreign media reports. (who.int) The CDC, for its part, said its U.S. measures were based on current epidemiological evidence, ongoing risk assessments and the “highly serious nature” of Bundibugyo virus disease. ### How broad is the outbreak now? (who.int) WHO said it was first alerted on May 5 to a high-mortality illness in Mongbwalu Health Zone in Ituri Province, including deaths among health workers. The agency said the current outbreak in Congo was occurring in Rwampara, Mongwalu and Bunia health zones. The WHO determination on May 16 made the Congo-Uganda event a public health emergency of international concern under the International Health Regulations. (en.yna.co.kr) WHO said response measures included rapid response teams, medical supplies, surveillance, laboratory confirmation, infection-control assessments, treatment centers and cross-border preparedness. (who.int) ### What comes next for travelers and health agencies? The CDC said its U.S. order will run for 30 days from May 22 and may be adjusted as additional information becomes available. The agency also said travelers from affected countries should monitor CDC travel health notices and seek medical attention if symptoms develop within 21 days of travel. South Korea’s foreign ministry said it would keep a special travel advisory in place for the rest of Congo, and Yonhap reported that Uganda had also been designated for special advisory treatment after South Korean disease authorities named Congo, Uganda and South Sudan priority quarantine management countries for Ebola. (who.int) (en.yna.co.kr) (cdc.gov)