Travel warnings for Congo, Uganda, South Sudan

The social-media warnings were partly right and partly too broad. The World Health Organization confirmed Ebola outbreaks in the Democratic Republic of the Congo and Uganda on May 15, and WHO declared the event a public health emergency of international concern on May 17. South Sudan, however, was not listed by WHO as a country with a confirmed outbreak as of May 24. Instead, it appeared in U.S. travel and entry measures because Washington applied screening and restrictions to people who had recently been in the DRC, Uganda or South Sudan, a neighboring country viewed as vulnerable because of cross-border movement and limited preparedness capacity. (who.int) ### Which countries actually had confirmed Ebola outbreaks? WHO said laboratory analysis in Ituri Province in northeastern Congo confirmed Bundibugyo virus disease, a species of Ebola, in eight of 13 samples tested on May 15. The Congolese health ministry declared the country’s 17th Ebola outbreak the same day. Uganda’s health ministry also confirmed an outbreak on May 15 after identifying an imported case from Congo in a Congolese man who died in Kampala, WHO said. (state.gov) By May 23, CDC said Uganda had reported five confirmed cases and one confirmed death, including three additional cases announced that day with links to earlier infections in travelers from Congo. ### Why did South Sudan get mentioned if it had no confirmed outbreak? (who.int) The U.S. State Department said on May 19 that it was implementing CDC restrictions for foreign nationals who had been in the DRC, Uganda or South Sudan in the previous 21 days. The department also said it had issued updated Level 4 travel advisories for all three countries. UNICEF said South Sudan was one of the priority neighboring countries for Ebola preparedness, adding that, unlike Uganda, South Sudan and some other nearby states did not have prior experience handling Ebola outbreaks and needed more international support. (who.int) The U.S. Embassy in Juba issued a May 18 health alert that referred to the Ebola outbreak in the DRC and Uganda, not South Sudan itself, and directed travelers to monitor symptoms for 21 days after travel to outbreak areas. (state.gov) ### How serious was the outbreak by late May? CDC said on May 23 that Congo had reported 746 suspected cases, 83 confirmed cases, 176 suspected deaths and nine confirmed deaths. (unicef.org) The agency described the situation as rapidly evolving and said the overall risk to the American public and travelers remained low. WHO said the outbreak involved the Bundibugyo species of Ebola, for which there is no licensed vaccine or specific therapeutic. (ss.usembassy.gov) WHO’s disease-outbreak notice said past Bundibugyo outbreaks had case fatality rates ranging from about 30% to 50%, while CDC said earlier outbreaks had mortality rates of roughly 25% to 50%. ### What were health agencies telling travelers? CDC said on May 19 it had issued a Level 3 travel health notice for people traveling to the DRC and a Level 1 notice for Uganda. (cdc.gov) The agency’s later public update said CDC and the Department of Homeland Security announced enhanced travel screening, entry restrictions and other public-health measures on May 18. The distinction matters because online posts warning against “non-essential travel” to all three countries mixed official outbreak information with broader government restrictions. (who.int) As of May 24, the confirmed Ebola outbreak was in the DRC and Uganda, while South Sudan was being treated by U.S. authorities as a neighboring at-risk country for screening and travel-control purposes. ### What should readers watch next? (cdc.gov) WHO said response measures included rapid-response teams, medical supplies, surveillance, treatment centers and cross-border preparedness. CDC said case counts were changing quickly, and its May 23 update was the latest public U.S. tally for Congo and Uganda. Travelers looking for the next official changes should watch WHO outbreak notices, CDC travel-health updates and foreign ministry advisories, because those have not treated Congo, Uganda and South Sudan in exactly the same way. (who.int) (cdc.gov)