What is MSF seeing in Congo’s hospitals that the Ebola response could be missing? Some context before today’s development: The Democratic Republic of the Congo declared its Bundibugyo Ebola outbreak on May 15. Government data released November 10 put the cumulative toll at 11,042 confirmed cases and 5,387 deaths. WHO’s Africa office had reported no decline in daily new cases, with North Kivu driving the recent rise, while insecurity and health worker strikes complicated contact tracing. This is Ebola Watch. U.S. entry restrictions, Europe’s very-low-risk assessment—what do they mean for your travel plans? First, MSF’s warning about missed cases and hospital spread.
From DD News:
Six months into Congo's Ebola outbreak, many cases are likely being missed, transmission in hospitals in some areas is rife and the virus is still spreading out of control, Médecins Sans Frontières said on Thursday.
With Congo’s outbreak already past eleven thousand confirmed cases, MSF now warns that missed infections and hospital transmission are undermining control. Six months after the outbreak was declared, that’s a deeply troubling assessment. Wait—hospital transmission. If you’re worried about someone working in a clinic there, that’s the detail that lands hardest: MSF says the virus is spreading extensively inside hospitals in some areas. And those eleven thousand are confirmed cases; MSF believes additional infections are being missed. DD News also reports no approved vaccine or treatment for this outbreak’s Bundibugyo virus, making infection prevention inside those facilities especially urgent.
Here's Fragomen, Del Rey, Bernsen & Loewy LLP:
The U.S. Centers for Disease Control and Prevention (CDC) has further extended its existing entry ban, issued in response to the Ebola outbreak in Africa, for another 30 days. The new CDC order applies to foreign national travelers who have departed from or were otherwise present within the Democratic Republic of the Congo (DRC), Uganda, or South Sudan in the past 21 days, regardless of their country of origin.
The U.S. Ebola entry restrictions remain in place: the November 10 extension adds another 30 days for certain foreign travelers. But if you're American, don't hear the citizen exemption and assume you can board a flight home. Fragomen reports the extended CDC order covers foreign nationals who've been in Congo, Uganda, or South Sudan within the past 21 days, regardless of their country of origin. It took effect November 10 at five p.m. Eastern; separate CDC website guidance also restricts U.S. citizens and nationals. Separate—and consequential. For an American volunteer leaving Congo, that guidance bars boarding a commercial flight bound for the U.S. after presence there within 21 days before departure; someone who's been only in Uganda or South Sudan faces designated-airport screening instead. And Fragomen says that since November 3, every passenger boarding an international flight to the U.S. must sign a statement confirming no presence in Congo during the preceding 21 days. Before booking, check current CDC instructions against your recent travel history—even if your departure airport is nowhere near those three countries.
Here's 2EU.brussels:
The European Centre for Disease Prevention and Control (ECDC) continues to assess the likelihood of infection for people living in the European Union and European Economic Area (EU/EEA) as very low in the Ebola outbreak caused by Bundibugyo virus. ECDC Director Pamela Rendi-Wagner presented the assessment to the European Parliament’s Public Health Committee (SANT) on 10 November.
We just covered the U.S. entry restrictions. Now ECDC says infection risk in the EU and EEA remains very low. If you're booking a flight, those can sound like conflicting signals—are they? They're answering different questions. ECDC's assessment concerns people living in the EU and EEA; it doesn't establish your risk on a trip to Congo. Pamela Rendi-Wagner told the European Parliament on November tenth that rapid detection and isolation help limit transmission in Europe. So don't stretch that European assessment into reassurance about a Congo itinerary. The geography matters. And keep the reporting date attached: ECDC recorded 10,990 confirmed cases and 5,354 associated deaths in Congo, using data through November eighth. Those are confirmed cases, not a combined confirmed-and-suspected tally—and they're not a November twelfth count.
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