WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo
On 17 July, the Director-General of the World Health Organization declared the current Ebola outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern under the International Health Regulations (IHR). Further information on the declaration, including temporary recommendations advised by the Emergency Committee, is available in the full statement, speech by WHO Director General, and news release. The latest updates on the outbreak situation are available here.
In view of this declaration, WHO publishes the following recommendations regarding international traffic.
- WHO strongly advises against the closure of borders or implementation of any restrictions on travel and trade, including general quarantine of travellers arriving from Ebola-affected countries (currently only the Democratic Republic of the Congo). Such measures push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease. Most critically, such measures are not supporting public health efforts as they negatively and significantly affect response operations from a security and logistics perspective and can compromise local economies.
- As per Article 43 of the IHR (2005), States Parties implementing additional health measures that significantly interfere with international traffic shall inform WHO, within 48 hours of implementation of such measures, their public health rationale and scientific evidence. WHO shall share this information with other States Parties. Significant interference with international traffic is understood as refusal of entry or departure of international travellers, baggage, cargo, containers, conveyances, goods and alike, or their delay for more than 24 hours.
- National authorities should work with airlines, airports, and other transport and tourism industries to encourage communication and collaboration across industries, and to ensure that the measures adopted are in line with WHO guidance for travel and transport during outbreaks (see links below).
- There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travelers to/from the affected country.
- Any person diagnosed with Ebola virus disease should not be allowed to travel unless the travel is part of an appropriate medical evacuation.
- Anyone with an illness consistent with Ebola virus disease or who had potentially been exposed to the virus in an outbreak affected area (i.e. a contact), are advised not to travel for 21 days since their last potential exposure, unless the travel is part of an appropriate medical evacuation.
Exit screening at international airports of affected country
- Exit screening is recommended at international airports in affected countries (currently only the Democratic Republic of the Congo). This includes non-invasive temperature screening, health checks and observations, risk communication and information sharing to travellers, conducted by suitably qualified and trained public health authorities. If a traveller presents with signs or symptoms such as high fever, an additional assessment should be undertaken of the risk that the illness may be caused by Ebola virus disease. Those that meet specified criteria of suspected Ebola virus disease*, should be referred to specialist medical care with appropriate infection, prevention and control precautions, and only where appropriate, laboratory testing to confirm or exclude Ebola virus disease.
- If a traveller or crew member presents with signs or symptoms related to EVD or is considered to be a high-risk contact of an EVD case (as determined by public health authorities conducting exit screening), the transportation company is advised to seek medical clearance from public health authorities prior to embarkation.
- If a person who has been exposed to Ebola virus and developed signs/ symptoms while on board of a commercial flight or other mode of transport, such patients should seek immediate medical attention upon arrival, and then be isolated to prevent further transmission. Although the risk to fellow travellers in such a situation is very low, contact tracing is recommended in such circumstances. Guidelines for cabin crew for managing a suspected case of communicable disease on board, issued by the International Air Transport Association, should be implemented by cabin crew.
Entry screening/cross-border screening
- Cross-border screening and screening at main internal roads of affected country should be in place to reinforce contact monitoring and case finding; information should be consistently shared with surveillance teams. Risk communication and community engagement at internal points of control and international points of entry should be implemented, to encourage self-reporting when presenting symptoms
- Entry screening at international airports or other ports of entry outside the neighbouring countries is not recommended as it is not effective and involves large amount of resources.
- Procedures to attend to emergency cases shall be put in place and be communicated to transportation companies.
WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo.
* The official case definitions are available from Ministère de la Santé in the Democratic Republic of the Congo, or respective national public health authorities in other countries. See also the WHO Recommended case definitions for Ebola or Marburg virus diseases.