Advice for clients present or intending to travel to Democratic Republic of the Congo.

The media have widely spoken about the discovery of the first case of Ebola disease in Goma, a large city of over one million inhabitants in the eastern part of the Democratic Republic of the Congo (DRC). It is the capital of North Kivu province where most of the 1650 deaths have occurred since the beginning of the outbreak. It is located near the borders to Rwanda and to Uganda, where a first case has just been reported. This is seen as a potentially worrisome development as most localities in this outbreak had previously been more remote. Some factors are reassuring, such as national and international efforts that have been ongoing for months, and an infrastructure and equipment and especially trained national and international staff that are in place. The population is well aware of precautions regarding contacts with people including the deceased who have or have had the disease, or the consumption of bush meat. There is also now an effective vaccine and over 3000 health workers (the most affected group risk -wise) in Goma have been vaccinated. Unfortunately on the negative side continued civil unrest remains a major concern, as since January 198 attacks against health facilities have occurred, with 7 deaths and 58 injured, including two community leaders last weekend.

The current Europ Assistance recommendation for its clients is to avoid any travel to the eastern DRC unless they are directly involved in the fight against the outbreak. For the latter the feasibility of systematic vaccination must be considered. There are no restrictions recommended to neighboring countries. Screening of passengers in all internal and corporate flights is recommended, both to protect travelers and avoid dissemination.