The CDC's Ebola Entry Ban Reaches Its Eighth Order in 176 Days, Still Limited to Three Countries
CDC renewed its Ebola entry ban on Nov. 10 as Congo's confirmed cases reached 10,879, but it still omits Kenya and Nigeria, which had travel-linked cases.
At 5 p.m. Eastern time on Nov. 10, the Centers for Disease Control and Prevention renewed its order barring entry to most foreign nationals who have been in the Democratic Republic of the Congo, Uganda or South Sudan in the previous 21 days. It is the eighth order since May 18, and it runs for 30 days, to about Dec. 10.
The new order, signed Nov. 9 by Assistant Secretary for Health Adm. Brian Christine, cites 10,879 confirmed cases and 5,302 deaths across 67 health zones in the Congo as of Nov. 6, from the Bundibugyo virus outbreak. U.S. citizens and nationals are exempt from the entry ban itself. Lawful permanent residents are not. A separate CDC order, which took effect Nov. 3, requires every person boarding a U.S.-bound flight to attest that they have not been in the Congo for 21 days.
How has the outbreak grown between orders?
Each renewal states the case count CDC relied on. We pulled those figures from the seven orders and notices in the Federal Register and the Nov. 10 order to build a timeline of the outbreak as the U.S. government has described it.
| Order takes effect | Day | Congo count cited (as of) | Cases added |
|---|---|---|---|
| May 18 (first order) | 0 | No specific count stated | |
| May 22 (amended) | 4 | 91 confirmed, 11 health zones (May 22) | |
| June 21 | 34 | 837 confirmed, 31 zones (June 15) | 746 |
| July 13 | 56 | 1,873 confirmed, 672 deaths (July 12) | 1,036 |
| Aug. 12 | 86 | 4,318 confirmed, 2,011 deaths (Aug. 9) | 2,445 |
| Sept. 11 | 116 | 6,779 confirmed, 3,267 deaths (Sept. 9) | 2,461 |
| Oct. 11 | 146 | 8,665 confirmed, 4,178 deaths (Oct. 5) | 1,886 |
| Nov. 10 | 176 | 10,879 confirmed, 5,302 deaths (Nov. 6) | 2,214 |
By our arithmetic, confirmed cases grew fastest between mid-July and early August, about 87 a day, and have run at roughly 70 a day since early October. The order says CDC works in 30-day steps to judge whether there has been a material change in the risk of importation. At about 70 new confirmed cases a day, the counts in its own orders do not show one. The crude case fatality ratio in the Nov. 10 figures is 48.7 percent.
The orders do not always agree with each other. The August order put the Aug. 9 count at 4,318 cases across 53 health zones. The September order restated the same Aug. 9 count across 41 health zones.
The order names three countries. The cases that have left the Congo have turned up in others.
Which countries does the order cover?
Still the same three, and the list no longer tracks where travel-associated cases have appeared. Uganda's outbreak is over: the World Health Organization says it has been controlled since August, and Uganda's count stayed at 20 confirmed cases and two deaths. South Sudan has reported no confirmed cases. It is listed because of its border with affected areas and its limited health infrastructure, the orders say.
Meanwhile, the Nov. 10 order itself describes travel-associated cases in two countries it does not cover. Kenya announced its first case and death on Oct. 6, in a person who had traveled from the Congo to Uganda and flown from Kampala to Nairobi on Oct. 2. Nigeria reported a case on Oct. 20 in a traveler arriving from Uganda. The WHO's Nov. 6 outbreak update counts nine confirmed cases and two deaths in Kenya, in a cluster that included four health workers, with no new cases since Oct. 19, and one imported case in Nigeria that was medically evacuated to Switzerland. The WHO advises against travel or trade restrictions on affected countries.
The order also names the hubs where outbreak-area travelers connect: Addis Ababa, Nairobi, Brussels, Doha, Dubai and Istanbul.
Who is covered, and who is not
The entry ban applies to covered noncitizens who left or were in the three countries in the past 21 days, regardless of nationality. Lawful permanent residents are included because the governing regulation, 42 C.F.R. 71.40(f), no longer exempts them, as the October order notes. For U.S. citizens, CDC guidance bars boarding commercial flights to the United States within 21 days of being in the Congo and routes travelers from Uganda or South Sudan through designated airports for screening, according to a Nov. 10 summary by the immigration firm Fragomen.
The new order was issued with a 15-day public comment period. The October order shows what commenters asked for: measurable criteria for adding and removing countries, and attention to permanent residents and to people who only transited a listed country.
What clinicians should do
Keep the travel history broader than the order. A febrile patient who was in Kenya, Nigeria or a regional hub in the past 21 days is outside the CDC's country list but inside the WHO's case reports. There is still no widely approved vaccine or specific antiviral for Bundibugyo virus disease, the orders note, and the isolation and testing steps in our October clinician checklist still apply. The next dates are fixed: the entry ban expires about Dec. 10 unless renewed, and the attestation order runs through Dec. 18.
Reported, fact-checked and edited by The Script Pad's editorial staff. See How we use AI.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
