A new United States health order that requires every person flying into the country to attest that they have not been in the Democratic Republic of the Congo (DRC) in the past 21 days took effect at 11.59pm Eastern Standard Time on 3 November, which is 6.59am on Wednesday in South Africa.

The order, issued by the US Centers for Disease Control and Prevention (CDC) and signed by the Assistant Secretary for Health, Brian Christine, on 28 October, applies to flights departing at or after that time. It runs until 18 December 2026 unless it is rescinded or changed earlier.

What the order requires

Every passenger and crew member on any aircraft bound for the US from a foreign country, including flights from South Africa, must sign an attestation. Under the order, the attestation confirms the person "has not been present in the Democratic Republic of the Congo (DRC) during the 21 days prior to boarding a flight to the United States."

Day zero is the day the person left the DRC, so a traveller can board on day 22. Presence includes connecting through a DRC airport. A parent or authorised representative may sign for a child under 18.

Airlines and other aircraft operators must confirm a signed attestation for everyone on board, must not board anyone without one, and must keep the records for at least 42 days after departure. The order covers commercial, cargo, general aviation and private flights.

Exemptions and penalties

Exemptions cover aircraft carrying Ebola patients under US government authorisation and people granted a CDC exemption for humanitarian or other important government reasons, such as emergency medical evacuations. Those exemptions may come with conditions such as monitoring or self-quarantine.

The order says airlines that do not comply may face criminal penalties, including fines of up to $100,000 for individuals and $200,000 for organisations, and may be refused permission to enter a US port. Travellers may face delayed travel or denied boarding, and knowingly false statements can be prosecuted.

Why the US is doing it

The order states that Bundibugyo-virus Ebola is confirmed in the DRC and that the CDC has concluded the current outbreak is already the largest known outbreak of the disease. It cites the incubation period of up to 21 days and the risk of travellers who are not yet showing symptoms.

As of 18 October, the order says, the DRC had reported 9,455 confirmed cases and 4,561 deaths across 66 health zones in eight provinces. Kenya had reported eight cases as of 19 October. The DRC health ministry has since reported more than 10,000 confirmed cases. The CDC has said no cases linked to this outbreak have been reported in the US.

What we do not yet know

  • How airlines will check attestations in practice.
  • Whether the order will be extended beyond 18 December.
  • Whether other countries will introduce similar rules.