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Starting the night of November 3, every passenger boarding a flight to the United States from abroad will have to sign an Ebola form first. A new Centers for Disease Control and Prevention order requires a signed statement that you haven’t been in the Democratic Republic of the Congo (DRC) in the past 21 days. That includes US citizens and green card holders.
For most travelers this means one more checkbox at check-in, and nothing else. The order covers flights that leave a foreign airport at or after 11:59 p.m. Eastern time on November 3. Anyone flying home from a trip abroad in November will see it, and airlines must refuse to board anyone who hasn’t signed.
What the order actually says
We read the 12-page order in full. Adm. Brian Christine, the Assistant Secretary for Health at the Department of Health and Human Services, signed it on October 22.
Reuters first reported the plan from a CDC memo, as carried by NBC News. The CDC has since posted the text with instructions for passengers and airlines.
The scope is wide. It covers commercial airlines, private jets and general aviation. It also covers passengers who only connect through a US airport on the way somewhere else.
There are only two exemptions. One is for flights carrying Ebola patients with US government approval. The other is for people the CDC excuses on humanitarian or other government grounds, such as medical evacuations.
The form itself, Attachment A, asks you to check one box. You either attest for yourself, or for someone who can’t act on their own. Then you print your name, sign and date it.
“Presence” in the DRC means any time on the ground there, by air, land or sea. A connection through a Congolese airport counts too, even if you never leave the plane. Flying over the country does not.
How you will actually fill it in
You don’t file it with the government directly. Your airline collects the form, ideally at check-in or at the gate of the last foreign airport before the US. The CDC wants airlines to build it into their apps and online check-in, so for many people it will be a box to tick.
The order accepts a paper signature, an electronic signature or an electronic checkbox. A few practical rules from the CDC’s guidance:
- Every passenger signs their own form. One form can’t cover a family.
- A parent or other authorized adult signs for anyone under 18.
- A relative or companion can sign for a passenger whose disability prevents it.
- You don’t have to carry a copy. The airline keeps the form for at least 42 days.
The form only applies to air travel, so land borders and seaports are outside it. Flights from Puerto Rico, Guam and other US territories don’t count as coming from abroad either.
The order has teeth on both sides. An airline that can’t confirm every passenger’s form won’t get permission to unload at a US airport. It also faces fines of up to $200,000.
Passengers who knowingly lie risk prosecution for making a false statement to the federal government. Anyone who refuses to sign can lose their seat on this trip and on future ones.
If you have been to Congo, Uganda or South Sudan
For people who really were in the DRC, the form changes little. The US already keeps them off flights.
Since May, the CDC has suspended entry for foreign nationals who were in the DRC, Uganda or South Sudan in the past 21 days. That ban has covered green card holders since late May. Its latest 30-day extension appeared in the Federal Register on October 15.
US citizens can’t board a US-bound flight within 21 days of leaving the DRC either, says the CDC’s outbreak page. NBC reported that the rule reached citizens in July. The day you leave counts as Day 0, and you may fly on Day 22. So someone who left Kinshasa on November 1 could fly to the US on November 23.
Americans coming back from Uganda or South Sudan, but not the DRC, can still fly home. They must land at Washington Dulles, Atlanta’s Hartsfield-Jackson or New York’s JFK for enhanced screening. Houston’s Bush Intercontinental was on that list until Customs and Border Protection dropped it on August 31.
At those airports, CDC staff ask about your travel and symptoms and take your temperature. Travelers then watch their own health for 21 days, with text reminders from the CDC, according to its guidance for returning travelers.
So the new form mostly closes a gap. Picture a traveler who passed through the DRC two weeks ago and then flew on from Nairobi or Addis Ababa. That person would now have to sign a federal statement about it. The CDC says in the order that airport screening and voluntary questions alone wouldn’t catch a disease that can incubate for up to 21 days.
How worried should you be
Not very, by the CDC’s own assessment. “The likelihood of Ebola spreading to the United States is considered very low,” the agency says on its outbreak page. It adds that “the overall risk to the American public and travelers remains low.” No cases linked to this outbreak have turned up in the US.
The outbreak in Africa is serious, though. The CDC counted 9,735 confirmed cases and 4,690 confirmed deaths as of October 21, almost all of them in the DRC. Uganda, Kenya, Nigeria and France have smaller numbers.
Kenyan health officials said all nine of their cases belong to one cluster. Nigeria’s single case is a woman who arrived from Uganda, Newsweek reported.
The virus behind it is Bundibugyo, a rarer member of the Ebola family. It has no approved vaccine or treatment, and it kills about half the people it infects, Reuters reported. Oxford began the first human trial of a Bundibugyo vaccine in July. The CDC order says trials of antibody drugs and an existing Ebola vaccine are underway in the DRC.
What keeps the risk low for ordinary travelers is how the virus spreads. Ebola passes through direct contact with an infected person’s bodily fluids. The CDC order also notes that infected people don’t spread it until symptoms begin.
The worry for officials is the long incubation period. Someone can catch it, feel fine and fly before getting sick. That’s how a doctor infected in the DRC ended up diagnosed in France, the order says.
Washington has wrestled with this problem before. Earlier this year, a Kenyan court blocked a US-backed plan to quarantine American Ebola patients in Kenya.
When it starts, and when it could end
The CDC planned briefing calls with US and foreign airlines on Friday, October 23, NBC reported. Airlines for America, the main US airline trade group, did not immediately comment.
The order runs until December 18 unless the CDC lifts it sooner, so it covers Thanksgiving travel. Any extension will depend on case counts, spread and the DRC’s ability to contain the outbreak, the order says. The separate entry ban for foreign nationals comes up for its next 30-day renewal around November 10.