From 3 November, all passengers boarding an international flight to or connecting through the United States must sign an attestation confirming they have not been present in the Democratic Republic of the Congo (DRC) in the 21 days before boarding. The measure, issued by the U.S. Centers for Disease Control and Prevention (CDC), is a precautionary step to "reduce the risk of Ebola importation", although the current "overall risk to the American public and travellers remains low."
What the CDC order requires
The CDC, within the Department of Health and Human Services, issued the Order on 22 October. On 28 October, it published an "Amended Order to clarify that the requirement for the attestation applies to all people travelling on any aircraft, including crew on passenger- and cargo-carrying aircraft involved in operation of aircraft or the positioning of crew not operating the aircraft (e.g., on 'deadhead' status)."
An attestation is a signed statement confirming the information provided is true. "Knowingly giving false or misleading information may result in criminal penalties, including fines and imprisonment", CDC officials warn. Passengers who refuse to sign or provide false information could face criminal penalties, including fines and a possible jail sentence, and may not be able to fly.
Who is affected
The rules apply not only to people who have visited the DRC for a holiday or business trip, but also to anyone who has travelled through the country, including passengers making a connecting flight at an airport in the DRC. The CDC states: "You will not be permitted to board a flight to the United States until 21 days after you leave DRC. This applies even if you were on an airplane that stopped at an airport in DRC regardless of whether you disembarked or stayed on the airplane."
Anyone who has been in the DRC must wait until the 21-day period has passed before boarding a flight to the United States. After leaving the DRC, travellers must remain outside the United States for 21 days and may return to the US beginning on Day 22.
Advice for UK passengers
Not everyone will be affected. In advice to UK travellers, gov.uk explains that the World Health Organisation (WHO) declared a Public Health Emergency of International Concern in the DRC and Uganda. Citing the same rules that came into effect at the start of November, it states: "If you are flying to or transiting through the US, you must complete and sign a form before boarding their flight. The form asks you to confirm whether you have been in the DRC in the 21 days before your flight."
It urges passengers to check with their airline for advice on completing the form before flying, warning that travellers may not be allowed to board if they do not complete it. "For passengers under 18, a parent, guardian or other authorised person must complete and sign the form on their behalf", gov.uk states. It further warns: "There are also temporary US entry restrictions for some people who have recently been in the DRC, Uganda or South Sudan. Check the guidance for travellers from Ebola-affected areas before you travel and contact your airline if you are unsure about the rules."
Signs and symptoms of Ebola
Ebola is caused by a virus caught from wild animals. It spreads from person to person when you touch infected body fluids, such as semen, saliva, blood, poo, pee and vomit. There have been outbreaks of the virus in Central, West and East Africa. "It's never been spread from person to person in the UK", the NHS explains.
The NHS notes symptoms can start between two and 21 days after being infected. Signs can appear suddenly and include flu-like symptoms, such as a high temperature, fatigue and a headache. Other symptoms include being sick, diarrhoea, tummy pain, skin rash, yellowing of the skin and eyes, blood in your poo, lots of bruises all over your body, bleeding from your ears, eyes, nose or mouth, muscle pain, sore throat, blood in vomit, and bleeding from nose, gums or vagina.
While the risk in the UK is low, Ebola is an emergency and needs to be treated quickly. Contact your doctor, NHS 111 or 999 if you suspect you have it.
