CDC Mandates Attestation for Air Travelers From Foreign Countries Regarding Democratic Republic of Congo Presence

The Centers for Disease Control and Prevention (CDC) has mandated a new public health requirement for all persons entering the United States by air from any foreign country. Effective November 3, 2026, travelers and crew members must provide a signed attestation confirming they have not been present in the Democratic Republic of the Congo (DRC) within the 21 days preceding their flight to the U.S. This Amended Order, issued on October 28, 2026, by the Assistant Secretary for Health, aims to bolster national health security against the potential introduction of serious communicable diseases, particularly in light of ongoing public health concerns linked to the DRC.

Background to the Amended Order

The CDC's action follows an initial order signed on October 22, 2026. The amendment, issued just six days later, primarily clarifies the scope of the requirement. Initially, the order referred to "passengers," but the amended version broadens this to "persons," explicitly including crew members on all flights destined for the United States. This adjustment reflects a comprehensive approach to border health security, recognizing that all individuals on an aircraft may pose a potential vector for disease transmission. The order is a direct response to global public health intelligence, indicating the need for specific precautions related to the DRC, a region that has faced challenges with outbreaks of highly contagious diseases like Ebola.

Key Provisions of the Requirement

The core of the Amended Order is the mandatory attestation. Every individual arriving in the U.S. by air from any foreign country must present a signed document, either in paper or digital format, confirming they have not been in the DRC in the 21 days prior to boarding their flight. This 21-day period is calculated with Day 0 being the day of departure from the DRC, Day 1 as the first full calendar day outside the DRC, meaning a person may board a flight to the U.S. on Day 22. The requirement is extensive, applying to all types of aircraft including commercial, cargo, general aviation, and private planes. It also covers flights where the U.S. is not the final destination but merely a transit point. This ensures a broad protective measure for U.S. entry points.

Airline and Aircraft Operator Responsibilities

The Amended Order places significant operational responsibilities on airlines and aircraft operators. These entities are now required to ensure that every person boarding an aircraft destined for the U.S. from a foreign country has completed and signed the necessary attestation. This is part of a "controlled free pratique" process, where compliance is a condition for an aircraft to be granted permission to enter a U.S. port of entry and disembark individuals. Airlines must retain these attestations, whether paper or digital, for at least 42 days after the flight's departure and must provide them to the U.S. Government upon request. The CDC encourages airlines to integrate this attestation into their paperless check-in systems. Crucially, while airlines may use third-party services for translation or data entry, the legal responsibility for compliance and the accuracy of any translations remains solely with the airline or operator.

Legal Framework and Enforcement

This Amended Order is issued under the authority of Sections 361, 365, 368, and 369 of the Public Health Service Act (42 U.S.C. 264, 268, 270, and 271), along with specific implementing regulations (42 CFR 71.20, 71.31(b), and 71.32(b)). It is not considered a new rule under the Administrative Procedure Act (APA), but rather an action taken under existing, established public health authorities. Enforcement mechanisms are robust. Customs and U.S. Coast Guard officers will assist in its implementation, with cooperation from other federal departments such as Homeland Security and Transportation. Individuals who knowingly and willfully submit false attestations may face prosecution by the U.S. Department of Justice under 18 U.S.C. 1001, which pertains to making false statements to the federal government. Furthermore, non-compliant airlines or operators could face penalties under various federal statutes.

Public Health Rationale and Implications

The CDC explicitly states the paramount objectives of this order: the preservation of human life, preventing the introduction, transmission, and spread of the Ebola virus into the United States, and preserving the health and safety of crew members, passengers, airport personnel, and communities. This directly links the attestation requirement to mitigating the risk of Ebola, a severe and often fatal disease. The order, effective from November 3, 2026, through December 18, 2026, for a 45-day period, provides a targeted public health intervention. Its implementation signifies the federal government's proactive stance on managing infectious disease threats at the nation's borders, impacting international travel logistics and requiring heightened vigilance from both travelers and the aviation industry.