21-day Congo attestation sparks deadly disease rule for US-bound flyers as major airlines seek CDC delay

New screening starts Nov. 3

Under the CDC rule, passengers on international flights to the United States must submit a paper or digital statement before boarding. The form is required even for people who have never traveled to the Democratic Republic of the Congo.

Airlines are responsible for gathering the statements and retaining them for at least 42 days after arrival. People who have been in the DRC during the 21-day period, including those who only transited through an airport there, cannot board a U.S.-bound flight without a government exemption. False information could lead to prosecution and fines, the CDC said.

Airline groups seek more time

Airlines for America, representing carriers such as American, Delta, Southwest, United and JetBlue, asked the CDC to reconsider the policy in an Oct. 26 letter. The group supports the public health aim but said the measure is too broad and the Nov. 3 launch leaves little time for preparation.

A4A cited changes to check-in systems, digital signatures, station procedures and staff training. It also urged the government to focus more closely on affected locations and recently exposed travelers, and requested exceptions for airline crews and U.S. military passenger charters.

The International Air Transport Association, which represents more than 370 airlines, also asked the CDC to revisit the requirement. Reuters reported that IATA objected to airlines having less than two weeks to change procedures and collect attestations from passengers and crew.

Ebola risk and screening

The CDC says the 21-day window reflects the longest period symptoms may take to appear after exposure. Infectious disease physician Tyler Evans said screening can help reduce transmission, including among people who do not yet show symptoms.

Evans, chief executive of Wellness Equity Alliance, described the outbreak as the second-largest Ebola outbreak in history. He has worked on Ebola responses in West Africa and the DRC, and said infectious diseases can cross borders.

Evans said early signs may resemble flu, including a high fever and fatigue. He also described Ebola as highly infectious and said it has one of the highest case fatality rates among infectious diseases.