Starting with flights that depart late on Nov. 3, travelers bound for San Francisco International and every other U.S. airport must sign a form saying they have not been in the Democratic Republic of the Congo in the previous 21 days.
Every passenger on an international flight to the United States, including the roughly 22,000 people a day who stepped off international flights at San Francisco International Airport last year, will soon have to sign a statement before boarding saying they have not been in the Democratic Republic of the Congo during the previous three weeks.
The requirement comes from an order signed Oct. 22 by Adm. Brian Christine, the assistant secretary for health at the Department of Health and Human Services, and published in the Federal Register on Oct. 27. It applies to flights departing at or after 11:59 p.m. Eastern time on Nov. 3, and it covers U.S. citizens and foreign nationals alike, as well as passengers who are only connecting through an American airport to another country.
The government’s case
The administration says the measure is needed to keep an Ebola outbreak in central Africa from reaching the United States. The order describes an outbreak of Bundibugyo virus disease, a form of Ebola for which there is no approved vaccine or treatment, that by Oct. 18 had produced 9,455 confirmed cases and 4,561 deaths in Congo, spread across 66 health zones in eight provinces.
The order says only about 20 percent of cases were being identified through follow-up of known contacts, and that about 80 percent of new cases in Ituri province could not be linked to known contacts, a sign that the virus is moving in ways health workers cannot track. It notes that a physician who had been in Congo was diagnosed in France, that Kenya reported its first case on Oct. 6, and that modeling suggests the outbreak could become one of the largest Ebola epidemics on record. Because the incubation period runs from two to 21 days, the order says, airport screening and voluntary questioning are not enough on their own.
The legal basis, according to the order, is Sections 361, 365, 368 and 369 of the Public Health Service Act and federal quarantine regulations at 42 C.F.R. 71.20, 71.31(b) and 71.32(b), which allow federal health officials to set conditions on the entry of arriving aircraft. HHS says the order is not a rule subject to the Administrative Procedure Act’s notice-and-comment requirements, and that even if it were, advance notice could prompt people in Congo to travel sooner to beat the deadline. The order states that its purpose is “preserving human life” and preventing the introduction of Ebola into the United States.
The Centers for Disease Control and Prevention did not respond to a request for comment sent Tuesday afternoon.
What travelers will have to do
Under the order, airlines must confirm before boarding that each passenger has completed and signed the attestation, on paper or digitally, and must refuse to board anyone who has not. Carriers must keep a copy for at least 42 days and hand it to the federal government on request. A parent or guardian may sign for a child under 18.
The 21 days are counted in calendar days, with the day of departure from Congo as Day 0; a traveler who was in the country may board a U.S.-bound flight on Day 22. The order exempts flights carrying Ebola patients under federal arrangements and allows the CDC to grant humanitarian exemptions, such as for medical evacuations. It does not apply to flights that pass over the United States without landing.
Airlines and passengers who violate the order face criminal penalties of up to $100,000 for an individual or $200,000 for an organization and up to a year in jail, and a false attestation can be prosecuted under the federal false-statements law.
The order’s dates are not entirely consistent. Its summary says it is effective for 45 days and runs through 11:59 p.m. on Dec. 18, while the body of the order says it remains in effect until Dec. 17 unless rescinded or modified sooner. HHS says any extension will depend on case counts, geographic spread and containment capacity.
What it means at SFO
San Francisco International handled about 16.1 million international passengers in 2025, including nearly 8 million international arrivals, according to airport traffic data. There are no nonstop flights between Congo and the Bay Area, so for most local travelers the practical effect will be one more form to sign before boarding.
The attestation adds to earlier federal measures. Since May, non-citizens who had recently been in Congo have been barred from entering, and Reuters reported that the restriction was extended to U.S. citizens in July. Under current CDC guidance, non-citizens who were in Uganda or South Sudan in the prior 21 days are also barred, and U.S. citizens returning from those countries are routed through Washington Dulles, Atlanta or New York’s Kennedy airport for screening. SFO is not one of the designated airports.
The California Department of Public Health issued a health alert to clinicians in May and has advised travelers returning from affected areas to monitor their health for 21 days. The CDC says no U.S. cases have been linked to the current outbreak, though an American humanitarian worker tested positive in July.
A different view from Geneva
The World Health Organization, in its Oct. 23 outbreak update, counted 9,704 confirmed cases and 4,687 deaths as of Oct. 20, with cases in Congo, Uganda, Kenya, Nigeria and France. The agency continues to advise against “any restriction of travel to, or trade with, affected countries,” a recommendation its emergency committee repeated in August.
The attestation itself is not a ban: it does not stop anyone who has been out of Congo for at least 21 days. Airlines for America, the trade group for major U.S. carriers, did not immediately comment to Reuters on the order, which the CDC has been explaining to carriers in briefing calls.
Anjali Venkatram covers national news and the federal policies, court rulings and trends that reach California, for National News. More from Anjali Venkatram
