By Claire Whitcomb
WASHINGTON — Beginning just before midnight on Nov. 3, every person who boards a plane bound for the United States — a Western New York family flying home from a vacation abroad, a Rochester executive returning from London, a student coming back from Lagos — will first have to sign a statement swearing they have not set foot in the Democratic Republic of the Congo in the previous 21 days.
The requirement, laid out in an order issued Oct. 22 by the Centers for Disease Control and Prevention, is the broadest travel measure Washington has imposed since an outbreak of Ebola caused by the Bundibugyo virus was declared in eastern Congo on May 15. It applies to U.S. citizens and green-card holders as well as foreign visitors, to private jets as well as airliners, and — in a detail that matters in Western New York — to passengers clearing U.S. customs before departure at preclearance airports such as Toronto Pearson.
It arrives in a week when the outbreak again jumped borders. On Oct. 20, Nigeria confirmed its first case, in a woman who had traveled from Uganda to the capital, Abuja. Kenya has now confirmed nine cases. And in the CDC’s own words, the epidemic “is spreading substantially faster than previous Ebola outbreaks and is now the second-largest Ebola outbreak on record.”
A review of the federal orders, state health department guidance and international case data shows a response that leans heavily on the airport — while the outbreak’s numbers continue to climb, the World Health Organization continues to advise against travel restrictions, and New York’s county health departments carry much of the work of watching travelers once they land.
The numbers behind the order
As of Oct. 21, the CDC’s situation summary counted 9,735 confirmed cases and 4,690 confirmed deaths: 9,704 cases and 4,687 deaths in Congo, nine cases and one death in Kenya, 20 confirmed cases and two deaths in Uganda, and single cases in Nigeria and France. The agency notes that Congo does not include probable cases in its official reporting and that suspected cases “have been temporarily excluded from the count.”
The pace has few precedents. The outbreak “surpassed 1,000 confirmed cases within 40 days of response activation,” the CDC says; Congo’s 2018 outbreak took about 235 days to reach that mark. “There are currently no FDA-approved vaccines or specific treatments designed to prevent BVD,” the New York State Department of Health says, using the abbreviation for Bundibugyo virus disease.
The federal government’s own legal filings describe a situation worse than the official tallies. In the order continuing entry restrictions, published in the Federal Register on Oct. 15, the Department of Health and Human Services wrote that the outbreak “appears to be expanding faster than any previously documented Ebola outbreak, with seven times as many cases observed 100 days after initial detection as experienced in the 2014 West Africa Ebola outbreak, the largest recorded outbreak worldwide.”
“Recent assessments indicate that the true magnitude of the outbreak may be two to four times greater than reported surveillance data suggest,” the order states.
The World Health Organization’s most recent Disease Outbreak News report on Congo found that contact follow-up — the shoe-leather work of checking on everyone exposed to a patient for 21 days — stood at 80.4% in early October, with 23,741 of 29,535 contacts reached, below the response’s 85% target. Of 372 deaths reported since WHO’s previous update, 264 occurred in communities rather than treatment centers, which WHO said “continues to point to delays in identifying illness and reaching appropriate care.”
Layer upon layer of restrictions
The Nov. 3 attestation sits on top of a stack of measures that has grown all year.
On May 18, three days after the outbreak was declared, the CDC barred entry by foreign nationals who had been in Congo, Uganda or South Sudan in the prior 21 days. An amended order four days later removed an exemption for lawful permanent residents. The restriction has since been renewed in 30-day increments — on June 21, July 13, Aug. 12, Sept. 11 and, most recently, Oct. 9. The current order took effect Oct. 11 and runs until 4:59 p.m. on Nov. 10, according to the Federal Register notice.
Americans, too, are now covered. Under current CDC rules, travelers “including Americans, who have been in DRC within 21 days of their flight will not be allowed to board commercial flights with U.S. destinations.” U.S. citizens returning from Uganda or South Sudan must fly into designated airports for enhanced screening. A June briefing by state health officials for New York hospitals listed those airports as Washington Dulles, Atlanta, Houston and New York’s John F. Kennedy International.
The attestation order is meant to close the remaining gap — travelers who reach the United States from Congo by way of a third country. Airlines must confirm that every passenger has signed and keep each form for 42 days so the government can request it. “Passengers who do not sign an attestation will not be allowed to board a flight to the United States,” the CDC says. Transit through an airport in Congo counts as presence there, and lying on the form can be prosecuted as a false statement under 18 U.S.C. § 1001.
The CDC’s guidance says the order covers flights departing from preclearance airports, and private and general aviation as well as commercial flights. It does not apply at land borders or seaports. That means a traveler driving across the Peace Bridge or the Lewiston-Queenston Bridge will not sign the form — though travelers returning from affected countries “are screened for potential exposures and symptoms by federal health authorities in US points of entry, including airports and land borders,” according to the state health department.
The burden lands first on airlines. Airlines for America, the U.S. airline industry’s trade group, did not immediately comment on the order, according to Reuters reporting republished by India Today, which said the CDC planned briefing calls with major carriers on Friday.
Who enforces it
The federal government concedes it cannot police the restrictions alone. In the October order, the Assistant Secretary for Health wrote that he had “requested that DHS aid in the enforcement of this Order because CDC does not have the capability, resources, or personnel needed to do so.”
The public has had little to say. The 30-day renewals have each opened short comment periods. During the period for the Sept. 11 order, the government wrote, “CDC received one comment.” That commenter supported strong measures but urged the agency to “publish measurable criteria for adding and removing countries” and raised concerns about applying restrictions to green-card holders and to people whose only presence in a listed country was in transit. The current comment window, under docket CDC-2026-0892, closes Oct. 30.
Those questions — what evidence would end the restrictions, and how they are weighed against the outbreak’s real risks — have not been answered with published criteria. They deserve to be before the next renewal.
What WHO says
The approach puts Washington at odds with the global health body. After Kenya’s first case on Oct. 6, WHO Director-General Tedros Adhanom Ghebreyesus wrote that “WHO advises against any restriction of travel to, or trade with, the affected countries based on the currently available information,” according to a post reproduced by CGTN.
The WHO Regional Office for Africa repeated that advice in its statement on Nigeria’s case, while urging countries in the region to “heighten monitoring at points of entry, with response plans in place.” The CDC, for its part, says the restrictions are meant “to reduce the risk of Ebola importation into the United States.”
Nigeria’s first case
Nigeria’s case shows how the virus moves. According to WHO, the patient is a woman with a recent travel history to Uganda whose symptoms began on Oct. 7, four days after she arrived in Nigeria. She sought care at a private health facility in Abuja on Oct. 11, and a laboratory confirmed Bundibugyo virus on Oct. 20. Nigeria’s government said 44 close contacts had been identified.
“Remain calm but vigilant. There is no need for panic,” Nigeria’s federal government told citizens in a press statement signed by Coordinating Minister of Health and Social Welfare Muhammad Ali Pate. The statement recalled that “Nigeria successfully contained Ebola in 2014, and we have the experience and public health systems to respond to this case.”
At a briefing Thursday in Abuja, Dr. Pate said the patient was improving. “Thankfully, that individual has been taken care of and, in fact, is recovering,” he said, according to The Punch. “The high-risk contacts have been quarantined fully in a facility. The others have been isolated, and we are ensuring that the isolation is enforced, consistent with public health expert guidelines.”
He also pushed back on doubts that the case was real. “The truth is, we do have a case. It has been tested three times, and those three times’ tests came back positive,” Dr. Pate said. “The alternative to trusting the experts is tragedy. It’s really tragedy.”
Nigeria has not canceled large gatherings. “At this moment, there is no indication that requires us to alter the course of large gatherings that have been planned,” he said.
What happens when travelers land in New York
For New Yorkers, the practical work of Ebola preparedness falls largely on the state and its local health departments.
Under the protocol described in a June 2026 briefing for health care providers, the CDC screens arriving travelers and assigns a risk level; the state health department shares their contact information with the local health department where they live, and the county monitors them for 21 days. High-risk travelers face full quarantine with video health checks. Lower-risk travelers get check-ins and take their own temperatures, without movement restrictions.
The flight manifests that drive that system, the state’s presentation warned, are “often delayed, often incorrect,” arrive “every day, including weekends,” and represented “usually about 150 passengers per day — could go down, could go up.” The slide also flagged “land crossings, broken travel” as a challenge — the itineraries that do not fit neatly into airport funneling.
New York has done this before. During the 2014-2016 West Africa epidemic, the state monitored more than 6,000 travelers, out of more than 30,000 nationwide, and “no returning travelers who were being monitored became ill with Ebola,” the presentation said.
Western New York’s nearest designated treatment hospital is in Rochester. State officials told providers that “places like Bellevue and Strong Memorial in Rochester are for TREATING patients with Ebola or evaluating someone who very much looks like a case of Ebola,” and that “any hospital in the state ought to be able to hold patients for evaluation.” The state’s Wadsworth Center in Albany, New York City’s public health laboratory and NYC Health + Hospitals/Bellevue can all test for Bundibugyo virus, the presentation said.
State Health Commissioner Dr. James McDonald said at the outset of the outbreak in May that the department “is closely monitoring the current Ebola outbreak” and that “there is no immediate risk to New Yorkers.” The department’s current guidance calls the risk to the public “extremely low.” Anyone who recently arrived in New York from an affected area and feels ill is told to separate from others and call the local health department — or the state at 518-473-4439 during business hours and 866-881-2809 after hours — before going to a doctor’s office.
What would make the system stronger
The documents point to several fixes within reach.
First, publish the criteria. The lone public commenter on the September order asked the CDC to say what conditions would add or remove a country from the list. Uganda’s last confirmed case was June 21, and its last patient was released July 16, according to the CDC — yet Uganda remains covered. Clear benchmarks would make each 30-day renewal easier to evaluate.
Second, fund the people who do the watching. The state’s own slides describe local health departments as the backbone of traveler monitoring, working from manifests that are “often delayed, often incorrect.” Counties across Western New York carry that load alongside everything else.
Third, look at the gaps the order itself acknowledges. The attestation does not apply at land borders or seaports, and its enforcement depends on airline check-in staff at foreign airports and on DHS, because the CDC says it lacks the personnel to do it.
And finally, help stop the outbreak where it is. With contact tracing in Congo below target and the official count possibly a fraction of the true toll, the surest protection for travelers landing at JFK or Toronto Pearson is fewer cases at the source.
The current entry order expires Nov. 10. Comments on it are due Oct. 30.
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