US-bound passengers, including from Nairobi, must sign Ebola declaration from 3 November

Every passenger boarding a flight to the United States, including in Nairobi, will have to sign a statement that they have not been in the Democratic Republic of Congo (DRC) in the previous 21 days, under an order from the US Centers for Disease Control and Prevention (CDC). The order takes effect at 11:59 pm Eastern Standard Time on 3 November, which is 7:59 am on 4 November in Nairobi, and applies to flights departing at or after that time.

The CDC's Notice and Order was signed on 22 October by Admiral Brian Christine, Assistant Secretary for Health at the US Department of Health and Human Services. It covers flights from any foreign country. A passenger without the signed attestation, on paper or in digital form, may not board. The CDC says the aim is to keep Bundibugyo virus disease, a form of Ebola, out of the United States.

Passengers connecting through the United States are covered whether or not it is their final destination. Flights that cross US airspace without landing are not. Each person signs a separate form, although a parent or another authorised person may sign for a child under 18 or for a passenger who cannot act for themselves.

The order defines presence in the DRC as any physical presence, including connecting through a DRC airport without leaving the aircraft. The 21 days are counted in calendar days: Day 0 is the day the person left the DRC, and someone who was there may board on Day 22.

Airlines must review each form before boarding, keep it for at least 42 days after the flight departs and hand it to the US government on request. An airline that does not confirm the attestations will not be cleared to disembark passengers at a US airport. The CDC encourages carriers to build the form into online check-in.

A passenger who does not provide the attestation, or gives false or misleading information, may face delays or be refused boarding, on that trip or on future ones. The US Department of Justice may prosecute anyone who knowingly and wilfully submits a false attestation.

The CDC can exempt individuals on humanitarian or other government grounds, such as emergency medical evacuations. The order stays in force until it is rescinded or modified, or until 18 December, whichever comes first.

The declaration comes on top of an earlier CDC order, in force since 11 October, that extends for 30 days the suspension of entry for non-US citizens, including US lawful permanent residents, who left or were present in the DRC, Uganda or South Sudan in the previous 21 days, whatever their country of origin. That order does not apply to US citizens and nationals. Kenya Airways says in a travel alert updated on 9 October that non-US citizens must remain outside Uganda, South Sudan and the DRC for more than 21 days before entering the US.

Kenya is named in the new order. It cites Kenya's Ministry of Health as announcing on 6 October the country's first Bundibugyo case: a person who travelled from the DRC to Uganda, flew from Kampala to Nairobi on 2 October and died in hospital on 5 October. By 19 October, the order says, Kenya had announced seven more confirmed cases among close contacts, making eight. The order lists Nairobi under a Level 1 CDC travel health notice, "practice usual precautions". On 23 October Kenya's Ministry of Health announced the death of a second patient, a 65-year-old woman; the country has recorded nine confirmed cases.

The order puts the DRC's confirmed Bundibugyo toll at 9,455 cases and 4,561 deaths in 66 health zones across eight provinces as of 18 October.

For passengers transiting Kenya, the Kenya Airways alert says they must meet Kenya's health rules and the entry rules of their final destination. Kenya applies enhanced screening to travellers from the DRC, Uganda and South Sudan, including those on indirect routings, the airline says.