New US health mandate comes in effect for travellers, as airlines push back

Effective at 11:59 p.m. Eastern Standard Time on November 3, 2026, all passengers on any airline flying to the United States must complete and sign a health attestation form confirming they have not been in the DRC during the 21 days prior to boarding. The rule applies to Cayman Airways flights scheduled on or after the morning of November 4, 2026.

Passengers may present the completed form in either paper or digital format at check-in or before boarding. A parent or authorised representative may complete the form on behalf of travellers under 18 or those unable to complete it themselves. Those who fail to provide the attestation will not be permitted to board.

The measure is part of the US government's public health response to the Ebola outbreak in the DRC. According to the US Centers for Disease Control and Prevention (CDC), the overall risk to the American public and travellers remains low, but the outbreak has grown to become the fastest-growing in the country's history, with more than 10,000 total infections reported and 9,637 confirmed cases of the rare Bundibugyo virus, including 4,646 deaths.

Under the restrictions, anyone who has been in the DRC within 21 days before departure — including US citizens and nationals — will not be allowed to board flights with US destinations and should plan to remain outside the United States for at least 21 days after leaving the DRC. The rule also covers passengers transiting through the DRC on a connecting flight, regardless of whether they disembark.

Additional restrictions apply to travellers arriving from South Sudan or Uganda. Non-US citizens and non-US nationals, including Green Card holders, who have been in either country within 21 days before departure will not be allowed to enter the United States. US citizens and nationals who have been in Uganda or South Sudan — but not the DRC — within 21 days before arrival must enter through designated US airports for public health screening.

Cayman Airways encouraged customers to familiarise themselves with the requirement and complete the necessary documentation ahead of their scheduled departure to avoid delays during check-in or boarding. The airline directed customers to the CDC website for additional information and access to the official attestation form.

The new mandate has drawn opposition from the airline industry. Airlines for America (A4A), which represents most major US carriers, and the International Air Transport Association (IATA), representing more than 370 airlines worldwide, have asked the CDC to scrap or delay the requirement.

IATA called the rule an "unreasonable" burden on carriers, noting that no other form of travel, including land crossings or maritime travel, is covered by the mandate. A4A said there is not enough time for airlines to put the necessary collection process in place, arguing that additional steps, including training staff to handle the signatures, "cannot be completed in the allotted time." Airlines will be tasked with collecting and retaining the forms for weeks after each flight.

For more information, travellers can visit the CDC's port health page at https://www.cdc.gov/port-health/legal-authorities/attestation-order.html, where printable and fillable versions of the attestation form are available.