Emergency Request Memo

D EPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

_______________________________________________________________________________________

Centers for Disease Control

and Prevention (CDC)

Atlanta GA 30341-3724

October 9, 2024

Dominic Mancini

Deputy Director

Office of Information and Regulatory Affairs

Office of Management and Budget

Washington, DC

Subject: Request for Emergency Review and Clearance

Dear Mr. Mancini:

Pursuant to Office of Management and Budget (OMB) procedures established at 5 CFR Part 1320, Controlling Paperwork Burdens on the Public, I request that the proposed information collection project, 2024 Marburg Traveler Monitoring Assessment, be processed in accordance with section 1320.13, Emergency Processing.

I have determined that this information must be collected prior to the expiration of time periods established under Part 1320, and that this information is essential to inform CDC and interagency decision makers on state/local health department traveler monitoring activities related to travelers coming from areas affected by a Marburg virus outbreak originating in Rwanda. On Sept. 27, 2024, the Republic of Rwanda's Ministry of Health reported cases of MVD the country, including in some patients in health facilities. Illnesses have been reported in several provinces around the country. As of Oct. 8, 2024, Rwanda has recorded 56 illnesses and 12 deaths from Marburg virus disease. Given the rapidly changing situation and out of an abundance of caution, CDC has been directed to implement enhanced public health measures with goal of preventing importation of Marburg into the United States and spread within U.S. communities. 

MVD is a severe illness in humans with extremely high case fatality rates. The scale of this outbreak may continue to worsen. The best strategy to control the spread of the virus to the United States is to stop it at the source with core public health intervention and supplemented by an enhanced public health entry risk assessment and monitoring programs in the United States.

To further protect U.S. communities from an imported case of Marburg, the United States must be prepared to respond domestically by providing state and local health departments and healthcare facilities with the necessary assessments and questionnaires that can assist in identifying high-risk exposures in travelers arriving from areas affected by the outbreak. CDC proposes to conduct this assessment to determine the proportion of travelers that state and local health departments were able to contact for traveler monitoring and inform the develop of future guidance and recommendations for traveler monitoring. This information collection is necessary to facilitate public health monitoring and transmission of information to assist state and local health departments to complete a 21-day follow-up period and prevent further spread of Marburg.

CDC cannot reasonably comply with the normal clearance due to the public harm that will result if routine processing of this request is required. Given the quickly changing situation, it is not feasible for CDC to consult with members of the public regarding this information collection. CDC consulted with state and local health departments via email and calls on this information collection. Based on state and local health department input, CDC was better able to tailor the information collection to meet critical emergency response needs while also ensuring state and local health departments were not overly burdened with this collection. CDC requests authorization to collect information from state and local health departments to mitigate the risk of transmission and spread of Marburg to the United States. If an emergency approval is not granted, then the spread of Marburg to the United States is more likely.

Given that this is an emerging public health situation, and a timely public health response is critical to containment, please provide an approval/disapproval determination of this request to collect information under an emergency clearance by 5pm ET, October 16, 2024.

Respectfully,

________________________________________

Daniel B. Jernigan, MD MPH

Director, National Center for Emerging and Zoonotic Infectious Diseases

Centers for Disease Control and Prevention