Emergency Request Memo

DEPARTMENT 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 Air Entry Questionnaires 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 the CDC’s ability to assess risk of
symptoms or exposure to Marburg virus disease (MVD) in travelers coming to the United States from
areas affected by an outbreak of MVD originating in Rwanda. On Sept. 27, 2024, the Republic of
Rwanda's Ministry of Health reported cases of MVD in 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 MVD
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 interventions, including case finding, contact tracing,
and exit screening of travelers. As part of a layered intervention strategy, the U.S. government is
supplementing activities in support of the Government of Rwanda with an enhanced public health entry
risk assessment for travelers arriving from countries affected by the MVD outbreak that originated in
Rwanda.
To further protect U.S. communities from an imported case of MVD, 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 symptoms of or high-risk
exposures to MVD in travelers arriving from areas affected by the outbreak. With assistance from the
Department of Homeland Security, CDC will conduct these emergency assessments at designated U.S.
airports that are receiving travelers from the outbreak areas, with assistance from the Department of
Homeland Security. This system of risk assessment and triage will facilitate transmission of information
to assist state and local health departments to complete a 21-day follow-up period and prevent
introduction and spread of MVD into the United States.

DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
_______________________________________________________________________________________
Centers for Disease Control
and Prevention (CDC)
Atlanta GA 30341-3724

CDC cannot reasonably comply with the normal clearance procedures 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 or other agencies or organizations regarding this
information collection. CDC requests authorization to use information collection instruments at select
U.S. ports of entry for 180 days to mitigate the risk of the importation and spread of MVD in the United
States. If an emergency approval is not granted, then the spread of MVD to the United States is more
likely.
Please provide an approval/disapproval determination of this request to collect information under an
emergency clearance by 5pm ET, October 11, 2024.

Respectfully,

Daniel B. Jernigan, MD MPH
Director, National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention