Emergency Request Memo - Marburg Symptom Traveler Monitoring and Feedback 18NOV2024

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

November 14, 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 Symptom Monitoring & Feedback 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. MVD is a severe illness in humans with
extremely high case fatality rates. 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 Nov. 11, 2024, Rwanda has recorded 65 illnesses
and 15 deaths from Marburg virus disease. The scale of this MVD outbreak may continue to worsen.
Given the rapidly changing situation and out of an abundance of caution, CDC began conducting public
health entry screening of travelers arriving in the U.S. that have been in Rwanda in the past 21 days.
Public health entry screening has been in effect at 3 airports (John F. Kennedy International Airport
(JFK), Chicago O'Hare International Airport (ORD), and Washington-Dulles International Airport (IAD)
since October 16, 2024. During public health entry screening, CDC staff confirm traveler contact
information, observe travelers for visible signs of illness, and ask travelers a few health and exposure
questions. If it is determined that a traveler needs symptom monitoring, they will be referred to the
appropriate public health authority. If a traveler does not have symptoms or a known history of exposure
to the virus that causes Marburg, they will receive information about how to self-monitor for Marburg
symptoms and what to do if they get sick. Currently traveler information is shared with state and local
health departments at the traveler’s destination for further monitoring and follow up. However,
monitoring of travelers requires significant time and resources and state and local health departments
have requested that CDC assist with traveler monitoring.
To further protect U.S. communities from an imported case of MVD, the United States must be prepared
to respond domestically by monitoring travelers that have been in Rwanda in the previous 21 days for
signs and symptoms of MVD. Travelers should complete a 21-day follow-up period to ensure they are
symptom free and prevent introduction and spread of MVD into the United States. CDC proposes to
conduct this data collection to assist state and local health departments with monitoring of travelers based
on CDC’s Interim Recommendations for Post-Arrival Public Health Management of Travelers from

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

Rwanda. 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. Additionally, this data collection will provide CDC with information
on how to reach travelers with health messages and public health information which will allow CDC to
better utilize outreach resources as the outbreak progresses.
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 has consulted with state and local health departments and has incorporated
their feedback into the data collection instruments and workflow processes. Based on state and local
health department input, CDC was able to tailor the information collection to meet critical emergency
response needs while also ensuring travelers, along with state and local health departments were not
overly burdened with this collection. CDC requests authorization to use information collection
instruments 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 and within the United States is more
likely.
Please provide an approval/disapproval determination of this request to collect information under an
emergency clearance by 12pm ET, November 22, 2024.
Respectfully,

signed by Wendi L.
Wendi L. Kuhnert - Digitally
Kuhnert -S
Date: 2024.11.15 14:10:32 -05'00'
S
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