For your safety and the well-being of those around you, please be informed that it is
mandatory to be screened for Marburg Virus Disease using Public Health Passenger
Declaration Form as part of preventive measures when you are departing from Rwanda.
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STEP 1
Your InfoSTEP 2
Your InfoSTEP 3
Epidemiological Risk Factors and Exposures to MVDSTEP 4
Epidemiological Risk Factors and Exposures to MVDPlease provide vour passport, firstname, and lastname
Passport/National ID
Enter FirstName
Enter LastName
Please provide vour Email, Phone Number
PhoneNumber
High fever (≥38 C) | Yes No |
Severe headache | Yes No |
Muscle ache | Yes No |
Vomiting/nausea | Yes No |
Diarrhea | Yes No |
Intense fatigue/general weakness/lethargy | Yes No |
Chest pain | Yes No |
Unexplained bleeding | Yes No |
During the past 21 days, have you, or a member of your group travelling with you, had close contact (Physical contact) with someone who had symptoms suggestive of Marburg virus disease? | ||
Yes | No | I don’t know |