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Federal forms, ICRs, and supporting documents

Information Collection Request

Active Surveillance for Ciguatera Fish Poisoning in Culebra, Puerto Rico

ICR 200409-0920-013 · OMB 0920-0667 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
7135 Active Surveillance for Ciguatera Fish Poisoning in Culebra, Puerto Rico Migrated
ICR Details
0920-0667 200409-0920-013
Historical Active
HHS/CDC
Active Surveillance for Ciguatera Fish Poisoning in Culebra, Puerto Rico
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 12/02/2004
Retrieve Notice of Action (NOA) 09/30/2004
Approved consistent with the following terms: approved per CDC memo submitted to OMB on 12/02/04. CDC will not generalize results of the Culebra study to the broader population of Puerto Rico or the Region consistent with the limitations of the proposed study design.
  Inventory as of this Action Requested Previously Approved
09/30/2006 09/30/2006
1,637 0 0
250 0 0
0 0 0
The National Center for Environmental Health, CDC, proposes an active surveillance system for ciguatera fish poisoning (CFP) in Culebra, Puerto Rico. CFP is a serious health threat to people in Puerto Rico. This surveillance system will quantify the public health burden of CFP by determining the incidence, risk factors, and economic effect of CFP in Culebra. We will administer a quarterly questionnaire to households in Culebra. The questionnaire collects information on household fish consumption and identifies individuals who have developed symptoms of CFP. When individuals are identified as having...
None
None
No
1
IC Title Form No. Form Name
Active Surveillance for Ciguatera Fish Poisoning in Culebra, Puerto Rico
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,637 0 0 1,637 0 0
Annual Time Burden (Hours) 250 0 0 250 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/30/2004