OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

National Disease Surveillance Program - II. Disease Summaries

ICR 200901-0920-004 · OMB 0920-0004 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form No Number HABISS Monthly Reporting Form Form Modified Repair queued
Form No number HABISS Form Modified Available
Form CDC 52.12 0920-0004 Waterborne Diseases Outbreak 52.12 Form Modified Available
Form 1 0920-0004 Diarrheal Diseases Campylobacter Form Modified Available
Justification for change in responses from eFORS to NORS.doc Justification for No Material/Nonsubstantive Change Uploaded 2008-12-22 Available
Changes from eFORS to NORS form.pdf Supplementary Document Uploaded 2008-12-22 Available
NORS Form.pdf Supplementary Document Uploaded 2008-12-22 Available
FoodborneOutbreak Form 5213 ReportingInstructions.pdf Supplementary Document Uploaded 2007-01-17 Available
NREVSS PCR Worksheet CDC 55.83D.pdf Supplementary Document Uploaded 2007-01-17 Available
NREVSS EM Worksheet CDC 55.83C.pdf Supplementary Document Uploaded 2007-01-17 Available
NREVSS VI Worksheet CDC 55.83B.pdf Supplementary Document Uploaded 2007-01-17 Available
IC Document Collections
IC IDCollectionTypeStatusForm
37707 0920-0004 Influenza Annual Survey 55.31A Instruction Modified
186749 HABISS Monthly Reporting Form Form Modified
186748 HABISS Form Modified
178378 0920-0004 Influenza Virus PHLIS (year-round) electronic Instruction Modified
178377 0920-0004 Influenza Virus PHLIS (Oct-May) electronic Instruction Modified
178376 0920-0004 Influenza Virus 55.31 (fax and internet year-round) Instruction Modified
178375 0920-0004 Listeria Case Form Instruction Modified
178374 0920-0004 Suspected Viral Gastroenteritis (AKA Calicivirus Surveillance) Instruction Modified
178373 0920-0004 Cholera and Other Vibrio Illnesses 52.79 Instruction Modified
178372 0920-0004 Waterborne Diseases Outbreak 52.12 Form Modified
178371 0920-0004 Rabies Monthly Report (electronic) Instruction Modified
178370 0920-0004 Rabies Monthly Report (paper) 55.28 Instruction Modified
178369 0920-0004 Foodborne Outbreak 52.13 Instruction Modified
178368 0920-0004 Influenza-Like Illness (year-round) 55.20E Instruction Modified
178367 0920-0004 Influenza-Like Illness (Oct-May) 55.20 Instruction Modified
178366 0920-0004 Influenza Virus 55.31 (fax and internet Oct-May) Instruction Modified
178365 0920-0004 National Respiratory and Enteric Virus Surveillance System NREVSS 55.83A-D Instruction Modified
178364 0920-0004 National Enterovirus Surveillance Report 55.9 Instruction Modified
178363 0920-0004 Arboviral Diseases Instruction Modified
178362 0920-0004 Diarrheal Diseases Shigella Instruction Modified
178361 0920-0004 Diarrheal Diseases Salmonella Instruction Modified
178360 0920-0004 Diarrheal Diseases Campylobacter Form Modified
ICR Details
0920-0004 200901-0920-004
Historical Active 200809-0920-003
HHS/CDC
National Disease Surveillance Program - II. Disease Summaries
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/22/2009
Retrieve Notice of Action (NOA) 01/07/2009
  Inventory as of this Action Requested Previously Approved
05/31/2010 05/31/2010 05/31/2010
154,295 0 153,944
22,356 0 22,127
0 0 0
NCEH is requesting that the Harmful Algal Bloom-related Illness Surveillance System (HABISS) be added to the other CDC Surveillance Systems covered under this clearance. The purpose of this information collection is to gather specific data related to harmful algal blooms using the Harmful Algal Bloom-related Illness Surveillance System (HABISS). As is the case for other conditions within the National Disease Surveillance Program, state and territorial epidemiologists and scientists will be responsible for the collection, interpretation, and transmission of medical and epidemiologic information. NCEH will use the information to monitor and analyze this data in order to better understand the impact of algal blooms on the health of the general public.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  70 FR 72435 12/05/2005
72 FR 2528 01/19/2007
No
  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 154,295 153,944 0 351 0 0
Annual Time Burden (Hours) 22,356 22,127 0 229 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This request will add another surveillance activity under the currently approved ICR. The currently approved burden will increase by 1,020 hours.
$40,000
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Carol Walker 4046394773
  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.
01/07/2009