Information Collection Request

Emerging Infections Program

ICR 201507-0920-003 · OMB 0920-0978 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Resistant Gram-Negative Bacilli Case Report Form Form New Repair queued
CDI Treatment Form Form New Available
CDI Case Report Form Form New Repair queued
ABCs Non Bacteremic Pneumococcal Disease Form Unchanged Available
FluSurv-Net Project Consent Form Form Unchanged Available
Influenza Hospitalization Surveillance Project Vaccination Telephone Survey Form Unchanged Available
FluSurv-NET Influenza Hospitalization Surveilance Project Case Report Form Form Unchanged Repair queued
Legionellosis ABCs Case Report Form Unchanged Available
ABCs Neonatal Infection Expanded Tracking Form Form Unchanged Repair queued
ABCs Invasive Pneumococcal Disease in Children Form Unchanged Available
Invasive Methicillin - Resistant - Staphylococcus aureus ABCs Case Report Form Form Unchanged Repair queued
ABCs Case Report Form Form Unchanged Available
Attachment_25_ CDI ASSENT for 13-15.pdf Supplementary Document Uploaded 2015-07-07 Available
Attachment_24_ADULT VERBAL CONSENT Assent 16_17 for CDI.PDF Supplementary Document Uploaded 2015-07-07 Available
60 day published.pdf Supplementary Document Uploaded 2015-07-07 Available
Part B_EIP OMB 2015 Revision_SMN 23Feb2016.docx Supporting Statement B Uploaded 2016-02-24 Repair queued
Part A_EIP OMB 2015 Revision_SMN 23Feb2016.docx Supporting Statement A Uploaded 2016-02-24 Available
EIP 2015 Change Request_justification_revised 2-17-15.docx Justification for No Material/Nonsubstantive Change Uploaded 2015-02-17 Available
Attachment 04_FoodNet Variable List_2014_12312013.pdf Supplementary Document Uploaded 2015-02-17 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
217339 CDI Telephone Interview Other-Telephone Interview New
217338 CDI Screening Form Other-Interview Screen New
217336 Resistant Gram-Negative Bacilli Case Report Form Form New
217335 CDI Treatment Form Form New
217334 CDI Case Report Form Form New
215016 ABCs Non Bacteremic Pneumococcal Disease Form Unchanged
207663 Yersinia Other-WORD Unchanged
207662 Vibrio Other-WORD Unchanged
207661 Shigella Other-WORD Unchanged
207660 Shiga toxin producing E. coli Other-WORD Unchanged
207659 Salmonella Other-WORD Unchanged
207658 Listeria monocytogenes Other-WORD Unchanged
207657 Cyclospora Other-WORD Unchanged
207656 Cryptosporidium Other-WORD Unchanged
207655 Campylobacter Other-WORD Unchanged
207654 FluSurv-Net Project Consent Form Form Unchanged
207653 Influenza Hospitalization Surveillance Project Vaccination Telephone Survey Form Unchanged
207652 Hemolytic Uremic Syndrome (HUS) Other-WORD Unchanged
207651 FluSurv-NET Influenza Hospitalization Surveilance Project Case Report Form Form Unchanged
207650 Legionellosis ABCs Case Report Form Unchanged
207649 ABCs Neonatal Infection Expanded Tracking Form Form Unchanged
207648 ABCs Invasive Pneumococcal Disease in Children Form Unchanged
207647 Invasive Methicillin - Resistant - Staphylococcus aureus ABCs Case Report Form Form Unchanged
207646 ABCs Case Report Form Form Unchanged
ICR Details
0920-0978 201507-0920-003
Historical Active 201502-0920-009
HHS/CDC 0978
Emerging Infections Program
Revision of a currently approved collection   No
Regular
Approved with change 02/24/2016
Retrieve Notice of Action (NOA) 07/13/2015
Previous terms continue: Approved consistent with the understanding that this consolidation will result in the modification and/or discontinuation of related CDC ICRs.
  Inventory as of this Action Requested Previously Approved
02/28/2019 36 Months From Approved 08/31/2016
81,110 0 42,010
22,755 0 12,455
0 0 0

This is a revision request seeking inclusion of additional core EIP activities to include Healthcare Associated Infections-Community (HAIC); active population-based surveillance for healthcare associated pathogens and infections (including Clostridium difficile infection). There are no changes being made to other parts of the EIP (ABCs, FoodNet or Influenza) included in this revision request..

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  80 FR 26051 05/06/2015
80 FR 39780 07/10/2015
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 81,110 42,010 0 39,100 0 0
Annual Time Burden (Hours) 22,755 12,455 0 10,300 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Increase in Burden due to addition of HAIC data collection instruments to 0920-0978.

$20,221,865
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Jeffrey Zirger 404 639-7118 [email protected]

  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.
07/13/2015