OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

National Disease Surveillance Program - II. Disease Summaries

ICR 201707-0920-010 · OMB 0920-0004 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Att F US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form Modified Repair queued
Att. CC Suspect Respiratory Virus Patient Form Form New Repair queued
Form CDC 55.20E Att. H U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form New Available
Att X Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form Modified Repair queued
Att W Adenovirus Typing Report Form Form Modified Available
Att T Antiviral Resistant Influenza Infection Case Report Form Form Unchanged Repair queued
Att M Human Infections with Novel Influenza A Virus Severe Outcomes Form Unchanged Repair queued
Att L Human Infection with Novel Influenza A Virus with Suspected Avian Source Form Removed Repair queued
Att R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report Form Removed Repair queued
Form CDC 43.50 Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report Form Removed Available
Form CDC 55.20 Att G US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly Form Modified Available
Att I_ US Outpatient Influenza-like Illiness Surveillance Network (ILINet) Daily Reports Form Removed Repair queued
Att J_Influenza Associated Pediatric Mortality Case Report Form Form Modified Repair queued
Att E_WHO Collaborating Center for Influenza Virus Surveillance Form Modified Available
Att S_Aggregate Hospitalization and Death Reporting Activity Weekly Report Form Form Removed Repair queued
Att K Human Infection with Novel Influenza A Virus Case Report Form Form Modified Repair queued
Att N Novel Influenza A Virus Infection Contact Tracing Form Form Removed Repair queued
Att P Novel Influenza A Virus Case Screening Form Form Modified Repair queued
Att O_Novel Influenza A Virus Status Case Status Summary Form Removed Repair queued
Att Y_ Viral Gastroenteritis Outbreak Submission Form Form Modified Available
Form CDC 52.12 Att Z_ Waterborne Diseases Transmission Form Modified Available
Form CDC 52.13 Att D_NORS Foodborne Disease Transmission_ Person to Person Disease Transmission_Animal Contact_Environmental Contamination_Unknown Transmission Mode Form Modified Available
Form CDC 55.83A Att U_National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form Modified Available
Form CDC 55.90 Att V_ National Enterovirus Surveillance Report 55.9 Form Modified Available
Attachment DD_Human Subjects Determination 2017_0920-0004 Revision.pdf Supplementary Document Uploaded 2017-08-30 Repair queued
Attachment C_Disease Summaries_Revision 2017_Final.doc Supplementary Document Uploaded 2017-08-30 Available
Attachment B_ 60 Day Federal Register Notice_0920_0004.pdf Supplementary Document Uploaded 2017-08-30 Available
Attachment A_Authorizing Legislation.pdf Supplementary Document Uploaded 2017-08-30 Available
0920-0004_Supporting Statement B_Revision 2017_Final.docx Supporting Statement B Uploaded 2017-08-30 Available
SSA 0920-0004 23AUG2017.docx Supporting Statement A Uploaded 2017-08-30 Available
Change Request 0920-0004_FINAL_clean3.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-12-23 Available
Non-substantive Change 0920-0004 Water_Foodborne_Flu 122014.docx Justification for No Material/Nonsubstantive Change Uploaded 2014-12-18 Available
IC Document Collections
IC IDCollectionTypeStatusForm
37707 Att F US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form Modified
228082 Att. CC Suspect Respiratory Virus Patient Form Form New
228068 Att. H U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form New
212473 Att X Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form Modified
212472 Att W Adenovirus Typing Report Form Form Modified
212471 Att T Antiviral Resistant Influenza Infection Case Report Form Form Unchanged
212470 Att M Human Infections with Novel Influenza A Virus Severe Outcomes Form Unchanged
212469 Att L Human Infection with Novel Influenza A Virus with Suspected Avian Source Form Removed
199058 Att R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report Form Removed
199057 Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report Form Removed
199056 Att G US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly Form Modified
199054 Att I_ US Outpatient Influenza-like Illiness Surveillance Network (ILINet) Daily Reports Form Removed
199052 Att BB_ Influenza Virus Electronic year round PHIN-MS Other-Variables for Reporting Unchanged
199051 Att AA_ Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements Other-Variables for Electronic Reporting Modified
199050 Att J_Influenza Associated Pediatric Mortality Case Report Form Form Modified
199049 Att E_WHO Collaborating Center for Influenza Virus Surveillance Form Modified
199045 Att S_Aggregate Hospitalization and Death Reporting Activity Weekly Report Form Form Removed
199043 Att K Human Infection with Novel Influenza A Virus Case Report Form Form Modified
199042 Att N Novel Influenza A Virus Infection Contact Tracing Form Form Removed
199040 Att P Novel Influenza A Virus Case Screening Form Form Modified
199039 Att O_Novel Influenza A Virus Status Case Status Summary Form Removed
178374 Att Y_ Viral Gastroenteritis Outbreak Submission Form Form Modified
178372 Att Z_ Waterborne Diseases Transmission Form Modified
178369 Att D_NORS Foodborne Disease Transmission_ Person to Person Disease Transmission_Animal Contact_Environmental Contamination_Unknown Transmission Mode Form Modified
178365 Att U_National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form Modified
178364 Att V_ National Enterovirus Surveillance Report 55.9 Form Modified
ICR Details
0920-0004 201707-0920-010
Historical Active 201612-0920-014
HHS/CDC 0920-0004
National Disease Surveillance Program - II. Disease Summaries
Revision of a currently approved collection   No
Regular
Approved without change 10/12/2017
Retrieve Notice of Action (NOA) 08/31/2017
  Inventory as of this Action Requested Previously Approved
10/31/2020 36 Months From Approved 10/31/2017
133,172 0 175,452
24,801 0 32,012
0 0 0
CDC requests approval for a Revision of 0920-0004 National Disease Surveillance Program - II. Disease Summaries. Revisions include addition of Forms, Discontinuation of Forms, and reformatting some questions. The overall result is a decrease in Burden Hours and Respondents.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  82 FR 18459 04/19/2017
82 FR 41267 08/30/2017
No
19
IC Title Form No. Form Name
Att M Human Infections with Novel Influenza A Virus Severe Outcomes None Human Infection with Novel Influenza A Virus Severe Outcomes
Att T Antiviral Resistant Influenza Infection Case Report Form none Antiviral-Resistant Influenza Infection Case Report
Att W Adenovirus Typing Report Form NA National Adenovirus Type Reporting System (NATRS) Form
Att X Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form None Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form
Att J_Influenza Associated Pediatric Mortality Case Report Form NA Influenza-Associated Pediatric Mortality Case Report
Att F US WHO Colloborating Laboratories Influenza Testing Methods Assessment NA WHO Collaborating Laboratories Influenza Testing Methods Assessment
Att V_ National Enterovirus Surveillance Report 55.9 CDC 55.90 Enterovirus Surveillance System Report Form
Att U_National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment CDC 55.83A, CDC 55.83D, CDC 55.83B NREVSS Antigen Detection Worksheet ,   NREVSS Polymerase Chain Reaction (PCR) Worksheet ,   NREVSS Virus Isolation (culture) Worksheet
Att D_NORS Foodborne Disease Transmission_ Person to Person Disease Transmission_Animal Contact_Environmental Contamination_Unknown Transmission Mode CDC 52.13 NORS - Foodborne, Person-to-Person, Animal Contact, Environmental Contamination, Unknown Transmission Mode
Att Z_ Waterborne Diseases Transmission CDC 52.12 NORS - Waterborne Disease Transmission
Att Y_ Viral Gastroenteritis Outbreak Submission Form None Viral Gastroenteritis Outbreak Submission Form
Att P Novel Influenza A Virus Case Screening Form None Novel Influenza A Virus Case Screening Form
Att K Human Infection with Novel Influenza A Virus Case Report Form NA Human Infection with Novel Influenza A Virus Case Report Form (addition of Suspected Avian Source)
Att E_WHO Collaborating Center for Influenza Virus Surveillance NA WHO Collaborating Center for Influenza Virus Surveillance
Att AA_ Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements
Att BB_ Influenza Virus Electronic year round PHIN-MS
Att G US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly CDC 55.20 US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly
Att. H U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E CDC 55.20E U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) - Workfolder_CDC 55.20E
Att I_ US Outpatient Influenza-like Illiness Surveillance Network (ILINet) Daily Reports None US Outpatient Influenza like Illness Surveillance Network (ILINet) Daily Reports
Att N Novel Influenza A Virus Infection Contact Tracing Form None Novel Influenza A Virus Infection Contact Tracing Form
Att O_Novel Influenza A Virus Status Case Status Summary None Novel Influenza A Virus Case Status Summary
Att S_Aggregate Hospitalization and Death Reporting Activity Weekly Report Form none Aggregate Hospital
Att R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report CDC 43.5, none CMRS Weekly ,   122 CMRS-City Health Officers or Vital Statistics Registrars Weekly Mortality Report
Att L Human Infection with Novel Influenza A Virus with Suspected Avian Source None Human Infection with Novel Influenza A Virus with Suspected Avian Source
Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report CDC 43.50 122 CMRS -City Health Officers or Vital Statistics Registrars Daily Mortality Report
Att. CC Suspect Respiratory Virus Patient Form NA Suspect Respiratory Virus Patient Form
  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 133,172 175,452 0 -42,280 0 0
Annual Time Burden (Hours) 24,801 32,012 0 -7,211 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Cutting Redundancy
Submission of 0920-0004 is a Revision containing both addition to and subtraction from current Burden Hours for individual collection instruments. Submission of this Revision results in an overall decrease in Burden Hours and Respondents.
$9,665,000
Yes Part B of Supporting Statement
    No
    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.
08/31/2017