OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCIRD] National Disease Surveillance Program - II. Disease Summaries

ICR 202603-0920-014 · OMB 0920-0004 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
US Collaborating Laboratories Influenza Testing Methods Assessment Form and Instruction Modified Available
Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction Modified Available
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction Modified Available
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction Modified Available
Aggregate case counts of person exposed to Highly Pathogenic Avian Influenza (HPAI) Form and Instruction Modified Available
Suspect Respiratory Virus Patient Form Form and Instruction Modified Available
Form CDC 55.20E U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) Form and Instruction Modified Available
Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form Form and Instruction Modified Available
National Adenovirus Type Reporting System (NATRS) Form Form and Instruction Modified Available
Antiviral-Resistant Influenza Infection Case Report Form and Instruction Modified Available
Human Infection with Novel Influenza A Virus Severe Outcomes Form and Instruction Modified Available
Influenza-Associated Pediatric Mortality Case Report Form and Instruction Modified Available
US Collaborating Center for Influenza Virus Surveillance Form and Instruction Modified Available
Human Infection with Novel Influenza A Virus Case Report Form Form and Instruction Modified Available
Novel Influenza A Virus Case Screening Form Form and Instruction Modified Available
Viral Gastroenteritis Outbreak Submission Form Form and Instruction Modified Available
Form CDC 55.83B NREVSS Virus Isolation (culture) Worksheet Form and Instruction Modified Available
Form CDC 55.83D NREVSS Polymerase Chain Reaction (PCR) Worksheet Form and Instruction Modified Available
Form CDC 55.83A NREVSS Antigen Detection Worksheet Form and Instruction Modified Available
Form CDC 55.90 Enterovirus Surveillance System Report Form Form and Instruction Modified Available
Public Comment.docx Public Comments Uploaded 2026-03-05 Available
Attachment DD Human Subjects Determination.pdf Supplementary Document Uploaded 2026-03-26 Available
Attachment C_Disease Summaries 0920-0004 _2026 Final_final.docx Supplementary Document Uploaded 2026-03-26 Available
Attachment B, 60 Day Federal Register Notice.pdf Supplementary Document Uploaded 2026-03-26 Available
Attachment A, Authorizing Legislation.pdf Supplementary Document Uploaded 2026-03-26 Available
SSB 0920-0004 Extension 2026 Final_final.docx Supporting Statement B Uploaded 2026-03-26 Available
SSA 0920-0004 Extension 2026 Final_final.docx Supporting Statement A Uploaded 2026-03-26 Available
IC Document Collections
IC IDCollectionTypeStatusForm
37707 US Collaborating Laboratories Influenza Testing Methods Assessment Form and Instruction ModifiedUS Collaborating Laboratories Influenza Testing Methods Assessment
258096 Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction ModifiedArthropod (Vector)-Borne Diseases (Non-Human Data)
258095 Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction ModifiedPediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)
258094 Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction ModifiedPediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form
258093 Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Form and Instruction ModifiedAggregate case counts of person exposed to Highly Pathogenic Avian Influenza (HPAI)
228082 Suspect Respiratory Virus Patient Form Form and Instruction ModifiedSuspect Respiratory Virus Patient Form
228068 U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form and Instruction ModifiedU.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet)
212473 Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form and Instruction ModifiedMiddle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form
212472 Adenovirus Typing Report Form Form and Instruction ModifiedNational Adenovirus Type Reporting System (NATRS) Form
212471 Antiviral Resistant Influenza Infection Case Report Form Form and Instruction ModifiedAntiviral-Resistant Influenza Infection Case Report
212470 Human Infections with Novel Influenza A Virus Severe Outcomes Form and Instruction ModifiedHuman Infection with Novel Influenza A Virus Severe Outcomes
199052 Influenza Virus Electronic year round PHIN-MS Other-Variables for Reporting Modified
199051 Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements Other-Variables for Electronic Reporting Modified
199050 Influenza Associated Pediatric Mortality Case Report Form Form and Instruction ModifiedInfluenza-Associated Pediatric Mortality Case Report
199049 US Collaborating Center for Influenza Virus Surveillance Form and Instruction ModifiedUS Collaborating Center for Influenza Virus Surveillance
199043 Human Infection with Novel Influenza A Virus Case Report Form Form and Instruction ModifiedHuman Infection with Novel Influenza A Virus Case Report Form
199040 Novel Influenza A Virus Case Screening Form Form and Instruction ModifiedNovel Influenza A Virus Case Screening Form
178374 Viral Gastroenteritis Outbreak Submission Form Form and Instruction ModifiedViral Gastroenteritis Outbreak Submission Form
178365 National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form and Instruction ModifiedNREVSS Virus Isolation (culture) Worksheet
178365 National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form and Instruction ModifiedNREVSS Polymerase Chain Reaction (PCR) Worksheet
178365 National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form and Instruction ModifiedNREVSS Antigen Detection Worksheet
178364 National Enterovirus Surveillance Report 55.9 Form and Instruction ModifiedEnterovirus Surveillance System Report Form
ICR Details
0920-0004 202603-0920-014
Received in OIRA 202512-0920-005
HHS/CDC 0920-26-0150
[NCIRD] National Disease Surveillance Program - II. Disease Summaries
Revision of a currently approved collection   No
Regular 04/13/2026
  Requested Previously Approved
36 Months From Approved 04/30/2026
135,404 134,983
27,517 27,468
0 0
These data are essential on the local, state, and federal levels for measuring trends in diseases, evaluating the effectiveness of current preventive strategies, and determining the need to modify current preventive measures. The following diseases/conditions are included in this program: Influenza Virus, Caliciviruses, Respiratory and Enteric Viruses, Parechoviruses, Arthropod-Borne Diseases and Enteroviruses. This Revision makes minor edits including changes to forms and a small burden increase.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  91 FR 1322 01/13/2026
91 FR 17656 04/07/2026
Yes
20
IC Title Form No. Form Name
Adenovirus Typing Report Form n/a National Adenovirus Type Reporting System (NATRS) Form
Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI n/a Aggregate case counts of person exposed to Highly Pathogenic Avian Influenza (HPAI)
Antiviral Resistant Influenza Infection Case Report Form n/a Antiviral-Resistant Influenza Infection Case Report
Arthropod (Vector)-Borne Diseases (Non-Human Data) n/a Arthropod (Vector)-Borne Diseases (Non-Human Data)
Human Infection with Novel Influenza A Virus Case Report Form n/a Human Infection with Novel Influenza A Virus Case Report Form
Human Infections with Novel Influenza A Virus Severe Outcomes n/a Human Infection with Novel Influenza A Virus Severe Outcomes
Influenza Associated Pediatric Mortality Case Report Form n/a Influenza-Associated Pediatric Mortality Case Report
Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements
Influenza Virus Electronic year round PHIN-MS
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form n/a Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form
National Enterovirus Surveillance Report 55.9 CDC 55.90 Enterovirus Surveillance System Report Form
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
Novel Influenza A Virus Case Screening Form n/a Novel Influenza A Virus Case Screening Form
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) n/a Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form n/a Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form
Suspect Respiratory Virus Patient Form n/a Suspect Respiratory Virus Patient Form
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)
US Collaborating Center for Influenza Virus Surveillance n/a US Collaborating Center for Influenza Virus Surveillance
US Collaborating Laboratories Influenza Testing Methods Assessment NA US Collaborating Laboratories Influenza Testing Methods Assessment
Viral Gastroenteritis Outbreak Submission Form n/a Viral Gastroenteritis Outbreak Submission Form
  Total Request 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 135,404 134,983 0 421 0 0
Annual Time Burden (Hours) 27,517 27,468 0 49 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Burden increase due to minor adjustments in respondents or time burden.
$10,941,698
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Kevin Joyce 404 639-1944 [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.
04/13/2026