0920-0004 National Enterovirus Surveillance Report 55.9

National Disease Surveillance Program - II. Disease Summaries

Enterovirus Surveillance Form CDC 55.9.xls

0920-0004 National Enterovirus Surveillance Report 55.9

OMB: 0920-0004

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Overview

REPORT FORM
ENTEROVIRUS CODE LIST
STATE FIPS CODE LIST


Sheet 1: REPORT FORM

National Enterovirus Surveillance System Report Form
















Form Approved
OMB No. 0920-0004




Reporting Lab :


Report Date:
























Positive Test Results







Age (# Only) Age Type (Days, Weeks, Months or Years) Sex (M/F/U) State of Residence (see codes--3rd sheet) Number of Enteroviruses detected from patient Enterovirus (see codes--2nd sheet) Source Specimen (see legend--far right) Specimen Date (mm/dd/yyyy) Enterovirus 2 Source Specimen 2 Specimen Date 2 Enterovirus 3 Source Specimen3 Specimen Date 3 Specimen Legend

1 CSF
2 Stool/Rectal Swab
3 Throat/NP Swab














4 Tissue Culture














5 Other














9 Unknown






















































































































































































































































































































































































































Date of Report
Reporting Official
Title






































Public reporting burden of this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0004).









Sheet 2: ENTEROVIRUS CODE LIST

AGENT SEROTYPE
201 Coxsackievirus A1
202 Coxsackievirus A2
203 Coxsackievirus A3
204 Coxsackievirus A4
205 Coxsackievirus A5
206 Coxsackievirus A6
207 Coxsackievirus A7
208 Coxsackievirus A8
209 Coxsackievirus A9
210 Coxsackievirus A10
211 Coxsackievirus A11
212 Coxsackievirus A12
213 Coxsackievirus A13
214 Coxsackievirus A14
215 Coxsackievirus A15
216 Coxsackievirus A16
217 Coxsackievirus A17
218 Coxsackievirus A18
219 Coxsackievirus A19
220 Coxsackievirus A20
221 Coxsackievirus A21
222 Coxsackievirus A22
224 Coxsackievirus A24
224 Echovirus 34
299 Coxsackievirus A Type Unknown
301 Coxsackievirus B1
302 Coxsackievirus B2
303 Coxsackievirus B3
304 Coxsackievirus B4
305 Coxsackievirus B5
306 Coxsackievirus B6
399 Coxsackievirus B Type Unknown
401 Echovirus 1
401 Echovirus 8
402 Echovirus 2
403 Echovirus 3
404 Echovirus 4
405 Echovirus 5
406 Echovirus 6
407 Echovirus 7
409 Echovirus 9
411 Echovirus 11
412 Echovirus 12
413 Echovirus 13
414 Echovirus 14
415 Echovirus 15
416 Echovirus 16
417 Echovirus 17
418 Echovirus 18
419 Echovirus 19
420 Echovirus 20
421 Echovirus 21
422 Echovirus 22
422 Parechovirus 1
423 Echovirus 23
423 Parechovirus 2
424 Echovirus 24
425 Echovirus 25
426 Echovirus 26
427 Echovirus 27
429 Echovirus 29
430 Echovirus 30
431 Echovirus 31
432 Echovirus 32
433 Echovirus 33
499 Echovirus Type Unknown
501 Enterovirus 68
502 Enterovirus 69
503 Enterovirus 70
504 Enterovirus 71
505 Enterovirus 73
599 Enterovirus 70/71
601 Poliovirus 1
602 Poliovirus 2
603 Poliovirus 3
699 Poliovirus Type Unknown
999 Enterovirus Type Unknown

Sheet 3: STATE FIPS CODE LIST

CODE ABBR STATENAME
1 AL ALABAMA
2 AK ALASKA
4 AZ ARIZONA
5 AR ARKANSAS
6 CA CALIFORNIA
8 CO COLORADO
9 CT CONNECTICUT
10 DE DELAWARE
11 DC DISTRICT OF COLUMBIA
12 FL FLORIDA
13 GA GEORGIA
15 HI HAWAII
16 ID IDAHO
17 IL ILLINOIS
18 IN INDIANA
19 IA IOWA
20 KS KANSAS
21 KY KENTUCKY
22 LA LOUISIANA
23 ME MAINE
24 MD MARYLAND
25 MA MASSACHUSETTS
26 MI MICHIGAN
27 MN MINNESOTA
28 MS MISSISSIPPI
29 MO MISSOURI
30 MT MONTANA
31 NE NEBRASKA
32 NV NEVADA
33 NH NEW HAMPSHIRE
34 NJ NEW JERSEY
35 NM NEW MEXICO
36 NY NEW YORK
37 NC NORTH CAROLINA
38 ND NORTH DAKOTA
39 OH OHIO
40 OK OKLAHOMA
41 OR OREGON
42 PA PENNSYLVANIA
44 RI RHODE ISLAND
45 SC SOUTH CAROLINA
46 SD SOUTH DAKOTA
47 TN TENNESSEE
48 TX TEXAS
49 UT UTAH
50 VT VERMONT
51 VA VIRGINIA
53 WA WASHINGTON
54 WV WEST VIRGINIA
55 WI WISCONSIN
56 WY WYOMING
60 AS AMERICAN SAMOA
64 FM FEDERATED STATES OF MICRONESIA
66 GU GUAM
69 MP NORTHERN MARIANA ISLANDS
70 PW PALAU
72 PR PUERTO RICO
74 UM U.S. MINOR OUTLYING ISLANDS
78 VI VIRGIN ISLANDS
99 UNK UNKNOWN
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AuthorAHL4
Last Modified ByAshley LaMonte
File Modified2003-03-25
File Created2001-09-28

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