Nrevss 55.83d

National Respiratory and Enteric Virus
Surveillance System (NREVSS)
2005-2006 Polymerase Chain Reaction (PCR) Worksheet
State & Local
Health Departments

Participating
Laboratories

Identify PCR
Positive Samples
Feedback
Fe
ed
ba
ck

NREVSS Reports
Internet

MMWR Updates
Season Summary

Enter Data on
the Internet
OR

Enter Data with
Touch-tone Telephone

Process & Analyze
Data

CDC

TM

CENTERS FOR DISEASE
C ONTROL AND P REVENTION

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES • Public Health Service
Public reporting burden of this collection of information is estimated to average 10 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).
.

CDC 55.83D Rev. 04/2005 (page 1 of 4)

National Respiratory and Enteric Virus Surveillance System
2005-2006 Polymerase Chain Reaction (PCR) Worksheet

Center Number

FORM APPROVED
OMB NO. 0920-0004

To Report Results: Log on to http://www2.ncid.cdc.gov/nrevss/odss/login.asp
OR call 1-800-232-0038 anytime after 12:00 noon Saturday and before 12:00 noon Tuesday
Enteric
Viruses

Respiratory Viruses by PCR

2005
Week
Ending
Saturday

CDC
Report
Week
Code

Jul 02
09
16
23
30
Aug 06
13
20
27
Sep 03
10
17
24
Oct 01
08
15
22
29
Nov 05
12
19
26
Dec 03
10
17
24
31

0527
0528
0529
0530
0531
0532
0533
0534
0535
0536
0537
0538
0539
0540
0541
0542
0543
0544
0545
0546
0547
0548
0549
0550
0551
0552
0553

CDC 55.83D Rev. 04/2005

RSV
No.
Tested

(page 2 of 4)

Respiratory
Adenovirus

Parainfluenza Virus (PIV)
No.
Pos.

No.
Tested

PIV 1
Pos.

PIV 2
Pos.

PIV 3
Pos.

PIV 4
Pos.

Unk.
Pos.

No.
Tested

No.
Pos.

Influenza
Virus

Human
Metapneumovirus

No.
No. AH1N1 AH3N2 A Unk.
B Pos.
Tested
Tested Pos.
Pos.
Pos.

No.
Pos.

Rotavirus
No.
Tested

No.
Pos.

Report
made
by
Initials/Date

Center Number

Enteric
Viruses

Respiratory Viruses by PCR

2006
Week
Ending
Saturday

CDC
Report
Week
Code

Jan 07
14
21
28
Feb 04
11
18
25
Mar 04
11
18
25
Apr 01
08
15
22
29
May 06
13
20
27
Jun 03
10
17
24
Jul 01

0601
0602
0603
0604
0605
0606
0607
0608
0609
0610
0611
0612
0613
0614
0615
0616
0617
0618
0619
0620
0621
0622
0623
0624
0625
0626

RSV
No.
Tested

Respiratory
Adenovirus

Parainfluenza Virus (PIV)
No.
Pos.

No.
Tested

PIV 1
Pos.

PIV 2
Pos.

PIV 3
Pos.

PIV 4
Pos.

Unk.
Pos.

No.
Tested

No.
Pos.

Influenza
Virus

Human
Metapneumovirus

No.
No. AH1N1 AH3N2 A Unk.
B Pos.
Tested
Tested Pos.
Pos.
Pos.

No.
Pos.

Rotavirus
No.
Tested

No.
Pos.

Report
made
by
Initials/Date

2005-2006 Polymerase Chain Reaction (PCR) Worksheet Worksheet

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Disease Control and Prevention (CDC)
1600 Clifton Road, N.E.
Atlanta, Georgia 30333
CDC 55.83D Rev. 04/2005 (page 3 of 4)

Influenza Branch
Division of Viral and Rickettsial Diseases
Building 6, Room 117, M/S A-32
For further information Call: (404) 639-3747
or FAX: (888) 232-1322
or E-Mail: [email protected]

Respiratory and Enteric Viruses Branch
Division of Viral and Rickettsial Diseases
Building 3, Room 111, M/S A-34
For further information Call: (404) 639-3596 or 639-0431
or FAX: (404) 639-1307
or E-Mail: [email protected]

INSTRUCTIONS FOR TELEPHONE REPORTING:
1.
2.
3.
4.

Please call in once a week, anytime between 12 noon on Saturday and 12 noon on Tuesday to be included
in the latest week’s report.
Use a touch tone telephone to Dial 1-800-232-0038. If you get a busy signal, wait a few minutes and call again.
Once you are connected you will hear a short welcome message and instructions on reporting, shown
in the example below.
To speed data entry, press the pound # key after entering a number to immediately move to the next question.
EXAMPLE:

•
•
•
•
•
•

“Welcome to the National Respiratory and Enteric Virus Surveillance System at
the Centers for Disease Control and Prevention”
Special NREVSS Message updated intermittently.
This voice system will prompt you for your response and then repeat your entry.
If your entry was incorrect, press the star key * , and the question will be repeated.
Enter your 6-digit center number.
To report results of antigen detection tests, press 1 ;
or virus isolations, press 2 ;
or electron microscopy, press 3 ;
or PCR, press 4 .
Enter the CDC report week code:

1 2 3 4 5 6

1
0 1 2 7

Total tests for RSV by PCR:
Number positive for RSV:

1 0
0

Total tests for parainfluenza by PCR:
Number positive for PIV 1:
Number positive for PIV 2:
Number positive for PIV 3:
Number positive for PIV 4:
Number positive for PIV type unknown:

4 5
0
0
1 5
1
2

Total tests for respiratory adenovirus by PCR:
Number positive for respiratory adenovirus:

4 5
1 2

Total tests for influenza by PCR:
Number positive for AH1N1
Number positive for AH3N2
Number positive for influenza A:
Number positive for influenza B:

1 8
0
1
0
1

Total tests for human metapneumovirus by PCR:
Number positive for human metapneumovirus:

1 5
5

Total tests for rotavirus by PCR:
Number positive for rotavirus:

1 5
1

To check your data, press 1 .
To re-enter your data, press 2 .
To save your data, press 3 .
CDC 55.83D Rev. 4/05 (Page 4 of 4)

To enter additional ports, press 4 .
To hear the weekly summary, press 5 .
To quit, press 6 .
Thank you, goodbye.

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