0920-0004 Non-Substantive Change Request

NATIONAL DISEASE SURVEILLANCE PROGRAM - II. DISEASE SUMMARIES

OMB No. 0920-0004

Change Request

January 21, 2014

The following diseases/conditions are currently included in this information collection:

Arboviral diseases (including West Nile Viruses) Influenza Virus

Campylobacter Rabies

Caliciviruses Respiratory and Enteric

Cholera and Shigella

other Vibrio illnesses Salmonella

Foodborne Outbreaks Waterborne Outbreaks

Enteroviruses Listeria

Harmful Algal Bloom-related Illness Babesiosis

Brucellosis

Due to the January 15, 2014 approval of the information collection request entitled “The National Electronic Disease Surveillance System” (OMB Control Number 0920-0728) and the terms of clearance embedded into its approval, CDC requests a non-substantive change request for the collection entitled “National Disease Surveillance Program - II. Disease Summaries” (OMB Control number 0920-0004). The following diseases/conditions will remain in OMB 0920-0004 The National Electronic Disease Surveillance System - II. Disease Summaries:

Influenza Virus

Caliciviruses

Respiratory and Enteric

Foodborne Outbreaks

Waterborne Outbreaks

Enteroviruses

Harmful Algal Bloom-related Illness

New proposed burden table includes a decrease of 7,643 hours.

Table 1 – Estimate of Annualized Burden Hours

FORM	Number of Respondents	Number of Responses per Respondent	Average Burden per Response (in hrs.)	Total Burden Hours
Foodborne Outbreak Form (CDC 52.13)	54	31.5	20/60	567
-Influenza virus (fax, Oct-May) (CDC 55.31)	5	33	10/60	28
-Influenza virus (fax, year round) (CDC 55.31)	21	52	10/60	182
Influenza virus (Internet; Oct-May) (CDC 55.31)	3	33	10/60	17
Influenza virus (Internet;year round) (CDC 55.31)	35	52	10/60	303
-Influenza virus (electronic, year round) (PHLIP)	5	52	5/60	22
-Influenza virus (electronic, year round) (PHIN)	17	52	5/60	74
Influenza Annual Survey (CDC 55.31A)	86	1	15/60	22
Weekly Influenza-like Illness (Oct-May) (CDC 55.20)	540	33	15/60	4455
Weekly Influenza-like Illness (year round) (CDC 55.20)	1260	52	15/60	16,380
Daily Influenza-like illness (Oct-May)	200	231	15/60	11,550
Daily Influenza-like illness (year round)	75	365	15/60	6,844
Influenza-Associated Pediatric Death Case Report Form	57	1	30/60	29
Novel and Pandemic Influenza A Virus Infection Case Investigation Form	57	1	30/60	29
Novel and Pandemic Influenza A Virus Infection Contact Trace Back Form	57	1	30/60	29
Novel and Pandemic Influenza A Virus Infection Contact Trace Forward Form	57	1	30/60	29
Novel Human Influenza A Virus Infection Case Report Form	57	1	30/60	29
Daily Novel and Pandemic Influenza A Virus State Case Status Summary Update	57	1	15/60	14
CMRS - City health officers or vital statistics registrars (daily)	58	365	12/60	4,234
CMRS - City health officers or vital statistics registrars (weekly)	122	52	12/60	1,269
Aggregate Hospitalization and Death Reporting Activity Weekly Report Form	56	52	10/60	485
National Enterovirus Surveillance Report: (CDC 55.9) (electronic)	25	12	15/60	75
National Respiratory & Enteric Virus Surveillance System (NREVSS) (CDC 55.83A-D) (electronic)	90	52	10/60	780
Suspected Viral Gastroenteritis (Calicivirus surveillance)	20	5	5/60	8
Waterborne Diseases Outbreak Form (CDC 52.12)	57	1	20/60	19
HABISS Data Entry	10	12	8	960
HABISS Monthly Reporting	10	12	30/60	60
Total				48,493

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