Ebola Transmission Dynamics among Household Contacts in West Africa: a Public Health Response Evaluation in Western Area, Sierra Leone

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Patient Laboratory Record	Form	New	Available
Contact Exit Questionnaire	Form and Instruction	New	Available
Questionnaire for Investigation of Contacts of Ebola-infected Case-Patients	Form and Instruction	New	Available
Questionnaire for Ebola-Affected Households	Form and Instruction	New	Available
Initial Questionnaire for Case-Patients	Form and Instruction	New	Available
Att4 Visual Diagram Storyboard 20150118.docx	Supplementary Document	Uploaded 2015-01-22	Available
AppndxF Sierra-Leone-Currency-Convert-USD.pdf	Supplementary Document	Uploaded 2015-01-22	Available
AppndxE Sierra-Leone-Minimum-Wage.pdf	Supplementary Document	Uploaded 2015-01-22	Available
AppndxD BLS Int Labor Comp Pgm Discont Notice.pdf	Supplementary Document	Uploaded 2015-01-22	Available
AppndxC Ebola Alert Crit Surveill Systm Diagram.docx	Supplementary Document	Uploaded 2015-01-22	Available
AppndxB SORN 09-20-0113 Epi Invest Case Records.pdf	Supplementary Document	Uploaded 2015-01-22	Available
AppndxA 42 USC 241 PH Service Act Section 301.pdf	Supplementary Document	Uploaded 2015-01-22	Available
20141231 CDCEmergReqEbolaHHTransmiss_Sierra Leone.pdf	Supplementary Document	Uploaded 2015-01-22	Available
SupStmnt B HHTransmiss Sierra Leone 20150118.docx	Supporting Statement B	Uploaded 2015-01-22	Available
SupStmnt A HHTransmiss Sierra Leone 20150121.docx	Supporting Statement A	Uploaded 2015-01-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214720	Patient Laboratory Record	Form	New
214719	Contact Exit Questionnaire	Form and Instruction	New
214718	Questionnaire for Investigation of Contacts of Ebola-infected Case-Patients	Form and Instruction	New
214717	Questionnaire for Ebola-Affected Households	Form and Instruction	New
214715	Initial Questionnaire for Case-Patients	Form and Instruction	New

ICR Details

OMB Control No: 0920-1043	ICR Reference No: 201501-0920-021
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15KA
Title: Ebola Transmission Dynamics among Household Contacts in West Africa: a Public Health Response Evaluation in Western Area, Sierra Leone
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 01/23/2015
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/23/2015
	Date Received in OIRA: 01/22/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2015	6 Months From Approved
Responses	2,809	0	0
Time Burden (Hours)	791	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The CDC is seeking emergency OMB clearance to effectively complement its ongoing international efforts for rapid case identification, contact tracing, and infection control of Ebola virus disease (EVD) in West Africa, The CDC seeks to augment the established Sierra Leone Ministry of Health and Sanitation (MOH) EVD surveillance system. Transmission of the Ebola virus in the rural areas of Sierra Leone typically occurs through attending funerals, participating in unsafe burial practices, and to a lesser extent, through household transmission. In a densely populated area, such as Western Area, Sierra Leone, it is unknown if household contact is a major route of transmission. The CDC seeks to assist the MOH further investigate transmission risk factors for the Ebola virus disease (EVD) specifically among household contacts of index case-patients in Western Area, Sierra Leone. Trained project assistants will conduct more detailed surveys on the same visits with the MOH contact tracing teams. The information gained will enable the MOH to implement improved control measures to prevent further spread of EVD within its country's affected households.

Emergency Justfication: Transmission of Ebola in the rural areas of Sierra Leone typically occurs through attending funerals, participating in unsafe burial practices, and to a lesser extent, through household transmission. In a densely populated area, such as Western Area, Sierra Leone, it is unknown if household contact is a major route of transmission. CDC will be requesting a regular clearance to help understand the potential role of household contact associated with the current outbreak in Western Africa more generally, but to expedite the initiation of this work, the CDC is seeking an emergency 180-day OMB approval to conduct information collections related to EVD investigations among household cohorts and individual household contacts of case-patients in Western Area, Sierra Leone. In the short term, the information collected via this emergency clearance will enhance the MOH in Sierra Leone’s ability to identify more targeted control measures, thus more rapidly control the spread of EVD within its country’s affected households.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Helth Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Patient Laboratory Record	None	Patient Laboratory Record
Questionnaire for Ebola-Affected Households	None	Questionnaire for Ebola-affected Households
Contact Exit Questionnaire	None	Contact Exit Questionnaire
Initial Questionnaire for Case-Patients	None	Initial Questionnaire for Case-Patients
Questionnaire for Investigation of Contacts of Ebola-infected Case-Patients	None	Questionnaire for Investigation of Household Contacts of Ebola-infected Case-Patients

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ICR Summary of Burden

table that charts list of burden

	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	2,809	0	0	2,809	0	0
Annual Time Burden (Hours)	791	0	0	791	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: 0920-15KA is a NEW Emergency ICR

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Annual Cost to Federal Government: $32,212

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/22/2015

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