Undetermined sources, modes of transmission, risk factors, and health outcomes for Zika virus infection - Puerto Rico, 2016

Emergency Epidemic Investigation Data Collections - Expedited Reviews

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:

Documents and Forms

Document Name Document Type
Undetermined sources, modes of transmission, risk factors, and health outcomes for Zika virus infection - Puerto Rico, 2016 Form and Instruction
Zika Virus Disease Case Investigation Form Appendix 1. ZIKV Case Investigation Form.pdf Form and Instruction
2016 Urgent Assessment of Blood Collection and Use in Pu Appendix 2 Blood collection assessment 16FEB2016.doc Form and Instruction
Signed ZIKA LOI.pdf Letter of Invitation - Puerto Rico 2016 IC Document
1. GenIC Request Form - EEI Generic ICR_Zika_PR.docx GenIC Request - EEI Zika_Puerto Rico 2016 IC Document
Zika_Puerto Rico 2016 Burden Memo.msg Zika_Puerto Rico 2016 _ Burden Memo IC Document

Information Collection (IC) Details

IC Title:	Undetermined sources, modes of transmission, risk factors, and health outcomes for Zika virus infection - Puerto Rico, 2016	Agency IC Tracking Number:	0920-1011-16PS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Zika Virus Disease Case Investigation Form	Appendix 1. ZIKV Case Investigation Form.pdf	NA	No		Paper Only
Form and Instruction	NA	2016 Urgent Assessment of Blood Collection and Use in Puerto Rico in Response to the Zika Virus Outbreak	Appendix 2 Blood collection assessment 16FEB2016.doc	NA	No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: 09-20-0113 Epidemic Investigation Case Records	FR Citation: 51 FR 42466

Number of Respondents: 102	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	102	102
Annual IC Time Burden (Hours)	77	77
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Letter of Invitation - Puerto Rico 2016	Signed ZIKA LOI.pdf	02/16/2016
GenIC Request - EEI Zika_Puerto Rico 2016	1. GenIC Request Form - EEI Generic ICR_Zika_PR.docx	02/16/2016
Zika_Puerto Rico 2016 _ Burden Memo	Zika_Puerto Rico 2016 Burden Memo.msg	02/16/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.