Form CDC 55.20E CDC 55.20E U.S. Outpatient Influenza-Like Illness Surveillance Netw

National Disease Surveillance Program - II. Disease Summaries

Attachment H_U.S. Outpatient Influenza like Illness Surveillance Network (ILINet)_CDC 55.20E

Att. H U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E

OMB: 0920-0004

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U.S. Outpatient Influenza-like Illness
Surveillance Network (ILi Net) Wor older

Form Approved
OMB 0920-0004

October 2, 2016 - September 30, 2017

INFLUENZA-LIKE ILLNESS {IU) is defined as:

Provider ID:
Password:

2016 - 201 I Season

Week
Ending
Date

CDC
Date
Code

OCT 8

1640

15
22
29
NOV 5
12
19
26
DEC3
10
17
24
31
JAN 7
14
21
28
FEB 4
11

18
25
MAR 4
11
18
25
APR 1
8
15
22
29
MAY6
13
20

Fever Q:.100 °F [37.8°(], oral or equivalent) AND cough and/or sore
throat (without a known cause other than influenza).
Patients with Ill
0-4

Yrs.

1641
1642
1643

1644

1645

1646

1647

1648

1649
16SO

16S1

16S2

1701

1702

1703

1704

5-24

Yrs.

25-49

Yrs.

50-64

Yrs.

>64

Yrs.

Total
Patients
Seen*

2016 - 2011 Season
Week
Ending
Date

CDC
Date
Code

MAY 27

1721

0-4

Yrs.

5-24

Yrs.

25-49

Yrs.

50-64

Yrs.

>64

Yrs.

Total
Patients
Seen*

1722

JUN3

1723

10

17

1724

24

1725

JUL 1

1726
1727

8
15

1728

1729

22

1730

29

1731

AUG 5
12

1732

19

1733

26

1734

SEP 2

1735

9

1736

16

Patients with Ill

1737

23

1706

1738

30

1739

1708

*Total Patients seen for any reason= (non-Ill + Ill)

1705

1707

1709

1710
1711
1712

1713

1714

Thank you for participating in the
U.S. Outpatient Influenza-like Illness
Surveillance Network (IL/Net).

1715

Please do not discard this workfolder.

1717

A postage paid envelope will be provided
in Summer 2017 for you to return this
workfolder to CDC.

1716
1718

1719

1720

CDC 55.20E REV. 05/2016 page 2 of
4 of 4

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES • CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)• Atlanta, Georgia 30329
INFLUENZA DIVISION • EPIDEMIOLOGY AND PREVENTION BRANCH• U.S. INFLUENZA SURVEILLANCE

Public reporting burden of this collection of information is estimated to average 5 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 Information Collection Review Office,
1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0004).


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