The purpose of this information collection is to obtain sufficient information on the results of contact investigations carried out by state and local public health professionals or maritime medical crews to assess the impact of a confirmed communicable disease of public health concern in a traveler. Information is used to assess the impact in terms of spread and health outcomes and to determine if further public health intervention is appropriate. Communicable diseases of interest include clinically active tuberculosis (TB), varicella, influenza-like illness, measles, and rubella.
US Code:
42 USC 264
Name of Law: The Public Health and Welfare
US Code:
42 USC 70-71
Name of Law: Quarantine, Inspection, Licensing
This Revision incorporates new forms for 2 conditions: varicella and influenza-like illness.
A number of forms were discontinued: non-TB maritime forms and all Ebola forms.
The estimated number of TB contact investigation forms is lower, but the burden per response for each report is higher.
Some forms include updated content.
All changes are summarized in detail in Section A.15.
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:
(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;
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.
Influenza-like Illness Investigation Outcome Reporting Form - Maritime