Emerging Infections Program

ICR 201808-0920-022

OMB: 0920-0978

Federal Form Document

Forms and Documents
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Status
Form and Instruction
Modified
Form and Instruction
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Form and Instruction
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Form and Instruction
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Form and Instruction
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Form and Instruction
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Justification for No Material/Nonsubstantive Change
2018-09-13
Justification for No Material/Nonsubstantive Change
2018-05-31
Supplementary Document
2018-04-18
Supporting Statement B
2018-03-29
Supporting Statement A
2018-03-29
Justification for No Material/Nonsubstantive Change
2018-01-23
Justification for No Material/Nonsubstantive Change
2017-05-03
Justification for No Material/Nonsubstantive Change
2016-12-28
Supplementary Document
2016-12-28
Justification for No Material/Nonsubstantive Change
2016-03-02
Supplementary Document
2015-07-07
Supplementary Document
2015-07-07
Justification for No Material/Nonsubstantive Change
2015-02-17
IC Document Collections
IC ID
Document
Title
Status
231114 Modified
231113 Modified
231112 Modified
231111 Unchanged
231110 Unchanged
230870 Removed
230869 Unchanged
220380 Modified
217336 Modified
217334 Modified
215016 Removed
207663 Unchanged
207662 Unchanged
207661 Unchanged
207660 Unchanged
207659 Unchanged
207658 Unchanged
207657 Unchanged
207656 Unchanged
207655 Unchanged
207653 Unchanged
207652 Unchanged
207651 Modified
207649 Modified
207648 Unchanged
207647 Modified
207646 Modified
ICR Details
0920-0978 201808-0920-022
Historical Active 201805-0920-010
HHS/CDC 0920-0978-18AXU
Emerging Infections Program
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 09/13/2018
Retrieve Notice of Action (NOA) 08/30/2018
Approved consistent with the understanding that CDC will clarify the applicability of its privacy responsibilities, described in OMB circular A-130 and 5 USC §552a(e)(3), to this information collection. CDC will document the reasons it has determined that a Privacy Act system records notice, Privacy Act statement, and privacy impact assessment are or are not required, and submit such documentation as deemed necessary to OMB as a change request (or in conjuction with an upcoming revision) within 6 months of the date of approval for the current ICR
  Inventory as of this Action Requested Previously Approved
05/31/2021 05/31/2021 05/31/2021
106,750 0 115,600
39,989 0 40,349
0 0 0

The Emerging Infections Programs (EIP) is to 1) detect and monitor emerging pathogens, the diseases they cause, and the factors influencing their emergence, and respond to problems as they are identified, 2) integrate laboratory science and epidemiology to optimize public health practice, 3) strengthen infrastructure to support surveillance and research and to implement prevention and control programs, and to 4) ensure implementation of prevention strategies and communication of public health information about emerging diseases. Surveillance efforts of the core EIP activities generate reliable estimates of the incidence of certain infections and provide the foundation for a variety of epidemiologic studies. This is a non-substantive change request. All requested changes represent minor modifications to already-approved instruments including revised formatting, rewording, new answer options, and the addition/subtraction of a limited number of questions. The burden has been reduced with adjustments to multiple instruments.

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  82 FR 60608 12/21/2017
83 FR 17412 04/19/2018
No

25
IC Title Form No. Form Name
ABCs Neonatal Infection Expanded Tracking Form 17AHK, 0920-0978 Att. 3 - ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) Neonatal Infection Expanded Tracking Form ,   ABC Surveillance Neonatal Infection Expanded Tracking Form
Influenza Hospitalization Surveilance Network Case Report Form 0920-0978, 0920-0978 Influenza Hospitalization Surveillance Network Case Report Form ,   2017-18 FluSurv-NET Influenza Hospitalization Surveillance Project Case Report Form
FoodNet Hemolytic Uremic Syndrome (HUS) NA FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) 0920-0978, 0920-0978 FluServ-NET Consent Form - English ,   FluSurv-NET Vaccination Phone Script (English/Spanish)
FoodNet Campylobacter 0920-0978 FoodNet Variable List (site transmitted variables)
FoodNet Cryptosporidium 0920-0978 FoodNet Variable List (site transmitted variables)
FoodNet Cyclospora 0920-0978 FoodNet Variable List (site transmitted variables)
FoodNet Listeria monocytogenes 0920-0978 FoodNet Variable List (site transmitted variables)
FoodNet Salmonella 0920-0978 FoodNet Variable List (site transmitted variables)
FoodNet Shigella 0920-0978 FoodNet Variable List (site transmitted variables)
FoodNet Vibrio 0920-0978 FoodNet Variable List (site transmitted variables)
FoodNet Yersinia 0920-0978 FoodNet Variable List (site transmitted variables)
ABCs Invasive Pneumococcal Disease in Children 17AHK Att. 4 - ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN
ABCs Surveillance for Non-Invasive Pneumococcal Pneumonia (SNiPP) Case Report Form none, CDC Non Bacteremic Pneumococcal 2015 ,   2016 Surveillance for Non-Invasive Penumococcal Pneumonia (SNiPP)
HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) VERSION:01-2016, NA, 0920-09078, VERSION: 11/2017, 0920-0978 2015 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare Associated Infection Community Interface (HAIC) Case Report ,   2016 Multi-site Gram Negative Surveillance Initiative (MuGSI) Healthcare Associated Infection Community Interface (HAIC) Case Report ,   2017 Multi-site Gram-Negative Surveillance Initiative (MuGSI) HAIC Case Report ,   2018 Multi-Site Gram-Negative Surveillance Initiative (MuGSI) Healthcare Associated Infection Community Interface (HAIC) Case Report ,   MuGSI Case Report Form for Carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (CRAB)
ABCs Severe GAS Infection Supplemental Form 0920-0978 ABCs - Severe GAS Infection: Supplemental Form
HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) 0920-0978, 0920-0978 Surveillance for Extended-Spectrum Beta- Lactamase-Producing Enterobacteriaceae Multi-Site Gram-Negative Bacilli Surveillance (MuGSI) Healthcare Associated Infection Community Interface (HAIC) CRF ,   MuGSI Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL)
HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) 0920-0978, 0920-0978 Invasive Methicillin-Sensitive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2018 ,   Invasive Methicillin-sensitive Staphylococcus aureus (MSSA) Infection Case Report Form
HAIC Candidemia Case Report Form 0920-0978, 0920-0978 HAIC Candidemia Case Report ,   CANDIDEMIA - CASE REPORT FORM
Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) 0920-0978 FluServ-NET Provider Vaccination History Fax Form
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) 0920-0978, 0920-0978 FluServ-NET Consent Form - Spanish ,   FluSurv-NET Vaccination Phone Script (English/Spanish)
HAIC Multi-Site Gram-Negative Bacilli Case Report Form for Carbapenem-Resistant Pseudomonas ajeruginosa (CR-PA) 0920-0978 Carbapenem-resistant Pseudomonas aeruginosa Multi-Site Gram-Negative Surveillance (MuGSI) Case Report
FoodNet Shiga toxin producing E. coli 0920-0978 FoodNet Variable List (site transmitted variables)
ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form 17AHK, 0920-0978 Att. 2 - ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form_HiNSES ,   ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form
HAIC CDI Case Report Form 0920-0978, 0920-0978 Clostridium Difficile Infection (CDI) Surveillance Emerging Infections Program Case Report ,   CDI Case Report and Treatment Form
ABCs Case Report Form 17AHK, 0920-0978 Att. 1 - 2017 ACTIVE BACTERIAL CORE SURVEILLANCE CASE REPORT ,   2019 ABC Surveillance Case Report
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) 0920-0978, 0920-0978 Invasive Methicillin-Resistant Staphylococcus aureaus Healthcare-Associated Infections Community Interface(HAIC) Case Report - 2018 ,   Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Infection Case Report Form

  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 106,750 115,600 0 -4,160 -4,690 0
Annual Time Burden (Hours) 39,989 40,349 0 2,428 -2,788 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Two collection instruments were deleted and others had minor edits that equaled an overall reduce in burden.

$31,091,990
Yes Part B of Supporting Statement
    Yes
    Yes
No
No
No
Uncollected
Kevin Joyce 404 639-1944 [email protected]

  No

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.
08/30/2018


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