Form 0920-0978 FoodNet Active Surveillance Variable List

Emerging Infections Program

Att5_FoodNetActiveSurvDataElements2019_OMB_20190808.xlsx

FoodNet Shigella

OMB: 0920-0978

Document [xlsx]
Download: xlsx | pdf

Variable Name Format Length Description Answers (Legal Values) Sent by Site or Created at CDC Comment Year(s) for which variable is available Category Included in standard data requests?
1 AgClinic Character 30 For possible E. coli cases: What was the result of specimen testing for Shiga toxin using an antigen-based test (e.g.EIA or lateral flow) at a clinical laboratory? Stx1+; Site Collect for all pathogens for which culture-independent results are available. Prior to 2011, called 'EiaClinic'. 2009-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For other pathogens: What was the result of specimen testing using an antigen-based test (e.g. EIA or lateral flow) at a clinical laboratory?
Positive;
Negative;
Indeterminate;
Not Tested
2 AgClinicTestType Character 100 For possible E.coli cases: Name of antigen-based test used at clinical laboratory Abbott Shiga Toxin Quik Check; Site Collect for all pathogens for which culture-independent results are available. 2011-current Culture-Independent Testing YES
Merck Duopath STEC Rapid Test;
Meridian Premier EHEC;
Meridian ImmunoCard STAT! E. coli O157 Plus;
Meridian ImmunoCard STAT! EHEC;
Remel ProSpecT STEC;
For possible Campylobactercases: Name of antigen-based test used at clinical laboratory Meridian ImmunoCard STAT! CAMPY;
Meridian Premier CAMPY;
Remel ProSpecT Campylobacter;
Remel Xpect Campylobacter;
For other pathogens: Name of antigen-based test used at clinical laboratory Other;
Unknown
3 AgeMnth Numeric 2 Age of case-patient in months if patient is <1yr 1-11 Site Collect for all cases 1996-current Demographics YES
4 AgeYr Numeric 3 Age of case-patient in years 1-105 Site Collect for all cases 1996-current Demographics YES
5 AgSphl Character 30 For possible E. coli cases: What was the result of specimen testing for Shiga toxin using an antigen-based test (e.g.EIA or lateral flow) at a state public health laboratory? Stx1+; Site Collect for all pathogens for which culture-independent results are available. Prior to 2011, called 'EiaSphl'. 2009-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For other pathogens: What was the result of specimen testing using an antigen-based test (e.g. EIA or lateral flow) at a state public health laboratory? Positive
Negative
Indeterminate
Not tested
6 AgSphlTestType Character 100 For possible E.coli cases: Name of antigen-based test used at state public health laboratory Abbott Shiga Toxin Quik Check; Site Collect for all pathogens for which culture-independent results are available. 2011-current Culture-Independent Testing YES
Merck Duopath STEC Rapid Test;
Meridian ImmunoCard STAT! EHEC;
Meridian Premier EHEC;
Remel ProSpecT STEC;
For possible Campylobacter cases: Name of antigen-based test used at state public health laboratory Meridian ImmunoCard STAT! CAMPY;
Meridian Premier CAMPY;
Remel ProSpecT Campylobacter;
Remel Xpect Campylobacter;
For other pathogens: Name of antigen-based test used at state public health laboratory Other;
Unknown
7 AR_antacid_any Character 10 In the 30 days before (your/your child’s) illness began, did (you/your child) have any form of antacid? Yes; No; Unknown; Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
8 AR_antacid_any_1 Character 30 What medications to block acids did (you/your child) take in the 30 days before {your/your child's) illness began? Aluminium hydroxide
Ami-Lac
Amphojel
Axid
Calcium carbonate
Cal Gest
Caltrate
calcium-based supplements
Dexilant
Dialume
Di-Gel
Gas-X with Maalox
Gaviscon
Gelusil
Genaton
Isopan
Maalox / Maox
Magaldrate
Magnesium Hydroxide
Masanti
Mi-Acid
Milantex
Milk of Magnesia
Mintox
Mylanta
Nexium
Nizatidine
Os-Cal
Oysco
Oyster (shell) calcium
Pepcid
Pepto Children's
Prevacid
Prilosec
Protonix
Ri-Mag
Riopan
Rolaids
Ron-Acid
Rulox
Tagamet
Tempo
Titralac
Tums
Zantac
Zegerid
Other
Unknown
Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
9 AR_antacid_any_2 Character 30 What medications to block acids did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
10 AR_antacid_any_3 Character 30 What medications to block acids did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
11 AR_antibiotic_use Character 10 Did (you/your child) take antibiotics for this illness? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
12 AR_antibiotic_use_1 Character 30 What antibiotics did (you/your child) take for this illness? Amoxicillin
Amoxicillin / Clavulanate
Ampicillin
Augmentin
Azithromycin
Bactrim
Biaxin
Ceclor
Cefaclor
Ceftin
Cefixime
Ceftriaxone
Cefuorixime
Cefzil
Cefprozil
Cephalexin
Cephradine
Chloramphenicol
Ciprofloxacin / Cipro
Clarithromycin
Dapsone
Doxycycline
Duricef
Erythromycin
Erythromycin / sulfisoxizole
Flagyl
Floxin
Keflex
Keftab
Levofloxacin
Levoquin
Metronidazole
Norfloxacin / Norflox
Ofloxacin / Oflox
Pediazole
Penicillin / Pen VK
Septra
Suprax
Tetracycline
Trimox
Trimethoprim / Sulfa
Zithromax / Z-Pak
Other
Unknown
Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
13 AR_antibiotic_use_2 Character 30 What antibiotics did (you/your child) take for this illness? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
14 AR_antibiotic_use_3 Character 30 What antibiotics did (you/your child) take for this illness? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
15 AR_antibiotic_use_4 Character 30 What antibiotics did (you/your child) take for this illness? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
16 AR_antibiotic_use_5 Character 30 What antibiotics did (you/your child) take for this illness? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
17 AR_antibiotic_use_6 Character 30 What antibiotics did (you/your child) take for this illness? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
18 AR_antibiotic_use_7 Character 30 What antibiotics did (you/your child) take for this illness? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
19 AR_antibiotic_use_8 Character 30 What antibiotics did (you/your child) take for this illness? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
20 AR_antibiotic_use30 Character 10 In the 30 days before (your/your child’s) illness began, did (you/your child) take any antibiotics? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
21 AR_antibiotic_use30_1 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Amoxicillin
Amoxicillin / Clavulanate
Ampicillin
Augmentin
Azithromycin
Bactrim
Biaxin
Ceclor
Cefaclor
Ceftin
Cefixime
Ceftriaxone
Cefuorixime
Cefzil
Cefprozil
Cephalexin
Cephradine
Chloramphenicol
Ciprofloxacin / Cipro
Clarithromycin
Dapsone
Doxycycline
Duricef
Erythromycin
Erythromycin / sulfisoxizole
Flagyl
Floxin
Keflex
Keftab
Levofloxacin
Levoquin
Metronidazole
Norfloxacin / Norflox
Ofloxacin / Oflox
Pediazole
Penicillin / Pen VK
Septra
Suprax
Tetracycline
Trimox
Trimethoprim / Sulfa
Zithromax / Z-Pak
Other
Unknown
Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
22 AR_antibiotic_use30_2 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
23 AR_antibiotic_use30_3 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
24 AR_antibiotic_use30_4 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
25 AR_antibiotic_use30_5 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
26 AR_antibiotic_use30_6 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
27 AR_antibiotic_use30_7 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
28 AR_antibiotic_use30_8 Character 30 What antibiotics did (you/your child) take in the 30 days before {your/your child's) illness began? Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
29 AR_comorb_abdominal Character 10 In the 6 months before (your/your child's) illness began, did (you/your child) have abdominal surgery (e.g., removal of appendix or gallbladder, or any surgery of the stomach or large intestine)? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
30 AR_comorb_cancer Character 10 In the 6 months before (your/your child's) illness began, were (you/your child) diagnosed or treated for cancer (including leukemia/lymphoma)? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
31 AR_comorb_diabetes Character 10 In the 6 months before (your/your child's) illness began, were (you/your child) diagnosed or treated for diabetes? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
32 Ar_Diet_veal Character 10 In the past 7 days, did (you/your child) eat any veal? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
33 AR_durationillness Numeric 10 How many days were (you/your child) sick? any number Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
34 AR_HHtrav6mo Character 10 In the 6 months before (your/your child's) illness began, did any member(s) of your household travel outside of the United States? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
35 AR_HHtrav6mo_country Text Field 70 In the 6 months before (your/your child's) illness began, what countries did the member(s) of your household visit? Text Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
36 AR_hosp_icu Character 10 During any part of the hospitalization, did you (your child) stay in an Intensive Care Unit (ICU) or a Critical Care Unit (CCU)? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
37 AR_probiotic_use30 Character 10 In the 30 days before (you/your child's) illness began, did (you/your child) take a probiotic?
Probiotics are live microorganims (such as certain types of bacteria) that may benefit your health. These can take the form of pills, powders, yogurts, and other fermented dairy products, as well as anything labeled as containing "live and active cultures" or "probiotics."
Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
38 AR_travel6mo Character 10 In the 6 months before (your/your child's) illness began, did (you/your child) travel outside of the United States? Yes; No; Unknown Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
39 AR_travel6mo_country Text Field 70 In the 6 months before (your/your child's) illness began, what countries did (you/your child) visit? Text Site Varies by site for Salmonella, Campylobacter, and Shigella 2018-current Exposure NO
40 Audit Character 7 Was case found during an audit? Yes; No Site Collect for all cases 1996-current Other NO
41 BioId Character 10 Was the pathogen identified by culture? Yes; No; Unknown; Not Tested Site Collect for all bacterial pathogens. Prior to 2011, called 'StecBioId'. 1996-current Culture-Independent Testing YES
42 BloodyDiarr Character 10 Did the case-patient have bloody diarrhea (self reported) during this illness? Yes; No; Unknown Site Collect actively for Campylobacter; passively for other pathogens. 2011-current Clinical Information YES
43 CEA_Beef Character 10 In the 7 days before illness, did you/your child eat beef or any foods containing beef? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
44 CEA_Chicken Character 10 In the 7 days before illness, did you/your child eat chicken or any foods containing chicken? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
45 CEA_Dairy Character 10 In the 7 days before illness, did you/your child eat or drink any dairy products (e.g., milk, yogurt, cheese, ice cream, etc.)? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
46 CEA_Dog Character 10 In the 7 days before illness, did you/your child have any contact with a dog? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
47 CEA_Eggs Character 10 In the 7 days before illness, did you/your child eat any eggs? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
48 CEA_Fish Character 10 In the 7 days before illness, did you/your child eat any fish or fish products? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
49 CEA_Lettuce Character 10 In the 7 days before illness, did you/your child eat any fresh, raw lettuce? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
50 CEA_Live_poultry Character 10 In the 7 days before illness, did you/your child have any contact with any live poultry (e.g., chickens, turkeys, hens, etc.)? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
51 CEA_Milk_raw Character 10 In the 7 days before illness, did you/your child drink any unpasteurized milk? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
52 CEA_Pig Character 10 In the 7 days before illness, did you/your child have any contact with any pigs? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
53 CEA_Pork Character 10 In the 7 days before illness, did you/your child eat pork or any foods containing pork? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
54 CEA_Reptile_amphib Character 10 In the 7 days before illness, did you/your child have any contact with a reptile or amphibian (e.g., frog, snake, turtle, etc.)? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
55 CEA_Ruminants Character 10 In the 7 days before illness, did you/your child have any contact with any cattle, goats, or sheep? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2016-current (Campy)
Exposure YES
56 CEA_Seafd Character 10 In the 7 days before illness, did you/your child eat any seafood (e.g., crab, shrimp, oysters, clams, etc.)? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2015-current (Campy)
Exposure YES
57 CEA_Turkey Character 10 In the 7 days before illness, did you/your child eat any turkey or any foods containing turkey? Yes; No; Unknown Site Collect for Salmonella and Campylobacter 2014-current (Salm);
2015-current (Campy)
Exposure YES
58 County Character 20 Case-patient's county of residence
Site Collect for all cases 1996-current Demographics YES
59 CultCdc Character 20 What was the culture result at CDC? (Does not include confirmation of isolates received.) Positive; Site Collect for all cases 2011-current (Campy); 2018-current (others) Lab Information YES
Negative;
Unknown;
No bacterial growth;
Not tested
60 CultClinic Character 20 What was the culture result at a clinical lab? Positive; Site Collect for all cases 2011-current (Campy); 2018-current (others) Lab Information YES
Negative;
Unknown;
No bacterial growth;
Not tested
61 CultSphl Character 20 What was the culture result at a state public health lab? (Does not include confirmation of isolates received.) Positive; Site Collect for all cases 2011-current (Campy); 2018-current (others) Lab Information YES
Negative;
Unknown;
No bacterial growth;
Not tested
62 Diarrhea Character 10 Did the case-patient have diarrhea (self-reported) during this illness? Yes; No; Unknown Site Collect actively for Campylobacter cases; passively for other pathogens. 2011-current Clinical Information YES
63 DOB Date mmddyy10. Case patient's date of birth
Site Collect for all cases 1996-current Demographics NO
64 DtAdmit Date mmddyy10. Date of first hospital admission for this illness
Site Collect for hospitalized cases 1996-current Hospitalization YES
65 DtAdmit2 Date mmddyy10. Date of hospital admission for second hospitalization for this illness
Site Collect for hospitalized cases 2008-current Hospitalization YES
66 DtDisch Date mmddyy10. Date of first hospital discharge for this illness
Site Collect for hospitalized cases 1996-current Hospitalization YES
67 DtDisch2 Date mmddyy10. Date of hospital discharge for second hospitalization for this illness
Site Collect for hospitalized cases 2008-current Hospitalization YES
68 DtEntered Date mmddyy10. Date case was entered into site's database
Site Collect for all cases 1996-current Other NO
69 DtOnset Date mmddyy10. Date that the case-patient’s symptoms first began for this illness
Site Collect for all cases 2009-current Clinical Information YES
70 DtRcvd Date mmddyy10. Date case-pateint's specimen was received in laboratory for initial testing
Site Collect for all cases 1996-current Lab Information NO
71 DtRptComp Date mmddyy10. Date case report form was completed
Site Collect for all cases 1996-current Other NO
72 DtSpec Date mmddyy10. Case-patient's specimen collection date
Site Collect for all cases 1996-current Lab Information YES
73 DtUSDepart Date mmddyy10. If case-patient patient traveled internationally, date of departure from the U.S.
Site Collect for cases that reported international travel during incubation period; if recently immigrated, leave blank 2004-current Travel YES
74 DtUSReturn Date mmddyy10. If case-patient traveled internationally, date of return to the U.S.
Site Collect for cases that reported international travel during incubation period; if recently immigrated, enter as date arrived to US 2004-current Travel YES
75 DxO157 Character 30 For possible E.coli cases: What was the result of specimen testing for O157 by EIA or PCR at a clinical laboratory? Positive; Site Collect for E.coli cases 2014-current Pathogen-specific (E.coli) YES
Negative;
Not tested
76 DxO157TestType Character 100 Name of EIA or PCR test used Meridian ImmunoCard STAT! E. coli O157 Plus; Site Collect for E.coli cases 2014-current Pathogen-specific (E.coli) YES
Biofire Filmarray Gastrointestinal (GI);
Diatherix Gastrointestinal;
Luminex xTag Gastrointestinal Pathogens;
Metametrix;
Lab-developed test;
Other
77 EforsNum Character 6 CDC FDOSS outbreak ID number 1-999999; Site Collect for cases that are part of a recognized outbreak 2004-current Outbreak YES
888888='multi-state outbreak with exposure in multiple states'
999999='multi-state outbreak with a single exposure outside of the FoodNet catchment area'
78 Ethnicity Character 1 Case-patient's ethnicity H (Hispanic), N (Non-Hispanic), U (Unknown) Site Collect for all cases 1996-current Demographics YES
79 Fever Character 10 Did the case-patient have fever (self-reported) during this illness? Yes; No; Unknown Site Collect actively for Campylobacter; passively for other pathogens. 2011-current Clinical Information YES
80 Homeless Character 7 In the 7 days before illness, did the case-patient experience homelessness? This includes staying in a shelter or car, building, or other structure not intended for housing. (This does not include staying with friends or family, correctional facilities, care or nusing facilities, single room occupancy, or other transitional housing.) Yes; No; Unknown Site Collect for Shigella cases 2019-current Demographics NO
81 Hospital Character 7 Was case-patient hospitalized within (+/-) 7 days of specimen collection? Yes; No; Unknown Site Collect for all cases 1996-current Hospitalization YES
82 HospTrans Character 7 If case-patient was hospitalized, was s/he transferred to another hospital? Yes; No; Unknown Site Collect for hospitalized cases 1996-current Hospitalization YES
83 HUS Character 7 Did case patient have a diagnosis of HUS? Yes; No; Unknown Site Collect for E.coli cases 2009-current Clinical Information YES
84 Immigrate Character 7 Did case-patient immigrate to the U.S.? (within 30 days of onset for Salmonella Typhi & Listeria, and 7 days for all other pathogens) Yes; No; Unknown Site Collect for all cases 2008-current Travel YES
85 Interview Character 7 Was the case-patient interviewed by public health (i.e. state or local health department or FoodNet staff)? Yes; No; Unknown Site Collect for all cases 2008-current Other YES
86 LabName Character 25 Name of submitting laboratory
Site Collect for all cases 1996-current Lab Information NO
87 LabNum Character 12 Local aliquot identification number Varies by state Site Collect for all cases 1996-current Lab Information NO
88 LocalID Character 16 Case-patient's medical record number Varies by state Site Collect for all cases 1996-current ID Field NO
89 OtherCdcTest Character 30 For possible E.coli cases: What was the result of specimen testing for Shiga toxin using another test at the CDC? Stx1+; Site Collect for all pathogens for which culture-independent results are available. 2011-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For other pathogens: What was the result of specimen testing using another test at CDC? Positive
Negative
Indeterminate
Not tested
90 OtherClinicTest Character 30 For possible E.coli cases: What was the result of specimen testing for Shiga toxin using another test at a clinical laboratory? Stx1+; Site Collect for all pathogens for which culture-independent results are available. 2011-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For other pathogens: What was the result of specimen testing using another test at a clinical laboratory? Positive
Negative
Indeterminate
Not tested
91 OtherClinicTestType Character 100 Name of other test used at a clinical laboratory Autoflourescence Site Collect for all pathogens for which culture-independent results are available. 2011-current Culture-Independent Testing YES
Stained Wet Mount;
Wet Mount;
Vero Cell Asay;
Other;
Unknown
92 OtherSphlTest Character 30 For possible E.coli cases: What was the result of specimen testing for Shiga toxin using another test at a state public health laboratory? Stx1+; Site Collect for all pathogens for which culture-independent results are available. 2011-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For other pathogens: What was the result of specimen testing using another test at a state public health laboratory? Positive
Negative
Indeterminate
Not tested
93 OtherSphlTestType Character 100 For other pathogens: Name of other test used at a state public health laboratory Autoflourescence Site Collect for all pathogens for which culture-independent results are available. 2011-current Culture-Independent Testing YES
Stained Wet Mount;
Wet Mount;
Vero Cell Asay;
Other;
Unknown
94 Outbreak Character 7 Was the case-patient part of a recognized outbreak? Yes; No Site Collect for all cases 2004-current Outbreak YES
95 OutbrkStID Character 30 State outbreak identification number Varies by state Site Collect if case is part of a recognized outbreak 2008-current Outbreak NO
96 OutbrkType Character 50 Type of outbreak that the case-patient was part of Foodborne; Waterborne; Animal contact; Person-to-person; Environmental contamination other than food/water; Indeterminate; Other; Unknown Site Collect if case is part of a recognized outbreak 2008-current Outbreak YES
97 Outcome Character 7 Case-patient's outcome (assessed for non-hospitalized cases within 7 days of specimen collection date and hospitalized cases at hospital discharge) Alive; Dead; Unknown Site Collect for all cases 1996-current Clinical Information YES
98 OutFetal Character 35 If Listeria case was pregnancy-associated, what was the outcome of the pregnancy? Note: fetal death includes miscarriage or stillbirth; delivery is a live birth. Still pregnant; Site Collect for Listeria cases 1996-current Pathogen-specific (Listeria) YES
Fetal death;
Delivery
Unknown;
99 Pathogen Character 25 Name of bacterial pathogen identified from the case-patient’s specimen Campylobacter; Site Collect for all cases. Prior to 2011, called 'Isolate'. 1996-current Lab Information YES
Cyclospora;
Shiga toxin-producing E. coli;
Listeria;
Salmonella;
Shigella;
Vibrio;
Yersinia;
100 PatID Character 9 Unique ID for case-patient's infection Varies by state Site Collect for all cases 1996-current ID field NO
101 PcrCdc Character 30 For possible E. coli cases: What was the result of specimen testing for Shiga toxin using PCR at CDC? Stx1+; Site Collect for all pathogens for which culture-independent results are available. 2009-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For other pathogens: What was the result of specimen testing for diagnosis using PCR at CDC? (Do not enter PCR results if PCR was performed for speciation or subtyping). Positive;
Negative;
Not tested
102 PcrClinic Character 30 For possible E. coli cases: What was the result of specimen testing for Shiga toxin using PCR at a clincal laboratory? Stx1+; Site Collect for all pathogens for which culture-independent results are available. 2010-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For Campylobacter, Cyclospora, Salmonella, Shigella, Yersinia: What was the result of specimen testing using PCR at a clinical laboratory? (where goal of testing is primary detection not subtyping or speciation) Positive;
Negative;
Not tested
For Vibrio,What was the result of specimen testing using PCR at a clinical laboratory? (where goal of testing is primary detection not subtyping or speciation) Vibrios
V cholerae
Vibrios&V cholerae
Not Tested
For specimens that were culture-confirmed Shigella and Shiga toxin-positive by PCR: What was the result of specimen testing using PCR at a clinical laboratory? (For specimens that were not culture-confirmed or were only positive for Shigella, indicate "positive" under Shigella section above) Shigella/Stx undiff
Shigella/Stx1
Shigella/Stx2
Shigella/Stx1&2
103 PcrClinicTestType Character 100 Name of PCR assay used at a clinical lab Biofire Filmarray Gastrointestinal (GI); Site Collect for all pathogens detected by PCR in a clinical lab 2011-current Culture-Independent Testing YES
Biofire Filmarray Meningitis/Encephalitis (ME);
Biofire Filmarray Blood Culture Identification (BCID);
BD Max Enteric Bacterial;
BD Max Extended Enteric Bacterial;
Diatherix Gastrointestinal;
Hologic Prodesse ProGastro SSCS;
Luminex Gram-Positive Blood Culture;
Luminex Verigene Enteric Pathogens;
Luminex xTag Gastrointestinal Pathogens;
Medical Diagnostics;
Lab-developed test
Unknown
104 PcrSphl Character 30 For possible E. coli cases: What was the result of specimen testing for Shiga toxin using PCR at a state public health laboratory? Stx1+; Site Collect for all pathogens for which culture-independent results are available. 2009-current Culture-Independent Testing YES
Stx2+;
Stx1+ & Stx2+;
Positive Undifferentiated;
Negative;
Not Tested
For other pathogens: What was the result of specimen testing for diagnosis using PCR at the state public health laboratory? (Do not enter PCR results if PCR was performed for speciation or subtyping). Positive
Negative
Not tested
For Vibrio,What was the result of specimen testing using PCR at a state public health laboratory? (where goal of testing is primary detection not subtyping or speciation) Vibrios
V cholerae
Vibrios&V cholerae
Not Tested
For specimens that were culture-confirmed Shigella and Shiga toxin-positive by PCR: What was the result of specimen testing using PCR at a clinical laboratory? (For specimens that were not culture-confirmed or were only positive for Shigella, indicate "positive" under Shigella section above) Shigella/Stx undiff
Shigella/Stx1
Shigella/Stx2
Shigella/Stx1&2
105 PcrSphlTestType Character 100 Name of PCR assay used at a state public health lab Biofire Filmarray Gastrointestinal (GI); Site Collect for all pathogens detected by PCR in a state public health lab 2015-current Culture-Independent Testing YES
Biofire Filmarray Meningitis/Encephalitis (ME);
Biofire Filmarray Blood Culture Identification (BCID);
BD Max Enteric Bacterial;
BD Max Extended Enteric Bacterial;
Diatherix Gastrointestinal;
Hologic Prodesse ProGastro SSCS;
Luminex Gram-Positive Blood Culture;
Luminex Verigene Enteric Pathogens;
Luminex xTag Gastrointestinal Pathogens;
Medical Diagnostics;
Lab-developed test
Unknown
106 PersonID Character 30 Identification number for person or patient Varies by state Site Collect for all cases 2008-current ID field NO
107 Pregnant Character 7 Is this Listeria case pregnancy-associated? Yes; No; Unknown Site Collect for Listeria cases 1996-current Pathogen-specific (Listeria) YES
108 Race Character 1 Case-patienty's race A (Asian); Site Collect for all cases 1996-current Demographics YES
B (Black);
I (American Indian or Alaskan Native);
M (Multi-Racial);
O (Other);
P (Pacific Islander or Native Hawaiian);
W (White);
U (Unknown)
109 ResultID Character 30 Unique identifier for laboratory result Varies by state Site Collect for all cases 2008-current ID field NO
110 RptComp Character 7 Is all of the information for this case complete? Yes; No; Unknown Site Collect for all cases 1996-current Other YES
111 SentCDC Character 7 Was specimen or isolate forwarded to CDC for testing or confirmation? Yes; No; Unknown Site Collect for all cases 2009-current Lab Information YES
112 SeroSite Character 60 Serotype/species of pathogen identified by culture, submitted by site For Campylobacter: n/a. Site Collect for Salmonella, Listeria, Shigella, Vibrio, Yersinia 1996-current Subtyping Information NO
For Listeria: 1; 1/2a; 1/2b; 1/2c; 3a; 3b; 3c; 4; 4b; Untypeable; Unknown
For Salmonella: See Kaufmann-White scheme
For Shigella: boydii; dysenteria;, flexneri; sonnei
For Vibrio: alginolyticus; cholerae; cincinnatiensis; damsela; fluvialis; furnissii; harveyi; hollisae; metschnikovi; mimicus; parahaemolyticus; vulnificus; Unknown
For Yersinia: ldovae; bercovieri;enterocolitica; frederiksenii; intermedia; kristensenii; mollaretii; pseudotuberculosis; rohdei; ruckeri; Unknown.
113 Sex Character 1 Case-patient's sex M (Male); F (Female); U (Unknown) Site Collect for all cases 1996-current Demographics YES
114 SiteID Character 10 Site identification number California – CDA2, CDA201, CDA20101, CDA20102, CDA20103, CDA202, CDA203, CDA6; Site Collect for all cases 1996-current ID field NO
Colorado – CDCO;
Connecticut – CDA5,
GA GOA – CDGE;
GA MSA – CDA1, CDA101;
Maryland - CDE1;
Minnesota –CDMN;
New Mexico – CDNM;
New York – CDNF;
Oregon – CDOR;
Tennessee – CDTN
115 SLabsID Character 30 State lab identification number Varies by state Site Collect for all cases for which the isolate was sent to a state public health lab 1996-current Lab Information NO
116 SpeciesClinic Character 60 For Campylobacter, what was the species result at clinical lab? For Campylobacter: jejuni; jejuni subsp jejuni; jejuni subsp. doylei; coli; ,lari; lari subsp. concheus; lari subsp. lari; upsaliensis;,helveticus; fetus; fetus subsp fetus; fetus subsp venerealis;hyointestinalis; hyointestinalis subsp. hyointestinalis; hyointestinalis subsp. lawsonii; sputorum; sputorum bv sputorum; sputorum bv paraureolyticus; lanienae; mucosalis;insulaenigrae; concisus; curvus; rectus; showae;gracilis; canadenesis; peloridis;avium; cuniculorum; hominis; Unknown; Not tested. Site Collect for Campylobacter 2010-current Subtyping Information NO
117 SpeciesSphl Character 60 For Campylobacter, what was the species result at SPHL? For Campylobacter: jejuni; jejuni subsp jejuni; jejuni subsp. doylei; coli; ,lari; lari subsp. concheus; lari subsp. lari; upsaliensis;,helveticus; fetus; fetus subsp fetus; fetus subsp venerealis;hyointestinalis; hyointestinalis subsp. hyointestinalis; hyointestinalis subsp. lawsonii; sputorum; sputorum bv sputorum; sputorum bv paraureolyticus; lanienae; mucosalis;insulaenigrae;concisus; curvus; rectus; showae;gracilis; canadenesis; peloridis;avium; cuniculorum; hominis; Unknown; Not tested. Site Collect for Campylobacter 2010-current Subtyping Information NO
118 SpecSite Character 30 Case patient's specimen collection source Abscess; Site Collect for all cases. If specimen source is something other than listed in legal values, please specify. Do not code as 'other'. 1996-current Lab Information NO
Amniotic fluid;
Blood;
Bone;
CSF;
Ear;
Gall bladder;
Genitals;
Joint;
Lung;
Peritoneal fluid;
Placenta;
Rectal swab;
Sputum;
Stool;
Urine;
Wound;
Unknown
119 State Character 2 Case patient's state of residence CA; CO; CT; GA; MD; MN; NM; NY; OR; TN Site Collect for all cases 1996-current Demographics YES
120 StecHAg Character 3 If E. coli, what was the H-antigen number? 1-99 Site Collect for E.coli cases 1996-current Pathogen-specific (E.coli) NO
999 = NM
121 StecOAg Character 3 If E. coli, what was the O-antigen number? 1-999 Site Collect for E.coli cases 1996-current Pathogen-specific (E.coli) NO
‘555'=not O157, O antigen pending or at CDC
’666'=not O157, O antigen unknown
‘777'=O antigen undetermined
'999'=O antigen rough
122 StecStx Character 40 Was E. coli Shiga toxin-producing? Yes; No; Unknown; Not Tested Site Collect for E.coli cases 1996-current Pathogen-specific (E.coli) NO
123 StLabRcvd Character 7 Was the isolate sent to a state public health laboratory? (Answer 'Yes' if it was sent to any state lab, even if it was sent to a lab outside of the case's state of residence) Yes; No; Unknown Site Collect for all cases 1996-current Lab Information YES
124 TravelDest Text Field 70 If case-patient traveled internationally, to where did they travel? List country, or countries, visited Site Collect for cases that reported international travel during incubation period 2004-current Travel YES
125 TravelInt Character 7 Did the case patient travel internationally? (within 30 days of onset for Salmonella Typhi & Listeria, 15 days for Cryptosporidum and Cyclospora, and 7 days for all other pathogens) Yes; No; Unknown Site Collect for all cases 2004-current Travel YES
126 WGS_ID Character 100 WGS ID Number Varies by state: from pulsenet or NCBI Site Collect for all cases that were WGS 2018-current Lab Information NO
127 Zipcode Character 10 Case-patient's zipcode 5 digit zipcode; 5 digit plus 4, if available. Site Collect for all cases 1996-current Demographics NO
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy