Documents description

Attachment 6, Description of information collection instruments and supporting documentation, National Outbreak Reporting System

NATIONAL OUTBREAK REPORTING SYSTEM — Attachment 3

This data dictionary includes all possible elements collected by the National Outbreak Reporting System (NORS), supplemented by reference tools attachments 4 and 5. No single outbreak report will have all data elements completed, as most elements are dependent on the selected mode of transmission. The data dictionary (Attachment 3) as well as supporting reference documents (Attachments 4 and 5) were previously approved as part of OMB Control No. 0920-0004 and are being submitted as a separate information collection request to allow for timely updating of information collection instruments, as necessary.

NORS was established in 2009. The electronic system allows the continual web-based, electronic reporting of foodborne, waterborne, and enteric person-to-person, animal contact, and environmental contamination other than food/water/animal contact, and unknown mode of transmission outbreaks. All data on outbreak-associated cases collected through NORS are submitted on an aggregate, per outbreak basis; no personally identifiable information are collected through NORS.

Data collected through NORS are used to inform, develop, and refine recommendations for prevention and control of future outbreaks. Data are published periodically in the Surveillance for Foodborne Disease Outbreaks Annual Report, as well as the Morbidity and Mortality Weekly Report and peer-reviewed journals. Data are available to the public via a website called NORS Dashboard (https://wwwn.cdc.gov/norsdashboard/) or through a data request process.

NORS FOODBORNE DISEASE TRANSMISSION, PERSON-TO-PERSON DISEASE TRANSMISSION, ANIMAL CONTACT, ENVIRONMENTAL CONTAMINATION, UNKNOWN TRANSMISSION MODE, (CDC FORM 52.13) - Attachment 4

This form should be considered as a reference tool for the NORS data dictionary, as all data are collected electronically, and no paper forms are submitted directly to CDC. This reference tool supports streamlined entry of basic data from an epidemiologic investigation of all foodborne disease outbreaks as well as enteric disease outbreaks caused by person-to-person transmission, animal contact, environmental contamination, and those that are spread by unknown modes of transmission. This reference tool also serves as a training device and a guide to health departments that routinely investigate outbreaks. The data dictionary (Attachment 3) as well as supporting reference documents (Attachments 4 and 5) were previously approved as part of OMB Control No. 0920-0004 and are being submitted as a separate information collection request to allow for timely updating of information collection instruments, as necessary

Historically, foodborne outbreak data collection was slow due to the time required for data entry and coding once the forms were received at CDC. In 1998, CDC introduced electronic reporting of foodborne outbreak data through the electronic Foodborne Outbreak Reporting System (eFORS). eFORS was a web-based reporting system that collected the same information as the paper form, and was used by local, county, or state organizations to enter, edit and analyze data as well as transmit data electronically to other state or federal offices. In 2009, the National Outbreak Reporting System (NORS) was established, allowing for integration of foodborne and waterborne outbreak surveillance systems, along with enhanced surveillance for enteric disease outbreaks spread by person-to-person transmission, environmental contamination, animal contact, and unknown modes of transmission.

State and local health departments use NORS (Attachment 3) to submit to CDC data on outbreaks they have investigated. CDC then analyzes these data and the data are published periodically in the Surveillance for Foodborne Disease Outbreaks Annual Report, as well as the MMWR and other peer-reviewed journals. In additional data are available to the public through the web-based available NORS Dashboard (https://wwwn.cdc.gov/norsdashboard/), as well as by request.

WATERBORNE DISEASE OUTBREAK REPORT FORM (CDC 52.12) - Attachment 5

This form should be considered as a reference tool for the NORS data dictionary, as all data are collected electronically, and no paper forms are submitted directly to CDC. This reference tool supports streamlined entry of basic data from an epidemiologic investigation of all waterborne disease outbreaks. This reference tool also serves as a training device and a guide to health departments that routinely investigate outbreaks. The data dictionary (Attachment 3) as well as supporting reference documents (Attachments 4 and 5) were previously approved as part of OMB Control No. 0920-0004 and are being submitted as a separate information collection request to allow for timely updating of information collection instruments, as necessary

CDC has collaborated with the Council of State and Territorial Epidemiologists and the Environmental Protection Agency (EPA) on the Waterborne Disease and Outbreak Surveillance System since 1971. This reference tool supports streamlined entry of epidemiologic, laboratory, and environmental health data collected during an epidemiologic investigation of an acute recreational water, drinking water, or other waterborne disease outbreak by public health departments in an individual state, territory, or Freely Associated State. In 2009, the National Outbreak Reporting System (NORS) was established, allowing for integration of foodborne and waterborne outbreak surveillance systems, along with enhanced surveillance for enteric disease outbreaks spread by person-to-person transmission, environmental contamination, animal contact, and unknown modes of transmission.

Data on reported waterborne disease outbreaks that were analyzed and published as 2-year reports in the Morbidity and Mortality Weekly Report. Reports date back to 1971 and are available online at http://www.cdc.gov/healthywater/surveillance/surveillance-reports.html. Data available since NORS launched in 2009 are also available to the public via a website called NORS Dashboard (https://wwwn.cdc.gov/norsdashboard/) or through a data request process. The data are used routinely to inform CDC recommendations related to waterborne disease prevention and to supply critical data for EPA decision-making regarding existing and new regulations related to drinking water safety.