Att BB Influenza virus (electronic, year round) (PHIN-MS)

OMB 0920-0004
Expiration Date: 08/31/2014

Influenza virus (electronic, year round) _PHIN-MS
Transmission File Structure; The transmission protocol calls for the required influenza data to be transmitted via an ASCII file using the csv (comma separated values) file
structure. A value enclosed within double quotes is optional; however, any value that contains a comma must be enclosed in double quotes. The data dictionary defined
below describes the file and the corresponding values expected by the receiving application at the CDC. The column name may not be the exact variable in your database but
provides a description to help place your corresponding variable into the right location. Should you require assistance please contact the PHLIS help desk at 404-639-3365 or
email at [email protected].

Variable*

Type (Length)

Description

Accepted Values

Site ID
Character (10)
Site ID assigned by CDC
NSFLU+State Abbreviation+Number :‘NSFLUWV01’
Must include both Specimen ID and Patient ID. If you don’t have both, repeat the one you do have.
Specimen ID
Character (30)
Unique specimen ID
Specimen/Accession/Aliquot ID assigned by each lab
Patient ID
Character (30)
Unique patient ID
Patient ID assigned by each lab
Must include at least either Patient birth date –or- patient age AND age type, if not all 3
Patient Birth Date
Date
(10)
Date of patient birth
(mm/dd/yyyy)
Patient Age
Numeric (3)
Patient Age
Numeric age; must be used with Patient Age Type
Patient Age Type
Character (1)
Patient Age Type
‘D’: day, ‘W’: Week, ‘M’: Month, ‘Y’: Year
Patient Gender
Character (1)
Patient gender
‘M’, ‘Male’, ‘F’, ‘Female’, ‘U’, ‘Unknown’
Patient State
Character (2)
Patient state of residence
State Abbreviation e.g.: GA, WV, MD
Patient County
Character (30)
Patient county of residence
County Name
Patient Zip Code
Numeric (9)
Patient zip code
Zip code or Zip code + 4 : e.g. 30329 or 30329-4018
Submitting Lab Name
Character (40)
Submitting laboratory name
Submitting Laboratory Name
Submitting Phys. Name Character (40)
Submitting physician name
Submitting Physician Name
Must include at least 1 of the following 3 dates, if not all
Collection Date
Date clinical specimen collected
(mm/dd/yyyy)
Date
(10)
Receive Date
Date
(10)
Date specimen/isolate received at laboratory
(mm/dd/yyyy)
Test Date
Date
(10)
Date specimen/isolate tested
(mm/dd/yyyy)
Specimen Type
Character (40)
Specimen type
‘Original clinical material’, ‘Isolate’, or ‘Unknown
Specimen Source
Character (40)
Description of specimen source
Nasal (swab or other method), Bronchial-Alveolar Lavage,
Nasopharyngeal (swab or other method), Sputum,
Throat (swab or other method), Serum, Unknown
Test Method
Character (40)
Description of test method or LOINC code associated If using values other than LOINC codes, other acceptable
with test ordered
values include, but are not limited to: Virus isolation,
Commercial Rapid PCR diagnostic test, Commercial Rapid

Public reporting burden of this collection of information is estimated to average 5 minutes per response. 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN:
PRA (0920-0004).

OMB 0920-0004
Expiration Date: 08/31/2014

Influenza virus (electronic, year round) _PHIN-MS

Test Result

Character (40)

Isolate Sent to CDC
Isolate Sent to CDC ID
Comments
Antiviral Medication
Outbreak Related

Character (1or7)
Character (30)
Character (66)
Character (1or7)
Character (1or7)

Facility Type

Character (22)

Travel Outside US

Character (1or7)

Description of test result or SNOMED result code
associated with the test result

AG diagnostic test, Antigen detection, IFA, EIA, PCR‘Virus
isolation’, ‘Commercial Rapid Diagnostic Test’, ‘Antigen
detection’, ‘IFA’, ‘EIA’, ‘PCR’
If using values other than SNOMED codes, other
acceptable non-SARS-CoV-2 values include, but are
not limited to: Influenza A (2009H1N1pdm),
Influenza A(H1), Influenza A(H3), Influenza B,
Influenza A(subtype unknown), Influenza
A(inconclusive), Influenza A(could not be subtyped),
Influenza A(H5), Presumptive Influenza A(H3N2)v,
Respiratory Syncytial Virus A, Respiratory Syncytial
Virus B, Respiratory Syncytial Virus Unknown,
Rhinovirus, Parainfluenza Virus 1, Adenovirus,
Negative, Not Detected

For SARS-CoV-2 test results, other acceptable values:
nCov Detected, nCov Not Detected, nCov
inconclusive, nCov invalidInfluenza A
(2009H1N1pdm), Influenza A(H1), Influenza A(H3),
Influenza B, Influenza B (yam), Influenza B (vic),
Influenza A(subtype unknown), Influenza
A(inconclusive), Influenza A(could not be subtyped),
Influenza A(H5), Other virus, Negative
Was the isolate sent to CDC?
‘Y’, ‘Yes’, ‘N’, ‘No’, ‘U’, ‘Unknown’
Laboratory ID for the isolate sent to CDC
Laboratory ID for isolate sent to CDC
Comments
Comments
Was the patient receiving influenza antiviral medication? ‘Y’, ‘Yes’, ‘N’, ‘No’, ‘U’, ‘Unknown’
Was the specimen outbreak related?
‘Y’, ‘Yes’, ‘N’, ‘No’, ‘U’, ‘Unknown’
Did the specimen come from and outpatient, inpatient,
or long-term care facility?
Did the patient travel outside the US within 10 days of

‘Outpatient’, ‘Inpatient’, ‘Long-Term Care Facility’, ‘U’,
‘Unknown’
‘Y’, ‘Yes’, ‘N’, ‘No’, ‘U’, ‘Unknown’

Public reporting burden of this collection of information is estimated to average 5 minutes per response. 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN:
PRA (0920-0004).

OMB 0920-0004
Expiration Date: 08/31/2014

Influenza virus (electronic, year round) _PHIN-MS
Countries Traveled To

Character (50)

Vaccination

Character (1or7)

illness onset?
List the countries the patient has traveled to within 10
days of illness onset.
Was the patient vaccinated?

(If yes, provide name of countries in text box below)
List the countries the patient has traveled to within 10 days
of illness onset.
‘Y’, ‘Yes’, ‘N’, ‘No’, ‘U’, ‘Unknown’

*Note: Bold variables are required. You may not have all the variables described above. You may leave them Blank or Null, but they must have a position in the transmitted
file. Either two double quotes “” or no value must be between the commas.
Example
“NSFLUWV01”,”CDC01152007”,”077659846”,”01/28/1982”,”25”,”Y”,”M”,”TN”,”Hamilton”,”11111”,”Public Health Lab”,”Dr.
Smith””11/11/2007”,”11/12/2007”,”11/12/2007”,”Original clinical material”,”Nasal swab”,”PCR”,”Influenza A(H1)”,”N”, ””,”” ,”N”,”N”,”N”,”U”,”N”,””

Public reporting burden of this collection of information is estimated to average 5 minutes per response. 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN:
PRA (0920-0004).