[NCEZID] Emerging Infections Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0978 Death Ascertainment Project Variables	Form and Instruction	Unchanged	Available
Form 0920-0978 HAIC Death Ascertainment Project	Form and Instruction	Unchanged	Repair queued
Form C5342262-A 2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified	Available
Form C5342262-A HAIC (MuGSI) Supplemental Surveillance Officer Survey	Form and Instruction	Modified	Repair queued
Form 0920-0978 CA CP-CRE Survey Questionnaire	Form	Modified	Available
Form 0920-0978 HAIC (MuGSI) Community-Associated CP-CRE Interview	Form	Modified	Repair queued
Form 0920-0978 2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	Form	Modified	Available
Form 0920-0978 HAIC -Labortary Testing Practices for Candidemia Questionnaire	Form	Modified	Repair queued
Form 0920-0978 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	Form and Instruction	Modified	Available
Form 0920-0978 HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey	Form and Instruction	Modified	Repair queued
Form 0920-0978 CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey	Form	Modified	Available
Form 0920-0978 HAIC Invasive Staphylococcus aureus Annual Laboratory Survey	Form	Modified	Repair queued
Form 0920-0978 Emerging Infections Progrom C. difficile Surveillance Nuring Home Telephone Call Survey	Form and Instruction	Unchanged	Available
Form 0920-0978 HAIC CDI LTCF Survey	Form and Instruction	Unchanged	Available
Form 0920-0978 Surveillance Officer's Survey- Clostridioides difficile Infection (CDI) Surveillance	Form	Modified	Available
Form 0920-0978 HAIC - CDI Annual Surveillance Officers Survey	Form	Modified	Available
Form 0920-0978 Annual Survey of Laboratory Testing Practices for C. difficile Infection	Form	Modified	Available
Form 0920-0978 HAIC CDI Annual Laboratory Survey	Form	Modified	Repair queued
Form CS 341327-A FluSurv-NET Laboratory Survey 2023–2024 Season	Form	Modified	Repair queued
Form CS 341327-A FluSrv-NET Laboratory Survey (2023-24)	Form	Modified	Repair queued
Form 0920-0978 FoodNET Clinical Lab Practices and Testing Volume	Form and Instruction	Modified	Repair queued
Form 0920-0978 Foodnet Clinical Laboratory Practices and Testing Volume	Form and Instruction	Modified	Available
Form Short Form 2024 CANDIDEMIA 2024 CASE REPORT FORM	Form	Modified	Available
Form Short Form 2024 HAIC Candidemia Case Report Form	Form	Modified	Repair queued
Form 0920-0978 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2023	Form and Instruction	Removed	Available
Form 0920-0978 HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA)	Form and Instruction	Removed	Repair queued
Form 0920-0978 2023 MuGSI Extended-Spectrum Beta-Lactamase (ESBL)-Producing Enterobacteriaceae/Omvasove Escjerocjoa coli (MuGSI) (HAIC) Case Report	Form	Removed	Available
Form 0920-0978 HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL)	Form	Removed	Repair queued
Form 0920-0978 APPENDIX 5A.2: PROVIDER ADULT VACCINATION HISTORY REQUEST LETTER/FORM	Form and Instruction	Modified	Available
Form 0920-0978 FluSurv-NET Hospitalization Surveillance Project History Fax Form (Children/Adults)	Form and Instruction	Modified	Repair queued
Form 0920-0978 APPENDIX 5B. CONTACTING PATIENTS, PROXIES OR PARENTS/GUARDIANS FOR VACCINATION STATUS	Form and Instruction	Modified	Available
Form 0920-0978 FluServ-NET Hospitalization Surveillance Project Vaccination PhoneScript / Consent Form (English/Spanish)	Form and Instruction	Modified	Repair queued
Form 0920-0978 ABC Severe GAS Infection Supplemental Form	Form and Instruction	Unchanged	Repair queued
Form 0920-0978 ABCs Severe GAS Infection Supplemental Form	Form and Instruction	Unchanged	Available
Form 0920-0978 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged	Available
Form 0920-0978 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged	Repair queued
Form CS342262-A 2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form	Modified	Available
Form CS342262-A HAIC- Multi-Site Gram-Negative Surveillance Initiative (MuGSI) Case Report Form (CFR)	Form	Modified	Repair queued
Form CS 342179-A CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	Form and Instruction	Modified	Available
Form CS 342179-A HAIC CDI Case Report Form	Form and Instruction	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Available
Form 0920-0978 FoodNet Active Surveillance Data Element - [Yersinia]	Form	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Available
Form 0920-0978 FoodNet Active Surveillance Data Element - [Vibrio]	Form	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Repair queued
Form 0920-0978 FoodNet Active Surveillance Data Element - [Shigella]	Form	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Available
Form 0920-0978 FoodNet Active Surveillance Data Element - [Shiga toxin producing E. coli]	Form	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Available
Form 0920-0978 FoodNet Active Surveillance Data Element - [Salmonella]	Form	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Available
Form 0920-0978 FoodNet Active Surveillance Data Element - [Listeria monocytogenes]	Form	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Repair queued
Form 0920-0978 FoodNet Active Surveillance Data Element - [Cyclospora]	Form	Modified	Repair queued
Form 0920-0978 FoodNet Variable List, 2024	Form	Modified	Available
Form 0920-0978 FoodNet Active Surveillance Data Element [Campylobacter]	Form	Modified	Repair queued
Form 0920-0978 FluSurv NET Vaccination Phone Script	Form and Instruction	Removed	Available
Form 0920-0978 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English)	Form and Instruction	Removed	Repair queued
Form 0920-0978 FoodNet CDC's FoodNet Hemolytic Uremic syndrome (HUS) Surveillance Case Report Form	Form and Instruction	Unchanged	Available
Form 0920-0978 FoodNet Hemolytic Uremic Syndrome (HUS)	Form and Instruction	Unchanged	Repair queued
Form 0920-0978 Data Collection Elements for COVID-19 Vaccination Status on 2023-24 FluSurv-NET Cases	Form	Modified	Available
Form CS340190-A 2022-23 FluSurv-NET Influenza Hospitalization Surveillance Project Case Report Form	Form and Instruction	Modified	Available
Form CS340190-A FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form (CFR)	Form and Instruction	Modified	Repair queued
Form 0920-0978 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Unchanged	Available
Form 0920-0978 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Unchanged	Repair queued
Form CDC 52.15A ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years)	Form and Instruction	Modified	Available
Form CDC 52.15A Active Bacterial Core Surveillance (ABCs) Invasive Pneumococcal Disease in Children (aged ≥2 months to	Form and Instruction	Modified	Repair queued
Form CDC 52.15B Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2024	Form	Modified	Available
Form CDC 52.15B HAIC Invasive Staphylococcus aureus Infection Case Report Form	Form	Modified	Available
Form CDC 52.12A 2024 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified	Available
Form CDC 52.12A 2024 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified	Repair queued
Att1_EIP2024_NonSub_DescriptionChanges_Sept2023.docx	Supplementary Document	Uploaded 2023-09-11	Repair queued
Att2_EIP2024_NonSub_Crosswalk_Sept2023.docx	Supplementary Document	Uploaded 2023-09-11	Repair queued
EIP 0920-0978_Non-sub change request_SEP092023(v3).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-09-11	Repair queued
Att10_COVID-19 Vaccination Status on FluSurv-NET Cases_20220808.pdf	Supplementary Document	Uploaded 2023-02-28	Repair queued
EIP 0920-0978_Non-sub change request_Oct2022FOR2023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-02-28	Repair queued
Att1_EIP2023_NonSub_DescriptionChanges_OCT2022.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-02-28	Repair queued
Att2_EIP2023_NonSub_Crosswalk_OCT2022.docx	Supplementary Document	Uploaded 2023-02-28	Repair queued
Att23- HAIC CA CP-CRE interview project manual.pdf	Supplementary Document	Uploaded 2022-04-25	Available
EIP CDI ICMS PIA Signed 2.pdf	Supplementary Document	Uploaded 2022-04-25	Repair queued
MuGSI PIA Signed.pdf	Supplementary Document	Uploaded 2022-04-25	Repair queued
Att2- 60-Day FRN_2022.docx	Supplementary Document	Uploaded 2022-04-25	Repair queued
Att1- Authorizing_Regulations_T42_section_241.pdf	Supplementary Document	Uploaded 2022-04-25	Repair queued
SSB_EIP 2022 Revision_04052022.docx	Supporting Statement B	Uploaded 2022-04-25	Repair queued
SSA_EIP 2022 Revision_04212022_SMN_Clean final_Updated_020723_highlighted edits_final OMB_final.docx	Supporting Statement A	Uploaded 2023-02-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
253051	HAIC Death Ascertainment Project	Form and Instruction	Unchanged	Death Ascertainment Project Variables
253051	HAIC Death Ascertainment Project	Form and Instruction	Unchanged
253049	HAIC (MuGSI) Supplemental Surveillance Officer Survey	Form and Instruction	Modified	2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report
253049	HAIC (MuGSI) Supplemental Surveillance Officer Survey	Form and Instruction	Modified
253048	HAIC (MuGSI) Community-Associated CP-CRE Interview	Form	Modified	CA CP-CRE Survey Questionnaire
253048	HAIC (MuGSI) Community-Associated CP-CRE Interview	Form	Modified
235058	HAIC -Labortary Testing Practices for Candidemia Questionnaire	Form	Modified	2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
235058	HAIC -Labortary Testing Practices for Candidemia Questionnaire	Form	Modified
235057	HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey	Form and Instruction	Modified	2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
235057	HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey	Form and Instruction	Modified
235056	HAIC Invasive Staphylococcus aureus Annual Laboratory Survey	Form	Modified	CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey
235056	HAIC Invasive Staphylococcus aureus Annual Laboratory Survey	Form	Modified
235055	HAIC CDI LTCF Survey	Form and Instruction	Unchanged	Emerging Infections Progrom C. difficile Surveillance Nuring Home Telephone Call Survey
235055	HAIC CDI LTCF Survey	Form and Instruction	Unchanged
235054	HAIC - CDI Annual Surveillance Officers Survey	Form	Modified	Surveillance Officer's Survey- Clostridioides difficile Infection (CDI) Surveillance
235054	HAIC - CDI Annual Surveillance Officers Survey	Form	Modified
235053	HAIC CDI Annual Laboratory Survey	Form	Modified	Annual Survey of Laboratory Testing Practices for C. difficile Infection
235053	HAIC CDI Annual Laboratory Survey	Form	Modified
235052	FluSrv-NET Laboratory Survey (2023-24)	Form	Modified	FluSurv-NET Laboratory Survey 2023–2024 Season
235052	FluSrv-NET Laboratory Survey (2023-24)	Form	Modified
235051	Foodnet Clinical Laboratory Practices and Testing Volume	Form and Instruction	Modified	FoodNET Clinical Lab Practices and Testing Volume
235051	Foodnet Clinical Laboratory Practices and Testing Volume	Form and Instruction	Modified
231114	HAIC Candidemia Case Report Form	Form	Modified	CANDIDEMIA 2024 CASE REPORT FORM
231114	HAIC Candidemia Case Report Form	Form	Modified
231113	HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA)	Form and Instruction	Removed	Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2023
231113	HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA)	Form and Instruction	Removed
231112	HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL)	Form	Removed	2023 MuGSI Extended-Spectrum Beta-Lactamase (ESBL)-Producing Enterobacteriaceae/Omvasove Escjerocjoa coli (MuGSI) (HAIC) Case Report
231112	HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL)	Form	Removed
231111	FluSurv-NET Hospitalization Surveillance Project History Fax Form (Children/Adults)	Form and Instruction	Modified	APPENDIX 5A.2: PROVIDER ADULT VACCINATION HISTORY REQUEST LETTER/FORM
231111	FluSurv-NET Hospitalization Surveillance Project History Fax Form (Children/Adults)	Form and Instruction	Modified
231110	FluServ-NET Hospitalization Surveillance Project Vaccination PhoneScript / Consent Form (English/Spanish)	Form and Instruction	Modified	APPENDIX 5B. CONTACTING PATIENTS, PROXIES OR PARENTS/GUARDIANS FOR VACCINATION STATUS
231110	FluServ-NET Hospitalization Surveillance Project Vaccination PhoneScript / Consent Form (English/Spanish)	Form and Instruction	Modified
230869	ABCs Severe GAS Infection Supplemental Form	Form and Instruction	Unchanged	ABC Severe GAS Infection Supplemental Form
230869	ABCs Severe GAS Infection Supplemental Form	Form and Instruction	Unchanged
220380	ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged	ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
220380	ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged
217336	HAIC- Multi-Site Gram-Negative Surveillance Initiative (MuGSI) Case Report Form (CFR)	Form	Modified	2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report
217336	HAIC- Multi-Site Gram-Negative Surveillance Initiative (MuGSI) Case Report Form (CFR)	Form	Modified
217334	HAIC CDI Case Report Form	Form and Instruction	Modified	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
217334	HAIC CDI Case Report Form	Form and Instruction	Modified
207663	FoodNet Active Surveillance Data Element - [Yersinia]	Form	Modified	FoodNet Variable List, 2024
207663	FoodNet Active Surveillance Data Element - [Yersinia]	Form	Modified
207662	FoodNet Active Surveillance Data Element - [Vibrio]	Form	Modified	FoodNet Variable List, 2024
207662	FoodNet Active Surveillance Data Element - [Vibrio]	Form	Modified
207661	FoodNet Active Surveillance Data Element - [Shigella]	Form	Modified	FoodNet Variable List, 2024
207661	FoodNet Active Surveillance Data Element - [Shigella]	Form	Modified
207660	FoodNet Active Surveillance Data Element - [Shiga toxin producing E. coli]	Form	Modified	FoodNet Variable List, 2024
207660	FoodNet Active Surveillance Data Element - [Shiga toxin producing E. coli]	Form	Modified
207659	FoodNet Active Surveillance Data Element - [Salmonella]	Form	Modified	FoodNet Variable List, 2024
207659	FoodNet Active Surveillance Data Element - [Salmonella]	Form	Modified
207658	FoodNet Active Surveillance Data Element - [Listeria monocytogenes]	Form	Modified	FoodNet Variable List, 2024
207658	FoodNet Active Surveillance Data Element - [Listeria monocytogenes]	Form	Modified
207657	FoodNet Active Surveillance Data Element - [Cyclospora]	Form	Modified	FoodNet Variable List, 2024
207657	FoodNet Active Surveillance Data Element - [Cyclospora]	Form	Modified
207655	FoodNet Active Surveillance Data Element [Campylobacter]	Form	Modified	FoodNet Variable List, 2024
207655	FoodNet Active Surveillance Data Element [Campylobacter]	Form	Modified
207653	Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English)	Form and Instruction	Removed	FluSurv NET Vaccination Phone Script
207653	Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English)	Form and Instruction	Removed
207652	FoodNet Hemolytic Uremic Syndrome (HUS)	Form and Instruction	Unchanged	FoodNet CDC's FoodNet Hemolytic Uremic syndrome (HUS) Surveillance Case Report Form
207652	FoodNet Hemolytic Uremic Syndrome (HUS)	Form and Instruction	Unchanged
207651	FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form (CFR)	Form	Modified	Data Collection Elements for COVID-19 Vaccination Status on 2023-24 FluSurv-NET Cases
207651	FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form (CFR)	Form and Instruction	Modified	2022-23 FluSurv-NET Influenza Hospitalization Surveillance Project Case Report Form
207651	FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form (CFR)	Form and Instruction	Modified
207649	Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Unchanged	Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form
207649	Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Unchanged
207648	Active Bacterial Core Surveillance (ABCs) Invasive Pneumococcal Disease in Children (aged ≥2 months to <5 years) and Adults (aged ≥65 years)	Form and Instruction	Modified	ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years)
207648	Active Bacterial Core Surveillance (ABCs) Invasive Pneumococcal Disease in Children (aged ≥2 months to	Form and Instruction	Modified
207647	HAIC Invasive Staphylococcus aureus Infection Case Report Form	Form	Modified	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2024
207647	HAIC Invasive Staphylococcus aureus Infection Case Report Form	Form	Modified
207646	2024 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified	2024 Active Bacterial Core Surveillance (ABCs) Case Report
207646	2024 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0978	ICR Reference No: 202309-0920-002
Status: Historical Inactive	Previous ICR Reference No: 202302-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0978-23HY
Title: [NCEZID] Emerging Infections Program
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 09/19/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/12/2023
Terms of Clearance: Changes are substantive; recommend resubmitting as a revision. Previous terms continue: Approval is consistent with the understanding that CDC will continue to add (and keep current) language on each program's website and in their reports that clearly caveats the interpretation of longitudinal trends due to temporal changes in methods, definitions, geographic coverage (for example, changes in the number and characteristics of participating hospitals).

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2026	02/28/2026	02/28/2026
Responses	132,520	0	132,520
Time Burden (Hours)	53,784	0	53,784
Cost Burden (Dollars)	0	0	0

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Abstract: 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 Revision requests the use of two additional forms and including minor revised language and rewording to improve clarity and readability of the data collection forms. Programs covered by this ICR include: Active Bacterial Core surveillance (ABCs): active population-based laboratory surveillance for invasive bacterial diseases; Foodborne Diseases Active Surveillance Network (FoodNet): active population-based laboratory surveillance to monitor the incidence of select enteric diseases; Influenza: active population-based surveillance for laboratory confirmed influenza-related hospitalizations; and Healthcare Associated Infections-Community Interface (HAIC): active population-based surveillance for healthcare associated pathogens and infections (including Clostridium difficile infection).

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 4891	01/31/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 24305	04/25/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 32

table that charts list of burden

IC Title	Form No.	Form Name
2024 Active Bacterial Core Surveillance (ABCs) Case Report	CDC 52.12A	2024 Active Bacterial Core Surveillance (ABCs) Case Report
ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	0920-0978	ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
ABCs Severe GAS Infection Supplemental Form	0920-0978	ABC Severe GAS Infection Supplemental Form
Active Bacterial Core Surveillance (ABCs) Invasive Pneumococcal Disease in Children (aged ≥2 months to <5 years) and Adults (aged ≥65 years)	CDC 52.15A	ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years)
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	0920-0978	Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form
FluServ-NET Hospitalization Surveillance Project Vaccination PhoneScript / Consent Form (English/Spanish)	0920-0978	APPENDIX 5B. CONTACTING PATIENTS, PROXIES OR PARENTS/GUARDIANS FOR VACCINATION STATUS
FluSrv-NET Laboratory Survey (2023-24)	CS 341327-A	FluSurv-NET Laboratory Survey 2023–2024 Season
FluSurv-NET Hospitalization Surveillance Project History Fax Form (Children/Adults)	0920-0978	APPENDIX 5A.2: PROVIDER ADULT VACCINATION HISTORY REQUEST LETTER/FORM
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form (CFR)	CS340190-A, 0920-0978	2022-23 FluSurv-NET Influenza Hospitalization Surveillance Project Case Report Form ,   Data Collection Elements for COVID-19 Vaccination Status on 2023-24 FluSurv-NET Cases
FoodNet Active Surveillance Data Element - [Cyclospora]	0920-0978	FoodNet Variable List, 2024
FoodNet Active Surveillance Data Element - [Listeria monocytogenes]	0920-0978	FoodNet Variable List, 2024
FoodNet Active Surveillance Data Element - [Salmonella]	0920-0978	FoodNet Variable List, 2024
FoodNet Active Surveillance Data Element - [Shiga toxin producing E. coli]	0920-0978	FoodNet Variable List, 2024
FoodNet Active Surveillance Data Element - [Shigella]	0920-0978	FoodNet Variable List, 2024
FoodNet Active Surveillance Data Element - [Vibrio]	0920-0978	FoodNet Variable List, 2024
FoodNet Active Surveillance Data Element - [Yersinia]	0920-0978	FoodNet Variable List, 2024
FoodNet Active Surveillance Data Element [Campylobacter]	0920-0978	FoodNet Variable List, 2024
FoodNet Hemolytic Uremic Syndrome (HUS)	0920-0978	FoodNet CDC's FoodNet Hemolytic Uremic syndrome (HUS) Surveillance Case Report Form
Foodnet Clinical Laboratory Practices and Testing Volume	0920-0978	FoodNET Clinical Lab Practices and Testing Volume
HAIC (MuGSI) Community-Associated CP-CRE Interview	0920-0978	CA CP-CRE Survey Questionnaire
HAIC (MuGSI) Supplemental Surveillance Officer Survey	C5342262-A	2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report
HAIC - CDI Annual Surveillance Officers Survey	0920-0978	Surveillance Officer's Survey- Clostridioides difficile Infection (CDI) Surveillance
HAIC -Labortary Testing Practices for Candidemia Questionnaire	0920-0978	2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
HAIC CDI Annual Laboratory Survey	0920-0978	Annual Survey of Laboratory Testing Practices for C. difficile Infection
HAIC CDI Case Report Form	CS 342179-A	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
HAIC CDI LTCF Survey	0920-0978	Emerging Infections Progrom C. difficile Surveillance Nuring Home Telephone Call Survey
HAIC Candidemia Case Report Form	Short Form 2024	CANDIDEMIA 2024 CASE REPORT FORM
HAIC Death Ascertainment Project	0920-0978	Death Ascertainment Project Variables
HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA)	0920-0978	Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2023
HAIC Invasive Staphylococcus aureus Annual Laboratory Survey	0920-0978	CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey
HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey	0920-0978	2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
HAIC Invasive Staphylococcus aureus Infection Case Report Form	CDC 52.15B	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2024
HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL)	0920-0978	2023 MuGSI Extended-Spectrum Beta-Lactamase (ESBL)-Producing Enterobacteriaceae/Omvasove Escjerocjoa coli (MuGSI) (HAIC) Case Report
HAIC- Multi-Site Gram-Negative Surveillance Initiative (MuGSI) Case Report Form (CFR)	CS342262-A	2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English)	0920-0978	FluSurv NET Vaccination Phone Script

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: This non-substantive change request is for changes to the disease-specific data elements for ABCs, FoodNet, FluSurv-NET, and HAIC. The changes made to all forms under this non-substantive request will aid in improving surveillance efficiency and data quality to clarify the burden of disease and possible risk factors for disease. This information can be used to inform strategies for preventing disease and negative outcomes. Specifically, changes were made for clarification purposes, to assist data collectors in capturing data in a standardized fashion to improve accuracy. As a result of proposed changes, the estimated annualized burden is expected to increase by 2,034 hours, from 53,784 to 55,818..

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Annual Cost to Federal Government: $36,032,895

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/12/2023

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