[NCEZID] Emerging Infections Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project	Form and Instruction	Unchanged	Available
Form HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project	Form and Instruction	Unchanged	Repair queued
Form HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey	Form and Instruction	Unchanged	Available
Form HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey	Form and Instruction	Unchanged	Repair queued
Form HAIC.400.2 Community-Associated CP-CRE Interview	Form and Instruction	Unchanged	Available
Form HAIC.400.2 Community-Associated CP-CRE Interview	Form and Instruction	Unchanged	Available
Form HAIC 400.12 2025 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	Form and Instruction	Modified	Available
Form HAIC.400.12 2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	Form and Instruction	Modified	Available
Form HAIC.400.12 HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	Form and Instruction	Modified	Repair queued
Form HAIC 400.6 2024 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	Form and Instruction	Modified	Available
Form HAIC.400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	Form and Instruction	Modified	Available
Form HAIC.400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	Form and Instruction	Modified	Missing upstream
Form HAIC.400.5 CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey	Form and Instruction	Unchanged	Available
Form HAIC.400.5 CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey	Form and Instruction	Unchanged	Repair queued
Form HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey	Form and Instruction	Unchanged	Available
Form HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey	Form and Instruction	Unchanged	Repair queued
Form HAIC 400.9 HAIC Surveillance Officer’s Survey	Form and Instruction	Modified	Available
Form HAIC.400.9 HAIC Surveillance Officer’s Survey	Form and Instruction	Modified	Available
Form HAIC.400.9 HAIC-Surveillance Officer's Survey	Form and Instruction	Modified	Repair queued
Form HAIC 400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection	Form and Instruction	Modified	Available
Form HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection	Form and Instruction	Modified	Available
Form HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection	Form and Instruction	Modified	Available
Form FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season	Form	Unchanged	Available
Form FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season	Form	Unchanged	Missing upstream
Form FN.200.10 FoodNET Lab Survey Variable List, 2024	Form	Unchanged	Available
Form FN.200.10 FoodNET Lab Survey Variable List 2024	Form	Unchanged	Repair queued
Form HAIC 400.11 CANDIDEMIA 2025 CASE REPORT FORM	Form and Instruction	Modified	Available
Form HAIC.400.11 CANDIDEMIA 2024 CASE REPORT FORM	Form and Instruction	Modified	Available
Form HAIC.400.11 CANDIDEMIA 2024 CASE REPORT FORM	Form and Instruction	Modified	Repair queued
Form HAIC 400.4 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified	Available
Form HAIC.400.4 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2024	Form and Instruction	Modified	Available
Form HAIC.400.4 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified	Repair queued
Form FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM	Form and Instruction	Unchanged	Available
Form FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM	Form and Instruction	Unchanged	Repair queued
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form	Form and Instruction	Unchanged	Available
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form	Form and Instruction	Unchanged	Repair queued
Form ABC.100.3 2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged	Available
Form ABC.100.3 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged	Missing upstream
Form HAIC 400.1 2025 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified	Available
Form HAIC.400.1 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form	Modified	Repair queued
Form HAIC.400.1 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form	Modified	Missing upstream
Form HAIC 400.7 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	Form and Instruction	Modified	Available
Form HAIC.400.7 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	Form and Instruction	Modified	Available
Form HAIC.400.7 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	Form and Instruction	Modified	Repair queued
Form FN 200.8 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Available
Form FN.200.8 FoodNet Variable List, 2024_ (YERSINIA)	Form and Instruction	Modified	Available
Form FN.200.8 FoodNet Variable List, 2024_ (YERSINIA)	Form and Instruction	Modified	Missing upstream
Form FN 200.7 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Repair queued
Form FN.200.7 FoodNet Variable List, 2024_ (VIBRIO)	Form and Instruction	Modified	Available
Form FN.200.7 FoodNet Variable List, 2024_ (VIBRIO)	Form and Instruction	Modified	Missing upstream
Form FN 200.6 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Repair queued
Form FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA)	Form and Instruction	Modified	Available
Form FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA)	Form and Instruction	Modified	Repair queued
Form FN 200.5 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Available
Form FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)	Form and Instruction	Modified	Available
Form FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)	Form and Instruction	Modified	Repair queued
Form FN 200.4 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Available
Form FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA)	Form and Instruction	Modified	Available
Form FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA)	Form and Instruction	Modified	Repair queued
Form FN 200.3 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Available
Form FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCYTOGENES)	Form and Instruction	Modified	Available
Form FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES)	Form and Instruction	Modified	Missing upstream
Form FN 200.2 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Available
Form FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA)	Form and Instruction	Modified	Available
Form FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA)	Form and Instruction	Modified	Available
Form FN 200.1 FoodNet Variable List, (Site-transmitted variables) - 2025	Form and Instruction	Modified	Available
Form FN.200.1 FoodNet Variable List, 2024_ (CAMPYLOBACTER)	Form and Instruction	Modified	Available
Form FN.200.1 FoodNet Variable List, 2024_(CAMPYLOBACTER)	Form and Instruction	Modified	Repair queued
Form FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW	Form and Instruction	Unchanged	Available
Form FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish)	Form and Instruction	Unchanged	Available
Form ABC.200.9 FoodNet CDC's FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance Case Report Form	Form and Instruction	Unchanged	Available
Form ABC.200.9 FoodNet Hemolytic Uremic Syndrome (HUS)	Form and Instruction	Unchanged	Repair queued
Form FSN 300.1 2024-25 Influenza Hospitalization Surveillance Network (FluSurv-NET) Case Report Form	Form and Instruction	Modified	Available
Form FSN.300.1 Influenza Hospitalizatin Surveillance Network (FluSurv-NET) Case Report Form	Form and Instruction	Modified	Available
Form FSN.300.1 FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form	Form and Instruction	Modified	Missing upstream
Form ABC 100.5 2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM	Form and Instruction	Modified	Available
Form ABC.100.5 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM	Form and Instruction	Modified	Available
Form ABC.100.5 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Modified	Repair queued
Form ABC 100.2 2025 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	Repair queued
Form ABC.100.2 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 ABC.100.2 ABCs Invasive Pneumococcal Disease in Children and Adults	Form and Instruction	Modified	Missing upstream
Form ABC 100.1 2025 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified	Available
Form ABC.100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified	Available
Form ABC.100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified	Missing upstream
EIP 0920-0978_Non-sub change request_2025 08OCT2024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-10-08	Available
EIP 0920-0978_Non-sub change request_2025 08OCT2024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-10-08	Repair queued
Att 2_Collection Instrument Cross walk.docx	Supplementary Document	Uploaded 2024-10-08	Repair queued
Att 2_Collection Instrument Cross walk.docx	Supplementary Document	Uploaded 2024-10-08	Repair queued
Att 1 Program ChangesAdjustments_rev 08OCT2024.docx	Supplementary Document	Uploaded 2024-10-08	Available
Att 1 Program ChangesAdjustments_rev 08OCT2024.docx	Supplementary Document	Uploaded 2024-10-08	Repair queued
Att. 6-Explanation for Program Changes.docx	Supplementary Document	Uploaded 2024-07-11	Available
Att. 6-Explanation for Program Changes.docx	Supplementary Document	Uploaded 2024-07-11	Missing upstream
Att. 5-Human Subjects Determination Memo.pdf	Supplementary Document	Uploaded 2024-07-11	Available
Att. 5-Human Subjects Determination Memo.pdf	Supplementary Document	Uploaded 2024-07-11	Repair queued
Att. 4a-Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-07-11	Available
Att. 4a-Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-07-11	Available
Att. 2-Federal Register 60day FRN.pdf	Supplementary Document	Uploaded 2024-07-11	Available
Att. 2-Federal Register 60day FRN.pdf	Supplementary Document	Uploaded 2024-07-11	Missing upstream
Att. 1-Section 301 of the Public Health Service Act (42 USC 241).pdf	Supplementary Document	Uploaded 2024-07-11	Available
Att. 1-Section 301 of the Public Health Service Act (42 USC 241).pdf	Supplementary Document	Uploaded 2024-07-11	Repair queued
2. Supporting Statement B_EIP OMB 2024 Revision.docx	Supporting Statement B	Uploaded 2024-07-11	Available
2. Supporting Statement B_EIP OMB 2024 Revision.docx	Supporting Statement B	Uploaded 2024-07-11	Missing upstream
1. Supporting Statement A_EIP OMB 2024 Revision.docx	Supporting Statement A	Uploaded 2024-07-11	Available
1. Supporting Statement A_EIP OMB 2024 Revision.docx	Supporting Statement A	Uploaded 2024-07-11	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
253051	Data Elements Transferred to CDC for the HAIC Death Ascertainment Project	Form and Instruction	Unchanged	Data Elements Transferred to CDC for the HAIC Death Ascertainment Project
253051	Data Elements Transferred to CDC for the HAIC Death Ascertainment Project	Form and Instruction	Unchanged
253049	2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey	Form and Instruction	Unchanged	2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey
253049	2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey	Form and Instruction	Unchanged
253048	Community-Associated CP-CRE Interview	Form and Instruction	Unchanged	Community-Associated CP-CRE Interview
253048	Community-Associated CP-CRE Interview	Form and Instruction	Unchanged
235058	HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	Form and Instruction	Modified	2025 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
235058	HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	Form and Instruction	Modified	2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
235058	HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	Form and Instruction	Modified
235057	2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	Form and Instruction	Modified	2024 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
235057	2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	Form and Instruction	Modified	2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
235057	2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	Form and Instruction	Modified
235056	CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey	Form and Instruction	Unchanged	CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey
235056	CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey	Form and Instruction	Unchanged
235055	Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey	Form and Instruction	Unchanged	Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey
235055	Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey	Form and Instruction	Unchanged
235054	HAIC-Surveillance Officer's Survey	Form and Instruction	Modified	HAIC Surveillance Officer’s Survey
235054	HAIC-Surveillance Officer's Survey	Form and Instruction	Modified	HAIC Surveillance Officer’s Survey
235054	HAIC-Surveillance Officer's Survey	Form and Instruction	Modified
235053	Annual Survey of Laboratory Testing Practices for C. difficile Infection	Form and Instruction	Modified	Annual Survey of Laboratory Testing Practices for C. difficile Infection
235053	Annual Survey of Laboratory Testing Practices for C. difficile Infection	Form and Instruction	Modified	Annual Survey of Laboratory Testing Practices for C. difficile Infection
235053	Annual Survey of Laboratory Testing Practices for C. difficile Infection	Form and Instruction	Modified
235052	FluSurv-NET Laboratory Survey 2023–2024 Season	Form	Unchanged	FluSurv-NET Laboratory Survey 2023–2024 Season
235052	FluSurv-NET Laboratory Survey 2023–2024 Season	Form	Unchanged
235051	FoodNET Lab Survey Variable List 2024	Form	Unchanged	FoodNET Lab Survey Variable List, 2024
235051	FoodNET Lab Survey Variable List 2024	Form	Unchanged
231114	CANDIDEMIA 2024 CASE REPORT FORM	Form and Instruction	Modified	CANDIDEMIA 2025 CASE REPORT FORM
231114	CANDIDEMIA 2024 CASE REPORT FORM	Form and Instruction	Modified	CANDIDEMIA 2024 CASE REPORT FORM
231114	CANDIDEMIA 2024 CASE REPORT FORM	Form and Instruction	Modified
231113	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report
231113	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2024
231113	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified
231111	FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM	Form and Instruction	Unchanged	FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM
231111	FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM	Form and Instruction	Unchanged
230869	ABCs Severe GAS Infection: Supplemental Form	Form and Instruction	Unchanged	ABCs Severe GAS Infection: Supplemental Form
230869	ABCs Severe GAS Infection: Supplemental Form	Form and Instruction	Unchanged
220380	2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged	2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
220380	2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Form and Instruction	Unchanged
217336	2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form and Instruction	Modified	2025 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report
217336	2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form	Modified
217336	2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	Form	Modified
217334	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	Form and Instruction	Modified	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
217334	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	Form and Instruction	Modified	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
217334	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	Form and Instruction	Modified
207663	FoodNet Variable List, 2024_ (YERSINIA)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207663	FoodNet Variable List, 2024_ (YERSINIA)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (YERSINIA)
207663	FoodNet Variable List, 2024_ (YERSINIA)	Form and Instruction	Modified
207662	FoodNet Variable List, 2024_ (VIBRIO)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207662	FoodNet Variable List, 2024_ (VIBRIO)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (VIBRIO)
207662	FoodNet Variable List, 2024_ (VIBRIO)	Form and Instruction	Modified
207661	FoodNet Variable List, 2024_ (SHIGELLA)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207661	FoodNet Variable List, 2024_ (SHIGELLA)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (SHIGELLA)
207661	FoodNet Variable List, 2024_ (SHIGELLA)	Form and Instruction	Modified
207660	FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207660	FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)
207660	FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)	Form and Instruction	Modified
207659	FoodNet Variable List, 2024_ (SALMONELLA)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207659	FoodNet Variable List, 2024_ (SALMONELLA)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (SALMONELLA)
207659	FoodNet Variable List, 2024_ (SALMONELLA)	Form and Instruction	Modified
207658	FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207658	FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (LISTERIA MONOCYTOGENES)
207658	FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES)	Form and Instruction	Modified
207657	FoodNet Variable List, 2024_ (CYCLOSPORA)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207657	FoodNet Variable List, 2024_ (CYCLOSPORA)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (CYCLOSPORA)
207657	FoodNet Variable List, 2024_ (CYCLOSPORA)	Form and Instruction	Modified
207655	FoodNet Variable List, 2024_(CAMPYLOBACTER)	Form and Instruction	Modified	FoodNet Variable List, (Site-transmitted variables) - 2025
207655	FoodNet Variable List, 2024_(CAMPYLOBACTER)	Form and Instruction	Modified	FoodNet Variable List, 2024_ (CAMPYLOBACTER)
207655	FoodNet Variable List, 2024_(CAMPYLOBACTER)	Form and Instruction	Modified
207653	FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish)	Form and Instruction	Unchanged	FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW
207653	FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish)	Form and Instruction	Unchanged
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	Form and Instruction	Modified	2024-25 Influenza Hospitalization Surveillance Network (FluSurv-NET) Case Report Form
207651	FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form	Form and Instruction	Modified	Influenza Hospitalizatin Surveillance Network (FluSurv-NET) Case Report Form
207651	FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form	Form and Instruction	Modified
207649	Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Modified	2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM
207649	Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Modified	ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM
207649	Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	Form and Instruction	Modified
207648	ABCs Invasive Pneumococcal Disease in Children and Adults	Form and Instruction	Modified	2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years)
207648	ABCs Invasive Pneumococcal Disease in Children and Adults	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	ABCs Invasive Pneumococcal Disease in Children and Adults	Form and Instruction	Modified
207646	2024 Active Bacterial Core Surveillance (ABCs) Case Report	Form and Instruction	Modified	2025 Active Bacterial Core Surveillance (ABCs) Case Report
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: 202410-0920-009
Status: Historical Active	Previous ICR Reference No: 202406-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0978
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: Approved with change	Conclusion Date: 10/10/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/09/2024
Terms of Clearance: Approved consistent with the understanding that in the next revision/extension of the package, the agency will update the race/ethnicity question in this information collection to be in compliance with the updated SPD 15 (effective as of March 28, 2024). This includes updates to use detailed race/ethnicity questions (SPD 15, Figure 1) or the provision of a justification in the Supporting Statement A #7 why CDC cannot use the detailed question.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2027	09/30/2027	09/30/2027
Responses	88,158	0	92,358
Time Burden (Hours)	40,013	0	41,483
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 Non-Substantive Change Request is submitted to make minor modifications to already-approved instruments including revised formatting, rewording, new answer options, and the addition/subtraction of a limited number of questions. There is a small net decrease in Burden Hours based on changes made to one FoodNet form.

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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:
	89 FR 14501	02/27/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 58736	07/19/2024
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
2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	ABC.100.3	2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey	HAIC 400.6, HAIC.400.6	2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey ,   2024 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report	HAIC 400.1, HAIC.400.1	2025 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report
2024 Active Bacterial Core Surveillance (ABCs) Case Report	ABC 100.1, ABC.100.1	2024 Active Bacterial Core Surveillance (ABCs) Case Report ,   2025 Active Bacterial Core Surveillance (ABCs) Case Report
2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey	HAIC.400.3	2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey
ABCs Invasive Pneumococcal Disease in Children and Adults	ABC.100.2, ABC 100.2	ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years) ,   2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years)
ABCs Severe GAS Infection: Supplemental Form	ABC.100.4	ABCs Severe GAS Infection: Supplemental Form
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form	ABC 100.5, ABC.100.5	ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM ,   2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM
Annual Survey of Laboratory Testing Practices for C. difficile Infection	HAIC 400.8, HAIC.400.8	Annual Survey of Laboratory Testing Practices for C. difficile Infection ,   Annual Survey of Laboratory Testing Practices for C. difficile Infection
CANDIDEMIA 2024 CASE REPORT FORM	HAIC 400.11, HAIC.400.11	CANDIDEMIA 2024 CASE REPORT FORM ,   CANDIDEMIA 2025 CASE REPORT FORM
CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey	HAIC.400.5	CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey
CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT	HAIC 400.7, HAIC.400.7	CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT ,   CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
Community-Associated CP-CRE Interview	HAIC.400.2	Community-Associated CP-CRE Interview
Data Elements Transferred to CDC for the HAIC Death Ascertainment Project	HAIC.400.13	Data Elements Transferred to CDC for the HAIC Death Ascertainment Project
Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey	HAIC.400.10	Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey
FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish)	FSN.300.2	FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW
FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM	FSN.300.3	FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM
FluSurv-NET Laboratory Survey 2023–2024 Season	FSN.300.4	FluSurv-NET Laboratory Survey 2023–2024 Season
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form	FSN 300.1, FSN.300.1	Influenza Hospitalizatin Surveillance Network (FluSurv-NET) Case Report Form ,   2024-25 Influenza Hospitalization Surveillance Network (FluSurv-NET) Case Report Form
FoodNET Lab Survey Variable List 2024	FN.200.10	FoodNET Lab Survey Variable List, 2024
FoodNet Hemolytic Uremic Syndrome (HUS)	ABC.200.9	FoodNet CDC's FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance Case Report Form
FoodNet Variable List, 2024_ (CYCLOSPORA)	FN 200.2, FN.200.2	FoodNet Variable List, 2024_ (CYCLOSPORA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES)	FN 200.3, FN.200.3	FoodNet Variable List, 2024_ (LISTERIA MONOCYTOGENES) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SALMONELLA)	FN 200.4, FN.200.4	FoodNet Variable List, 2024_ (SALMONELLA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)	FN 200.5, FN.200.5	FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SHIGELLA)	FN 200.6, FN.200.6	FoodNet Variable List, 2024_ (SHIGELLA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (VIBRIO)	FN 200.7, FN.200.7	FoodNet Variable List, 2024_ (VIBRIO) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (YERSINIA)	FN 200.8, FN.200.8	FoodNet Variable List, 2024_ (YERSINIA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_(CAMPYLOBACTER)	FN 200.1, FN.200.1	FoodNet Variable List, 2024_ (CAMPYLOBACTER) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
HAIC-Surveillance Officer's Survey	HAIC 400.9, HAIC.400.9	HAIC Surveillance Officer’s Survey ,   HAIC Surveillance Officer’s Survey
HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE	HAIC 400.12, HAIC.400.12	2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE ,   2025 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report	HAIC.400.4, HAIC 400.4	Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2024 ,   Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report

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ICR Summary of Burden

table that charts list of burden

	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	88,158	92,358	0	-4,200	0	0
Annual Time Burden (Hours)	40,013	41,483	0	-1,470	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Change Request is submitted to 0920-0978 to make minor modifications to already-approved instruments including revised formatting, rewording, new answer options, and the addition/subtraction of a limited number of questions. There is a small net decrease in Burden Hours based on changes made to FoodNet FN 200.1 Form.

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Annual Cost to Federal Government: $41,699,051

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: 10/09/2024

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