[NCIRD] National Disease Surveillance Program - II. Disease Summaries

Forms and Documents

Document	Type	Status	Availability
US Collaborating Laboratories Influenza Testing Methods Assessment	Form and Instruction	Modified	Available
Arthropod (Vector)-Borne Diseases (Non-Human Data)	Form and Instruction	Modified	Available
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)	Form and Instruction	Modified	Available
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form	Form and Instruction	Modified	Available
Aggregate case counts of person exposed to Highly Pathogenic Avian Influenza (HPAI)	Form and Instruction	Modified	Available
Suspect Respiratory Virus Patient Form	Form and Instruction	Modified	Available
Form CDC 55.20E U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet)	Form and Instruction	Modified	Available
Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form	Form and Instruction	Modified	Available
National Adenovirus Type Reporting System (NATRS) Form	Form and Instruction	Modified	Available
Antiviral-Resistant Influenza Infection Case Report	Form and Instruction	Modified	Available
Human Infection with Novel Influenza A Virus Severe Outcomes	Form and Instruction	Modified	Available
Influenza-Associated Pediatric Mortality Case Report	Form and Instruction	Modified	Available
US Collaborating Center for Influenza Virus Surveillance	Form and Instruction	Modified	Available
Human Infection with Novel Influenza A Virus Case Report Form	Form and Instruction	Modified	Available
Novel Influenza A Virus Case Screening Form	Form and Instruction	Modified	Available
Viral Gastroenteritis Outbreak Submission Form	Form and Instruction	Modified	Available
Form CDC 55.83B NREVSS Virus Isolation (culture) Worksheet	Form and Instruction	Modified	Available
Form CDC 55.83D NREVSS Polymerase Chain Reaction (PCR) Worksheet	Form and Instruction	Modified	Available
Form CDC 55.83A NREVSS Antigen Detection Worksheet	Form and Instruction	Modified	Available
Form CDC 55.90 Enterovirus Surveillance System Report Form	Form and Instruction	Modified	Available
Public Comment.docx	Public Comments	Uploaded 2026-03-05	Available
Attachment DD Human Subjects Determination.pdf	Supplementary Document	Uploaded 2026-03-26	Available
Attachment C_Disease Summaries 0920-0004 _2026 Final_final.docx	Supplementary Document	Uploaded 2026-03-26	Available
Attachment B, 60 Day Federal Register Notice.pdf	Supplementary Document	Uploaded 2026-03-26	Available
Attachment A, Authorizing Legislation.pdf	Supplementary Document	Uploaded 2026-03-26	Available
SSB 0920-0004 Extension 2026 Final_final.docx	Supporting Statement B	Uploaded 2026-03-26	Available
SSA 0920-0004 Extension 2026 Final_final.docx	Supporting Statement A	Uploaded 2026-03-26	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
37707	US Collaborating Laboratories Influenza Testing Methods Assessment	Form and Instruction	Modified	US Collaborating Laboratories Influenza Testing Methods Assessment
258096	Arthropod (Vector)-Borne Diseases (Non-Human Data)	Form and Instruction	Modified	Arthropod (Vector)-Borne Diseases (Non-Human Data)
258095	Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)	Form and Instruction	Modified	Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)
258094	Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form	Form and Instruction	Modified	Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form
258093	Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI	Form and Instruction	Modified	Aggregate case counts of person exposed to Highly Pathogenic Avian Influenza (HPAI)
228082	Suspect Respiratory Virus Patient Form	Form and Instruction	Modified	Suspect Respiratory Virus Patient Form
228068	U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E	Form and Instruction	Modified	U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet)
212473	Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form	Form and Instruction	Modified	Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form
212472	Adenovirus Typing Report Form	Form and Instruction	Modified	National Adenovirus Type Reporting System (NATRS) Form
212471	Antiviral Resistant Influenza Infection Case Report Form	Form and Instruction	Modified	Antiviral-Resistant Influenza Infection Case Report
212470	Human Infections with Novel Influenza A Virus Severe Outcomes	Form and Instruction	Modified	Human Infection with Novel Influenza A Virus Severe Outcomes
199052	Influenza Virus Electronic year round PHIN-MS	Other-Variables for Reporting	Modified
199051	Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements	Other-Variables for Electronic Reporting	Modified
199050	Influenza Associated Pediatric Mortality Case Report Form	Form and Instruction	Modified	Influenza-Associated Pediatric Mortality Case Report
199049	US Collaborating Center for Influenza Virus Surveillance	Form and Instruction	Modified	US Collaborating Center for Influenza Virus Surveillance
199043	Human Infection with Novel Influenza A Virus Case Report Form	Form and Instruction	Modified	Human Infection with Novel Influenza A Virus Case Report Form
199040	Novel Influenza A Virus Case Screening Form	Form and Instruction	Modified	Novel Influenza A Virus Case Screening Form
178374	Viral Gastroenteritis Outbreak Submission Form	Form and Instruction	Modified	Viral Gastroenteritis Outbreak Submission Form
178365	National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment	Form and Instruction	Modified	NREVSS Virus Isolation (culture) Worksheet
178365	National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment	Form and Instruction	Modified	NREVSS Polymerase Chain Reaction (PCR) Worksheet
178365	National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment	Form and Instruction	Modified	NREVSS Antigen Detection Worksheet
178364	National Enterovirus Surveillance Report 55.9	Form and Instruction	Modified	Enterovirus Surveillance System Report Form

ICR Details

OMB Control No: 0920-0004	ICR Reference No: 202603-0920-014
Status: Received in OIRA	Previous ICR Reference No: 202512-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-26-0150
Title: [NCIRD] National Disease Surveillance Program - II. Disease Summaries
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/13/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2026
Responses	135,404	134,983
Time Burden (Hours)	27,517	27,468
Cost Burden (Dollars)	0	0

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Abstract: These data are essential on the local, state, and federal levels for measuring trends in diseases, evaluating the effectiveness of current preventive strategies, and determining the need to modify current preventive measures. The following diseases/conditions are included in this program: Influenza Virus, Caliciviruses, Respiratory and Enteric Viruses, Parechoviruses, Arthropod-Borne Diseases and Enteroviruses. This Revision makes minor edits including changes to forms and a small burden increase.

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Authorizing Statute(s): US Code: 42 USC 241 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:
	91 FR 1322	01/13/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 17656	04/07/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 20

IC Title	Form No.	Form Name
Adenovirus Typing Report Form	n/a	National Adenovirus Type Reporting System (NATRS) Form
Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI	n/a	Aggregate case counts of person exposed to Highly Pathogenic Avian Influenza (HPAI)
Antiviral Resistant Influenza Infection Case Report Form	n/a	Antiviral-Resistant Influenza Infection Case Report
Arthropod (Vector)-Borne Diseases (Non-Human Data)	n/a	Arthropod (Vector)-Borne Diseases (Non-Human Data)
Human Infection with Novel Influenza A Virus Case Report Form	n/a	Human Infection with Novel Influenza A Virus Case Report Form
Human Infections with Novel Influenza A Virus Severe Outcomes	n/a	Human Infection with Novel Influenza A Virus Severe Outcomes
Influenza Associated Pediatric Mortality Case Report Form	n/a	Influenza-Associated Pediatric Mortality Case Report
Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements
Influenza Virus Electronic year round PHIN-MS
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form	n/a	Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form
National Enterovirus Surveillance Report 55.9	CDC 55.90	Enterovirus Surveillance System Report Form
National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment	CDC 55.83A, CDC 55.83D, CDC 55.83B	NREVSS Antigen Detection Worksheet ,   NREVSS Polymerase Chain Reaction (PCR) Worksheet ,   NREVSS Virus Isolation (culture) Worksheet
Novel Influenza A Virus Case Screening Form	n/a	Novel Influenza A Virus Case Screening Form
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)	n/a	Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form	n/a	Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form
Suspect Respiratory Virus Patient Form	n/a	Suspect Respiratory Virus Patient Form
U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E	CDC 55.20E	U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet)
US Collaborating Center for Influenza Virus Surveillance	n/a	US Collaborating Center for Influenza Virus Surveillance
US Collaborating Laboratories Influenza Testing Methods Assessment	NA	US Collaborating Laboratories Influenza Testing Methods Assessment
Viral Gastroenteritis Outbreak Submission Form	n/a	Viral Gastroenteritis Outbreak Submission Form

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ICR Summary of Burden

	Total Request	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	135,404	134,983	0	421	0	0
Annual Time Burden (Hours)	27,517	27,468	0	49	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: Miscellaneous Actions

Short Statement: Burden increase due to minor adjustments in respondents or time burden.

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Annual Cost to Federal Government: $10,941,698

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.     No

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: 04/13/2026

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