OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NCEH] Maritime Illness Database and Reporting System (MIDRS)

OMB 0920-1260 · HHS/CDC.

OMB 0920-1260

The CDC’s Vessel Sanitation Program (VSP) is requesting a 3-year Paperwork Reduction Act (PRA) clearance for this revision information collection request (ICR). In the past three years, the VSP has received 13,352 AGE reports to through its “Maritime Illness Database and Reporting System (MIDRS)” (OMB Control No. 0920-1260; expiration date 04/30/2022). Since the first quarter of 2020, the COVID-19 pandemic disrupted the number of cruise ship voyages operating to U.S. ports of call. Between March 2020 and October 2021, cruise industry operations were suspended under a federally issued No Sail Order, and then subsequently under a Conditional Sailing Order to prevent the risk of introducing, transmitting, and spreading COVID-19 by cruise ship travelers. As a result, the number of AGE reports submitted to MIDRS in 2020 and 2021 was substantially lower (n=2,667 and n=1,717, respectively), compared to 2019 (n=8,968). The information collected by the VSP is designed to align with and support the collaboration between the cruise ship industry and government to define and reduce health risks associated with vessels and to ensure a healthful and clean environment for vessels’ passengers and crew.

The latest form for [NCEH] Maritime Illness Database and Reporting System (MIDRS) expires 2026-07-31 and is listed under ICR 202204-0920-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1260 Recordkeeping of Engineering and Sanitation RecordsForm and Instruction
Form 0920-1260 72-hour Food/Activity History Template (AGE cases)Form and Instruction
Form 0920-1260 Last Symptom Check and Return to Work Clearance (food and nonfood employees)Form and Instruction
Form 0920-1260 Interviews to Determine AGE Status (initial, 24-hr, 48-hr)(asymptomatic cabin mates and immediate contacts of symptomatic crew)Form and Instruction
Form 0920-1260 Three-day Pre-embarkation AGE Illness Assessment (all crew members)Form and Instruction
Form 0920-26-0121 VSP_72-hrFoodActivityHistoryFormForm
Form 0920-1260 Recordkeeping of AGE Surveillance RecordsForm and Instruction
Form 0920-26-0121 VSP AGE LogForm
Form 0920-1260 Daily Reports of AGE LogsForm and Instruction
Form 092-1260 Special Reports exceeding 2%-3% AGE Threshold (web/phone/email/fax)Form and Instruction
Form 0920-1260 Att5a2 4 hr AGEIllnssRprt (phone email fax) 20220125Form and Instruction
Form 0920-1260 AGE Illness Report 4 hours before arrival (web)Form and Instruction
Form 0920-1260 AGE Illness Report 24 hours before arrival (phone/email/fax)Form and Instruction
Form 0920-26-0121 AGE Illness Report 24 Hours BeforeForm
Form 0920-1260 AGE Illness Report 24 hours before arrival (web)Form and Instruction
Attachment 4c.pdf (document unavailable)Public Comments
Attachment 4b.pdfPublic Comments
Attachment 4a.pdfPublic Comments
Attachment 4_0920-1260_60D FRN.pdfSupplementary Document
Attachment 3_ 42 CFR Part 71_Foreign Quarantine.pdfSupplementary Document
Attachment 2b_42USCSection269.pdfSupplementary Document
Attachment 2a_42USCSection264.pdfSupplementary Document
Attachment 1_VSP Environmental Public Health Standards.pdfSupplementary Document
30_Day_FRN_CDC__2026.docxSupplementary Document
Att8 IntlConventionofSafetyofLifeatSea.pdfSupplementary Document
Att7 ResearchDeterminationForm 20210916.pdfSupplementary Document
1 - VSP MIDRS Revision List Attachments 20220125.docxSupplementary Document
Att4b.VSP2018OperationsManual.pdfSupplementary Document
Att4a.42CFR71.1bii.pdfSupplementary Document
Att3b. 1987FRN_VSPfromDGMQtoNCEH.pdf (document unavailable)Supplementary Document
Att3a.1985FRN_VSPinDGMQ.pdfSupplementary Document
Att2. MIDRS_60D_FRN.pdfSupplementary Document
Att1c. 42CFRPart71 -- Foreign Quarantine.pdf (document unavailable)Supplementary Document
Att1b.42USCSection269.pdfSupplementary Document
Att1a. 42USCSection264.pdfSupplementary Document
0 - Privacy Act Checklist MIDRS Rev 20220125.docxSupplementary Document
1 - SSB_MIDRS Extension_2 19 2026.docxSupporting Statement B
1 - SSA_MIDRS Extension_2 19 2026.docx (document unavailable)Supporting Statement A
Recordkeeping of Engineering and Sanitation Records Form and Instruction
Recordkeeping of Engineering and Sanitation Records Form and Instruction
(Passenger) 72-hour Food/Activity History Template (AGE cases) Form and Instruction
(Passenger) 72-hour Food/Activity History Template (AGE cases) Form and Instruction
Last Symptom Check and Return to Work Clearance (food and nonfood employees) Form and Instruction
Last Symptom Check and Return to Work Clearance (food and nonfood employees) Form and Instruction
Interviews to Determine AGE Status (initial, 24-hr, 48-hr)(asymptomatic cabin mates and immediate contacts of symptomatic crew) Form and Instruction
Interviews to Determine AGE Status (initial, 24-hr, 48-hr)(asymptomatic cabin mates and immediate contacts of symptomatic crew) Form and Instruction
Three-day Pre-embarkation AGE Illness Assessment (all crew members) Form and Instruction
Three-day Pre-embarkation AGE Illness Assessment (all crew members) Form and Instruction
(CREW) 72-hour Food/Activity History Template (AGE cases) Form
(CREW) 72-hour Food/Activity History Template (AGE cases) Form
Recordkeeping of AGE Surveillance Records Form and Instruction
Recordkeeping of AGE Surveillance Records Form and Instruction
Daily Reports of AGE Logs Form
Daily Reports of AGE Logs Form and Instruction
Daily Reports of AGE Logs Form and Instruction
Special Reports exceeding 2%-3% AGE Threshold (web/phone/email/fax) Form and Instruction
Special Reports exceeding 2%-3% AGE Threshold (web/phone/email/fax) Form and Instruction
AGE Illness Report 4 hours before arrival (phone/email/fax) Form and Instruction
AGE Illness Report 4 hours before arrival (phone/email/fax) Form and Instruction
AGE Illness Report 4 hours before arrival (web) Form and Instruction
AGE Illness Report 4 hours before arrival (web) Form and Instruction
AGE Illness Report 24 hours before arrival (phone/email/fax) Form and Instruction
AGE Illness Report 24 hours before arrival (phone/email/fax) Form and Instruction
AGE Illness Report 24 hours before arrival (web) Form
AGE Illness Report 24 hours before arrival (web) Form and Instruction
AGE Illness Report 24 hours before arrival (web) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202603-0920-012 Extension without change of a currently approved collection 2026-03-18
202204-0920-002 Revision of a currently approved collection 2022-04-05 Approved without change
201812-0920-009 New collection (Request for a new OMB Control Number) 2019-03-04 Approved without change

OMB Details

71.21(c) Gastrointestinal Illness Report - 24 and 4 hours before arrival (MIDRS)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form NAGastrointestinal Illness (GI) TemplateNAForm and instruction
Form NAMIDRS Template - screenshotNAForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.