Justification for Change

National Notifiable Diseases Surveillance System (NNDSS)

OMB Control Number 0920-0728

Expiration Date: 01/31/2019

Program Contact

Umed Ajani

Associate Director for Surveillance

Division of Health Informatics and Surveillance

Center for Surveillance, Epidemiology and Laboratory Services

Centers for Disease Control and Prevention

1600 Clifton Rd, MS-E91

Atlanta, GA 30329

Phone: (404) 498-0258

E-mail: uajani@cdc.gov

Submission Date: June 1, 2016

Circumstances of Change Request for OMB 0920-0728

This is a nonmaterial/non-substantive change request for OMB No. 0920-0728, expiration date 01/31/2019, for the reporting of Nationally Notifiable Diseases. The National Notifiable Diseases Surveillance System (NNDSS) is the nation’s public health surveillance system that enables all levels of public health (local, state, territorial, federal and international) to monitor the occurrence and spread of the diseases and conditions that the Council of State and Territorial Epidemiologists (CSTE) has officially designated as either “nationally notifiable” or as under “national surveillance.” The NNDSS facilitates the submission and aggregation of case notification data voluntarily submitted to CDC from 57 jurisdictions: health departments in every U.S. state, New York City, Washington DC, and 5 U.S. territories (American Samoa, the Commonwealth of Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands). NNDSS also facilitates relevant data management, analysis, interpretation and dissemination of the information. The data are used to monitor health occurrence of notifiable conditions and to plan and conduct prevention and control programs at the state, territorial, local and national levels.

This request is for the addition of 32 new disease-specific data element for Hantavirus Pulmonary Syndrome (HPS).

Previously, only core NNDSS data elements were collected for HPS. A new HPS-specific tab has been created within the NNDSS data spreadsheet (Attachment 7). Information on a patient’s background, exposure information, clinical information, and specimen information are necessary to properly identify cases of HPS. The inclusion of data indicating use of extracorporeal membrane oxygenation (ECMO) for patient treatment follows from hospitals’ increasingly routine use of this intervention, where blood is oxygenated outside the body, to improve outcomes. The question on whether patient sought treatment before hospitalization is a tool to learn whether a patient may have visited a traditional healer before coming to the hospital, and whether such postponement of hospital treatment influences outcome.

The new data elements requiring the change request are in the following table:

New HPS Data Elements

Data Element Identifier	Data Element Name	Data Element Description
TBD	Last Name	Patient's last name
TBD	First Name	Patient's first name
TBD	Middle Initial	Patient's middle initial
TBD	Occupation	Patient's occupation
TBD	History of rodent exposure 8 weeks prior to illness onset	Did patient have history of rodent exposure during 8 week period prior to illness onset?
TBD	If yes, type of rodent exposure	If rodent exposure occurred, what was the type of exposure?
TBD	Exposure occurred while cleaning	Did exposure occur while cleaning?
TBD	Exposure occurred while working	Did exposure occur while working?
TBD	Exposure during recreational activity (camping, hiking)	Did exposure occur during a recreational activity?
TBD	Other exposure?	Other types of exposure? (Explain)
TBD	Fever >101F (38.3C)	Did patient have a fever >101F (38.3C)?
TBD	Thrombocytopenia (<150,000)	Did patient have thrombocytopenia (<150,000)?
TBD	Elevated hematocrit	Did patient have elevated hematocrit?
TBD	Elevated creatinine	Did patient have elevated creatinine?
TBD	Outcome of illness	What was the outcome of the illness?
TBD	Autopsy performed	If patient died, was autopsy performed?
TBD	Autopsy findings	Describe autopsy findings
TBD	Did patient seek care before admission	Did patient seek care before admission?
TBD	Date of pre-hospital treatment	Date of pre-hospital treatment
TBD	Outcome of treatment	What was the outcome of treatment (sent home, diagnosed as flu, etc)?
TBD	Supplemental oxygen required	Did the patient require supplemental oxygen?
TBD	Was patient on ECMO	Was patient on extracorporeal membrane oxygenation (ECMO)?
TBD	Was patient intubated	Was the patient intubated?
TBD	CXR with unexplained bilateral interstitial infiltrates or suggestive of ARDS	Did patient have chest x-ray (CXR) with unexplained bilateral interstitial infiltrates or suggestive of acute respiratory distress syndrome (ARDS)?
TBD	Notes on clinical course of illness	Describe clinical course of illness
LAB163	Specimen collection date	Specimen collection date
LAB203	Type of specimen	Type of specimen collected
LAB143	If specimen tested, at which laboratory	If specimen tested, at which laboratory?
LAB208	Test results	Test results (i.e. titer, IgM, IgG)
TBD	Name of patient’s physician	Name of patient’s physician
TBD	Physician's email	Physician's email
TBD	Physician's phone number	Physician's phone number

Burden

The annualized burden hours and cost to reporting jurisdictions to submit these data to CDC does not change from the original estimates in the “Estimates of Annualized Burden Hours and Costs” section in A.12 of OMB No. 0920-0728. The addition of new disease-specific data elements will not add any additional burden because the reporting jurisdictions already collect those data elements. There will be no increase in burden for the reporting jurisdictions to send those data elements to CDC since most case notifications are submitted electronically from already existing databases via automated electronic transfers. CSTE recommends that jurisdictions collect these data for their own surveillance purposes. Requesting jurisdictions to submit these data (that they will already collect) to CDC will not increase the burden to the jurisdictions.

A.12A. Estimates of Annualized Burden Hours

Respondents	Number of Respondents	Number of Responses per Respondent	Average Burden Per Response (in hours)	Total Burden (in hours)
Weekly and Annual Submissions
States	50	52	10	26000
Territories	5	52	5	1300
Cities	2	52	10	1040
Total				28,340

A.12B. Estimates of Annualized Cost Burden

Type of Respondents	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden Per Response (in hours)	Total Burden Hours	Hourly Wage Rate	Respondent Cost
States	Weekly and Annual	50	52	10	26,000	$35.63	$926,380
Territories	Weekly and Annual	5	52	5	1,300	$35.63	$46,319
Cities	Weekly and Annual	2	52	2	1,040	$35.63	$37,055
Total							$1,009,754

5