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

ICR 202405-0920-001

OMB: 0920-0004

Federal Form Document

Forms and Documents

Document Name	Status
US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form	Unchanged
US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form	Unchanged
Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction	Unchanged
Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction	Unchanged
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction	Unchanged
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction	Unchanged
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction	Unchanged
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction	Unchanged
Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Form and Instruction	Modified
Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Form and Instruction	Modified
Suspect Respiratory Virus Patient Form Form	Unchanged
Suspect Respiratory Virus Patient Form Form	Unchanged
Form CDC 55.20E U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form	Unchanged
Form CDC 55.20E U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form	Unchanged
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form	Unchanged
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form	Unchanged
Adenovirus Typing Report Form Form	Unchanged
Adenovirus Typing Report Form Form	Unchanged
Antiviral Resistant Influenza Infection Case Report Form Form	Unchanged
Antiviral Resistant Influenza Infection Case Report Form Form	Unchanged
Human Infections with Novel Influenza A Virus Severe Outcomes Form	Unchanged
Human Infections with Novel Influenza A Virus Severe Outcomes Form	Unchanged
Influenza Associated Pediatric Mortality Case Report Form Form	Unchanged
Influenza Associated Pediatric Mortality Case Report Form Form	Unchanged
WHO Collaborating Center for Influenza Virus Surveillance Form	Unchanged
WHO Collaborating Center for Influenza Virus Surveillance Form	Unchanged
Human Infection with Novel Influenza A Virus Case Report Form Form	Modified
Human Infection with Novel Influenza A Virus Case Report Form Form	Modified
Novel Influenza A Virus Case Screening Form Form	Modified
Novel Influenza A Virus Case Screening Form Form	Modified
Viral Gastroenteritis Outbreak Submission Form Form	Unchanged
Viral Gastroenteritis Outbreak Submission Form Form	Unchanged
Form CDC 55.83A National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form	Unchanged
Form CDC 55.83A National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form	Unchanged
Form CDC 55.90 National Enterovirus Surveillance Report 55.9 Form	Unchanged
Form CDC 55.90 National Enterovirus Surveillance Report 55.9 Form	Unchanged
ICR Change request memo_OMB 0920-0004 20240503.docx Justification for No Material/Nonsubstantive Change	2024-05-06
ICR Change request memo_OMB 0920-0004 20240503.docx Justification for No Material/Nonsubstantive Change	2024-05-06
Attachment DD 103122NL-NR.pdf Supplementary Document	2023-01-26
Attachment DD 103122NL-NR.pdf Supplementary Document	2023-01-26
Attachment C_Disease Summaries 0920-0004 _2023 FINAL_final.docx Supplementary Document	2023-01-26
Attachment C_Disease Summaries 0920-0004 _2023 FINAL_final.docx Supplementary Document	2023-01-26
Attachment B 60 Day Federal Register Notice.pdf Supplementary Document	2023-01-26
Attachment B 60 Day Federal Register Notice.pdf Supplementary Document	2023-01-26
Authorizing Legislation.pdf Supplementary Document	2023-01-26
Authorizing Legislation.pdf Supplementary Document	2023-01-26
SSB 0920-0004 REINSTATEMENT 2023 FINAL.docx Supporting Statement B	2023-01-26
SSB 0920-0004 REINSTATEMENT 2023 FINAL.docx Supporting Statement B	2023-01-26
SSA 0920-0004 REINSTATEMENT 2023 FINAL_final.docx Supporting Statement A	2023-01-26
SSA 0920-0004 REINSTATEMENT 2023 FINAL_final.docx Supporting Statement A	2023-01-26

IC Document Collections

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