Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adenovirus Typing Report Form Unchanged 52 13 0 Form NA National Adenovirus Type Reporting System (NATRS) Form
Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Modified 2704 451 0 Form and Instruction n/a Aggregate case counts of person exposed to Highly Pathogenic Avian Influenza (HPAI)
Form and Instruction 0920-0004 Aggregate counts of persons exposed to highly pathogenic avian influenza HPAI_06MAY2024
Antiviral Resistant Influenza Infection Case Report Form Unchanged 171 86 0 Form none Antiviral-Resistant Influenza Infection Case Report
Arthropod (Vector)-Borne Diseases (Non-Human Data) Unchanged 2964 2964 0 Form and Instruction n/a Arthropod (Vector)-Borne Diseases (Non-Human Data)
Human Infection with Novel Influenza A Virus Case Report Form Modified 114 67 0 Form NA Human Infection with Novel Influenza A Virus Case Report Form (addition of Suspected Avian Source)
Form and Instruction 0920-0004 Human Infection with Novel Influenza A Virus Case Report Form 06MAY2024
Human Infections with Novel Influenza A Virus Severe Outcomes Unchanged 57 86 0 Form None Human Infection with Novel Influenza A Virus Severe Outcomes
Influenza Associated Pediatric Mortality Case Report Form Unchanged 114 57 0 Form NA Influenza-Associated Pediatric Mortality Case Report
Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements Unchanged 2964 247 0 Other-Variables for Electronic Reporting
Influenza Virus Electronic year round PHIN-MS Unchanged 156 13 0 Other-Variables for Reporting
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Unchanged 171 71 0 Form None Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form
National Enterovirus Surveillance Report 55.9 Unchanged 240 60 0 Form CDC 55.90 Enterovirus Surveillance System Report Form
National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Unchanged 28600 7150 0 Form CDC 55.83A NREVSS Antigen Detection Worksheet
Form CDC 55.83D NREVSS Polymerase Chain Reaction (PCR) Worksheet
Form CDC 55.83B NREVSS Virus Isolation (culture) Worksheet
Novel Influenza A Virus Case Screening Form Modified 57 14 0 Form None Novel Influenza A Virus Case Screening Form
Form and Instruction 0920-0004 Novel Influenza A Virus Case Screening Form 06MAY2024
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Unchanged 104 78 0 Form and Instruction n/a Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Unchanged 208 52 0 Form and Instruction n/a Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form
Suspect Respiratory Virus Patient Form Unchanged 50 25 0 Form NA Suspect Respiratory Virus Patient Form
U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Unchanged 93600 15600 0 Form CDC 55.20E U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) - Workfolder_CDC 55.20E
US WHO Colloborating Laboratories Influenza Testing Methods Assessment Unchanged 113 19 0 Form NA WHO Collaborating Laboratories Influenza Testing Methods Assessment
Viral Gastroenteritis Outbreak Submission Form Unchanged 100 8 0 Form None Viral Gastroenteritis Outbreak Submission Form
WHO Collaborating Center for Influenza Virus Surveillance Unchanged 2444 407 0 Form NA WHO Collaborating Center for Influenza Virus Surveillance
Total burden requested under this ICR: 134983 27468 0  
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