[NCEZID] Emerging Infections Program

OMB 0920-0978

The Emerging Infections Programs (EIP) is to 1) detect and monitor emerging pathogens, the diseases they cause, and the factors influencing their emergence, and respond to problems as they are identified, 2) integrate laboratory science and epidemiology to optimize public health practice, 3) strengthen infrastructure to support surveillance and research and to implement prevention and control programs, and to 4) ensure implementation of prevention strategies and communication of public health information about emerging diseases. Surveillance efforts of the core EIP activities generate reliable estimates of the incidence of certain infections and provide the foundation for a variety of epidemiologic studies. This is a request for a non-substantive change. Requested changes represent minor modifications to already-approved instruments to include a limited number of data elements pertaining to COVID-19.

The latest form for [NCEZID] Emerging Infections Program expires 2022-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction
Form HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction
Form HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction
Form HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction
Form HAIC.400.2 Community-Associated CP-CRE Interview Form and Instruction
Form HAIC.400.2 Community-Associated CP-CRE Interview Form and Instruction
Form HAIC.400.12 HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction
Form HAIC.400.12 HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction
Form HAIC.400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction
Form HAIC.400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction
Form HAIC.400.5 CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction
Form HAIC.400.5 CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction
Form HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction
Form HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction
Form HAIC.400.9 HAIC-Surveillance Officer's Survey Form and Instruction
Form HAIC.400.9 HAIC-Surveillance Officer's Survey Form and Instruction
Form HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction
Form HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction
Form FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season Form
Form FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season Form
Form FN.200.10 FoodNET Lab Survey Variable List 2024 Form
Form FN.200.10 FoodNET Lab Survey Variable List 2024 Form
Form HAIC.400.11 CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction
Form HAIC.400.11 CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction
Form HAIC.400.4 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction
Form HAIC.400.4 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction
Form FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction
Form FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form Form and Instruction
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form Form and Instruction
Form ABC.100.3 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction
Form ABC.100.3 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction
Form HAIC.400.1 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form
Form HAIC.400.1 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form
Form HAIC.400.7 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction
Form HAIC.400.7 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction
Form FN.200.8 FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction
Form FN.200.8 FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction
Form FN.200.7 FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction
Form FN.200.7 FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction
Form FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction
Form FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction
Form FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction
Form FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction
Form FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction
Form FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction
Form FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction
Form FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction
Form FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction
Form FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction
Form FN.200.1 FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction
Form FN.200.1 FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction
Form FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction
Form FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction
Form ABC.200.9 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction
Form ABC.200.9 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction
Form FSN.300.1 FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction
Form FSN.300.1 FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction
Form ABC.100.5 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction
Form ABC.100.5 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction
Form ABC.100.2 ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction
Form ABC.100.2 ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction
Form ABC.100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction
Form ABC.100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction
EIP 0920-0978_Non-sub change request_2025 08OCT2024.docx Justification for No Material/Nonsubstantive Change
EIP 0920-0978_Non-sub change request_2025 08OCT2024.docx Justification for No Material/Nonsubstantive Change
Att 2_Collection Instrument Cross walk.docx Supplementary Document
Att 2_Collection Instrument Cross walk.docx Supplementary Document
Att 1 Program ChangesAdjustments_rev 08OCT2024.docx Supplementary Document
Att 1 Program ChangesAdjustments_rev 08OCT2024.docx Supplementary Document
Att. 6-Explanation for Program Changes.docx Supplementary Document
Att. 6-Explanation for Program Changes.docx Supplementary Document
Att. 5-Human Subjects Determination Memo.pdf Supplementary Document
Att. 5-Human Subjects Determination Memo.pdf Supplementary Document
Att. 4a-Privacy Impact Assessment.pdf Supplementary Document
Att. 4a-Privacy Impact Assessment.pdf Supplementary Document
Att. 2-Federal Register 60day FRN.pdf Supplementary Document
Att. 2-Federal Register 60day FRN.pdf Supplementary Document
Att. 1-Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
Att. 1-Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
2. Supporting Statement B_EIP OMB 2024 Revision.docx Supporting Statement B
2. Supporting Statement B_EIP OMB 2024 Revision.docx Supporting Statement B
1. Supporting Statement A_EIP OMB 2024 Revision.docx Supporting Statement A
1. Supporting Statement A_EIP OMB 2024 Revision.docx Supporting Statement A
Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction
Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction
2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction
2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction
Community-Associated CP-CRE Interview Form and Instruction
Community-Associated CP-CRE Interview Form and Instruction
HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction
HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction
2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction
2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction
CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction
CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction
Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction
Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction
HAIC-Surveillance Officer's Survey Form and Instruction
HAIC-Surveillance Officer's Survey Form and Instruction
Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction
Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction
FluSurv-NET Laboratory Survey 2023–2024 Season Form
FluSurv-NET Laboratory Survey 2023–2024 Season Form
FoodNET Lab Survey Variable List 2024 Form
FoodNET Lab Survey Variable List 2024 Form
CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction
CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction
Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction
Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction
FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction
FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction
ABCs Severe GAS Infection: Supplemental Form Form and Instruction
ABCs Severe GAS Infection: Supplemental Form Form and Instruction
2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction
2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction
2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form
2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form
CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction
CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction
FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction
FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction
FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction
FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction
FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction
FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction
FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction
FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction
FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction
FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction
FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction
FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction
FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction
FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction
FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction
FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction
FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction
FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction
FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction
FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction
ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction
ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction
2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction
2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction

All Historical Document Collections

202410-0920-009 Approved with change	No material or nonsubstantive change to a currently approved collection	2024-10-09
202406-0920-004 Approved without change	Revision of a currently approved collection	2024-07-26
202312-0920-011 Approved with change	No material or nonsubstantive change to a currently approved collection	2023-12-29
202309-0920-002 Improperly submitted and continue	No material or nonsubstantive change to a currently approved collection	2023-09-12
202302-0920-009 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-03-01
202204-0920-008 Approved without change	Revision of a currently approved collection	2022-04-25
202112-0920-010 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-12-15
202108-0920-013 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-08-26
202011-0920-004 Approved with change	No material or nonsubstantive change to a currently approved collection	2020-11-16
202009-0920-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-09-09
202007-0920-014 Approved with change	No material or nonsubstantive change to a currently approved collection	2020-07-29
202006-0920-015 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-06-25
201910-0920-008 Approved with change	No material or nonsubstantive change to a currently approved collection	2019-10-29
201902-0920-001 Approved without change	Revision of a currently approved collection	2019-02-27
201808-0920-022 Approved with change	No material or nonsubstantive change to a currently approved collection	2018-08-30
201805-0920-010 Approved without change	No material or nonsubstantive change to a currently approved collection	2018-06-05
201803-0920-010 Approved without change	Revision of a currently approved collection	2018-04-25
201801-0920-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2018-01-24
201705-0920-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-05-04
201612-0920-015 Approved without change	No material or nonsubstantive change to a currently approved collection	2016-12-30
201603-0920-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2016-03-02
201507-0920-003 Approved with change	Revision of a currently approved collection	2015-07-13
201502-0920-009 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-02-17
201501-0920-018 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2015-01-22
201402-0920-016 Approved without change	No material or nonsubstantive change to a currently approved collection	2014-02-28
201309-0920-007 Approved without change	No material or nonsubstantive change to a currently approved collection	2013-09-19
201307-0920-003 Approved without change	New collection (Request for a new OMB Control Number)	2013-07-08

OMB Details

ABCs Case Report Form

Federal Enterprise Architecture: Health - Consumer Health and Safety

Form 0920-0978

2020 ABC Surveillance Case Report

Form and instruction

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