National Outbreak Reporting System : Waterborne disease transmission
Corporate Authors:National Center for Emerging and Zoonotic Infectious Diseases (U.S.). Division of Foodborne, Waterborne, and Environmental Diseases. Waterborne Disease Prevention Branch.
Description:This form is used to report waterborne disease outbreaks. Pages 1-5 ask for the minimum or basic information about the outbreak investigation, epidemiological data, and clinical specimen and water test results. These are followed by sections specific to the type of water exposure. Only 1 of the 5 water exposure sections should be completed.
Public reporting burden of this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC, Project Clearance Officer, 1600 Clifton Road, MS D-24, Atlanta, GA, 30333, ATTN: PRA (0920-0004) <--DO NOT MAIL CASE REPORTS TO THIS ADDRESS
Form Approved OMB No. 0920-0004
CDC 52.12 Rev. 2 2013
Supporting Files:No Additional Files
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