Change Request (Feb 2023): Updated descriptors for 3 mpox data elements

National Notifiable Diseases Surveillance System (NNDSS)

OMB Control Number 0920-0728

Expiration Date: 07/31/2025

Program Contact

Umed A. Ajani

Associate Director for Science

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: February 1, 2023

Circumstances of Change Request for OMB 0920-0728

This is a non-substantive change request for OMB No. 0920-0728, expiration date 07/31/2025, for the reporting of Nationally Notifiable Diseases. Information on disease-specific data elements to be modified through this non-substantive change request is enumerated in the table below:

Disease Name in NNDSS Collection	Nationally Notifiable (NNC) OR Under Standardized Surveillance (CSS)	Current Case Notification (Y/N)	Proposed Case Notification (Y/N)	Current Disease-specific Data Elements (Y/N)	Proposed Disease-specific Data Elements (Y/N)	Number of Existing Data Elements in NNDSS	Proposed Number of NNDSS Data Elements to be Modified
Mpox	NNC			Y	Y	60	3

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 CDC and the Council of State and Territorial Epidemiologists (CSTE) officially designate as “nationally notifiable” or as under “standardized surveillance.” The NNDSS program creates the infrastructure for the surveillance system and facilitates the submission and aggregation of case notification data voluntarily submitted to CDC from 60 jurisdictions: public health departments in every U.S. state, New York City, Washington DC, 5 U.S. territories (American Samoa, the Commonwealth of Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands), and 3 freely associated states (Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau). The NNDSS also facilitates relevant data management, analysis, interpretation and dissemination of the information. The data are used to monitor the occurrence of notifiable conditions and to plan and conduct prevention and control programs at the state, territorial, local and national levels.

This request is to change the description for 3 disease-specific data elements that are already approved for mpox.

Mpox

The impetus/urgency for CDC to change the description of data elements for this condition

Since May 2022, clusters of mpox cases, have been reported in 103 countries that do not normally have mpox. As of this writing (27 January 2023) there are over 85,146 confirmed cases globally. Since May 2022, 30,106 confirmed cases in the U.S. have been identified. Most of U.S. cases do not have direct travel-associated exposure risks (i.e., travel to mpox endemic countries). Transmission during close contact and intimate contact is thought to be a major transmission route. NNDSS reporting will enhance the speed, accuracy, and comparability of data capture for monkeypox case notifications during this outbreak, particularly as new states are onboarded. Data collected will inform public health interventions to interrupt disease transmission and identify risk factors for infection. The current OMB-approved mpox data element descriptions for Birth Sex, Sexual Orientation and Gender Identity were derived from the mpox case report form, but do not match the previous OMB-approved NNDSS standards (for hepatitis and STD conditions), which align with the proposed data element descriptions from the United States Core Data for Interoperability (USCDI). To promote ongoing data harmonization efforts, the descriptions for these three data elements need to be updated to the USCDI standards. The data element concepts submitted for OMB approval more accurately reflect surveillance data which is collected by healthcare and/or jurisdictions based on their surveillance systems and processes versus data collection efforts directed by CDC.

Data Element Name	Current Data Element Description	New Data Element Description	Value Set Code	CDC Priority1 (New)
Birth Sex	What sex were you assigned at birth, on your original birth certificate?	Sex assigned at birth	PHVS_Sex_MFU	1
Sexual Orientation	Patient identified sexual orientation (i.e., an individual's physical and/or emotional attraction to another individual of the same gender, opposite gender, or both genders).	A person’s identification of their emotional, romantic, sexual, or affectional attraction to another person	PHVS_SexualOrientation_USCDI	2
Gender Identity	Do you currently describe yourself as male, female, or transgender?	A person’s internal sense of being a man, woman, both, or neither	PHVS_GenderIdentity_USCDI	1

Burden

There is no additional burden incurred by states, territories, freely associated states, or cities to change the description of data elements.

Ref: Attachment 10. Disease-specific Data

1 R=Required; 1=Priority 1, 2=Priority 2, 3=Priority 3

1