August 2022

NNDSS Begins Reconciliation of 2021 Annual Data

CDC expects to begin the process of reconciling 2021 annual NNDSS data in August 2022. CDC uses the annual reconciliation process to confirm that information in jurisdictions’ databases matches information in the CDC NNDSS database before finalizing data for each year.

Jurisdictions should ensure that necessary staff have access to the Message Validation, Processing, and Provisioning System (MVPS) portal. Jurisdiction Data Managers can request access for their jurisdictions’ staff by emailing the CDC Electronic Data Exchange mailbox at edx@cdc.gov with subject: “New MVPS User Access.”

What to Expect

The process of reconciling 2021 data will be very similar to the process used to reconcile 2020 data.

To start the process, a CDC NNDSS surveillance officer will email each jurisdiction a reconciliation packet.

Once a jurisdiction receives their reconciliation packet, an NNDSS surveillance officer will be available to help the jurisdiction through the rest of the reconciliation process. The reconciliation packet will include:

• a letter with an overview of the changes to the reconciliation process for 2021 NNDSS data,
• a production calendar with a timeline of key dates in the process,
• a week-ending calendar for 2021,
• an abbreviated event code list for 2021, and
• a copy of the jurisdiction’s reconciliation tables and instructions for reviewing the reconciliation tables.

During reconciliation, jurisdictions may use the reconciliation tables provided by their NNDSS surveillance officer along with the line list and case summary in the MVPS portal to review CDC NNDSS data and resolve discrepancies.

Jurisdictions should send case notifications to CDC to correct any differences and may request a new set of reconciliation tables at any time.

Jurisdictions should notify their NNDSS surveillance officer to “lock” their data when they have finished reviewing and updating their 2021 NNDSS data. After locking a jurisdiction’s data, the NNDSS surveillance officer will send updated reconciliation tables for final review and sign-off by the State or Territorial Epidemiologist. The deadline for State and Territorial Epidemiologist approval of the final 2021 data is December 1, 2022.

Process for 2021 Final NNDSS COVID-19 Data

The 2021 final NNDSS COVID-19 data will not be reconciled; however, CDC will collect final 2021 NNDSS aggregate COVID-19 case counts.

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  CDC will provide jurisdictions with an Excel spreadsheet containing instructions and information about the aggregate data needed for the 2021 NNDSS tables.

• Jurisdictions will submit their final aggregate case counts in an Epi Info™ web form. The Excel spreadsheet will provide jurisdictions with a preview of the data that will need to be entered into the Epi Info™ web form.
• State and Territorial Epidemiologists will “sign off” on the aggregate 2021 COVID-19 case counts within the Epi Info™ web form.
• CDC will use aggregate case counts in the 2021 NNDSS annual tables.

The tables will include confirmed, probable, and total cases of COVID-19 among U.S. residents, with stratifications by jurisdiction of residence, sex, age group, a combined race and ethnicity field, and month (based on Morbidity and Mortality Weekly Report weeks).

Jurisdictions should plan to send their final aggregate 2021 COVID-19 case counts to CDC by December 1, 2022. This is the same deadline for submitting final 2021 data for other NNDSS conditions.

Learning Resources for NNDSS Reconciliation

CDC has made additional guidance documents with more detailed steps in the NNDSS reconciliation process available within the reconciliation section of the MVPS portal.

CDC provided training on the 2021 reconciliation process during an eSHARE training webinar on August 16, 2022. Visit the eSHARE archives to access the slides and recordings for past eSHARE webinars. CDC typically posts eSHARE slides and recordings a few days after each webinar.

Update on Mpox Case Notification to CDC

CDC is making updates to the mpox case surveillance process. We are transitioning to implementation of the short case report form (sCRF) for reporting mpox cases to CDC and have updated the CDC mpox webpage for health departments with the sCRF and data dictionary.

CDC has retired the processes for reporting cases via the call center and via the original case report form (oCRF) in REDCap. However, CDC will be able to accept bulk upload files with the oCRF data elements for a short time, until jurisdictions can fully transition to the sCRF. All jurisdictions should begin to transition to the sCRF at this time.

For official case counts, the current method for submitting data to CDC is to send data directly to DCIPHER via direct entry, bulk upload, or an application programming interface (API).

CDC is using DCIPHER to compile mpox response data from multiple sources, including all case data from the call center and case report forms. Cases received in DCIPHER prior to the 2pm data cut off will be included in CDC case counts for that day and reflected on the CDC website. Please refer to the updated case reporting page on the website for more details.

How to Send Mpox Case Data to DCIPHER

• Enter the necessary sCRF data directly in the CDC DCIPHER platform or
• Enter the necessary data directly into an existing jurisdictional case surveillance system configured for mpox reporting. Then upload the reporting data to the CDC DCIPHER platform using a CSV file format or using an API.

To ensure timely reporting, initial reports can be submitted to CDC daily with only two minimum required data elements: Local Record ID and Case jurisdiction of residence. CDC asks that these initial records be updated with additional data as soon as possible as case investigations continue.

How to Prepare to Submit Mpox Initial Case Notifications Through NNDSS

Soon, CDC will implement NNDSS reporting for mpox case data. We are currently building the process to incorporate the data from NNDSS into DCIPHER. After onboarding to NNDSS, core data elements will be sent through NNDSS. Disease-specific data elements in the sCRF should still be sent directly to DCIPHER.

To initiate validation for your NNDSS transmission, please email the CDC Electronic Data Exchange mailbox at edx@cdc.gov with the subject “MPX validation.” The validation will confirm your:

• NNDSS submission and
• Case count after we merge data from NNDSS with other cases you have reported to the CDC Mpox Response.

You will be notified when your NNDSS data are being used in DCIPHER for official case counts.

In Case You Missed It: CDC Memorandum to State and Territorial Epidemiologists about Mpox

Position statement 22-ID-10, titled Public Health Reporting and National Notification for Mpox Virus Infection, was approved by the Council of State and Territorial Epidemiologists (CSTE) on June 23, 2022.

Jurisdictions should use the CSTE case definition described in the position statement for cases reported on or before August 1, 2022. Jurisdictions should not retroactively change the classification of cases reported prior to August 1, 2022, based on the new case definition.

CDC will post the mpox national surveillance case definition on the NNDSS case definitions webpage as soon as possible. Until that time, refer to the case definition in the CSTE position statement.

CSTE recommends that all states and territories make mpox virus infection reportable in their jurisdiction. Jurisdictions are encouraged to send all 2022 mpox cases to NNDSS, including all cases from previous months that were reported through the CDC Mpox Call Center, REDCap, DCIPHER direct entry, bulk CSV upload, or API. CDC’s NNDSS has assigned event code 11801 to mpox virus infection.

The CSTE position statement recommends that CDC publish confirmed and probable cases.  The CDC’s Mpox Response team is publishing national summaries and aggregate case data during the outbreak. When CDC begins publishing mypox cases in the NNDSS tables, they will include confirmed and probable cases.

If you have questions about sending mpox data to CDC via NNDSS, please email edx@cdc.gov with the subject line “Mpox reporting questions.”

An eSHARE webinar, “Kick-off for annual reconciliation of 2021 NNDSS data and NNDSS collection of final, aggregate 2021 COVID-19 case counts,” was held on August 16, 2022.

Visit the eSHARE archives to access the slides and recordings for past eSHARE webinars. CDC typically posts eSHARE slides and recordings a few days after each webinar.

To join an eSHARE webinar, please see your calendar invitation or contact the CDC Electronic Data Exchange mailbox at edx@cdc.gov for login information with the subject line “eSHARE invitation.”