Get the free Pertussis Disease Fact Sheet, P-00688. Pertussis Disease, Whooping Cough, Fact Sheet...

WISCONSIN DEPARTMENT OF HEALTH SERVICES Division of Public Health P00688 (R. 05/14) Page 1 of 2 Pertussis (Whooping Cough) Disease Fact Sheet What is pertussis? Pertussis is a contagious bacterial

How to fill out pertussis disease fact sheet

How to fill out a pertussis disease fact sheet:

1. Start by gathering the necessary information about the individual affected by pertussis, including their name, age, and contact information.
2. Fill in the medical history section of the fact sheet, providing details about any pre-existing health conditions or allergies that the person may have.
3. Document the symptoms experienced by the individual, such as persistent coughing, difficulty breathing, or fever.
4. Indicate when the symptoms first appeared and if there have been any changes or developments over time.
5. Include information about any medical treatments or medications that have been prescribed for pertussis.
6. Provide details about any laboratory tests or diagnostic procedures that have been conducted to confirm the pertussis diagnosis.
7. Document the dates and locations of any healthcare visits associated with pertussis, including the names of healthcare providers involved.
8. Note any contact the person may have had with others who may also be at risk of contracting pertussis.
9. Include information about vaccination history, including dates and types of pertussis vaccinations received.
10. Review the completed fact sheet for accuracy and make sure all sections are properly filled out.

Who needs a pertussis disease fact sheet?

1. Healthcare professionals who are treating the affected individual require the fact sheet to accurately assess and manage the pertussis case.
2. Public health agencies may need the fact sheet to track and monitor the spread of pertussis in a community.
3. Educational institutions, such as schools or daycares, may require the fact sheet to implement appropriate protocols and inform staff members or parents about potential exposure to pertussis.
4. Individuals who are affected by pertussis and their families may find the fact sheet useful for understanding the disease, its symptoms, and the recommended course of treatment or preventive measures.

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What is pertussis disease fact sheet?

The pertussis disease fact sheet is a document that provides information about the symptoms, transmission, and prevention of pertussis, also known as whooping cough.

Who is required to file pertussis disease fact sheet?

Healthcare providers and facilities are required to file pertussis disease fact sheets with the appropriate health authorities.

How to fill out pertussis disease fact sheet?

The pertussis disease fact sheet can usually be filled out online or submitted in paper form with the required information about the patient's diagnosis and treatment.

What is the purpose of pertussis disease fact sheet?

The purpose of the pertussis disease fact sheet is to help track and monitor cases of pertussis and prevent the spread of the disease through education and awareness.

What information must be reported on pertussis disease fact sheet?

The pertussis disease fact sheet typically requires information such as the patient's name, age, date of diagnosis, vaccination history, and contact information.