Get the free Influenza-associated Encephalopathy Case Reporting Form - new dhh louisiana

This document serves as a case reporting form for collecting clinical, laboratory, and neuro-imaging results on pediatric cases of influenza-associated encephalopathy, aimed at public health officials

How to fill out influenza-associated encephalopathy case reporting

How to fill out Influenza-associated Encephalopathy Case Reporting Form

1. Download the Influenza-associated Encephalopathy Case Reporting Form from the official health department website.
2. Fill in the patient's demographic information, including name, age, sex, and contact details.
3. Document the patient's medical history, including any previous influenza illnesses and vaccinations.
4. Detail the clinical presentation, including symptoms, onset dates, and the severity of the condition.
5. Record any laboratory results, including influenza virus testing and other relevant investigations.
6. Provide information on the treatment administered and the patient's response to treatment.
7. Include any follow-up details or prognosis related to the patient's condition.
8. Ensure all sections of the form are completed and sign the form.
9. Submit the completed form to the appropriate health authority as directed.

Who needs Influenza-associated Encephalopathy Case Reporting Form?

1. Healthcare providers who diagnose or are treating patients with influenza-associated encephalopathy.
2. Public health officials for monitoring and surveillance of influenza-related complications.
3. Researchers studying the epidemiology and impact of influenza on neurological conditions.

People Also Ask about

What is the CDC protocol for influenza A?

In addition to jurisdiction-specific instructions for sending specimens for subtyping, CDC now recommends that all influenza A positive respiratory specimens from hospitalized patients, especially from those in an ICU, be subtyped for seasonal influenza A viruses [A(H1) and A(H3)] as soon as possible following

What is influenza A associated encephalopathy?

* Influenza-associated encephalopathy or encephalitis (IAE) comprises a spectrum of neurologic syndromes that are triggered by influenza virus infection of the respiratory tract, resulting in a dysregulated host inflammatory response, leading to varying degrees of brain dysfunction, inflammation, or both (2,3).

What is the ICD 10 for encephalopathy due to influenza?

J10. 81 - Influenza due to other identified influenza virus with encephalopathy | ICD-10-CM.

What are reportable diseases to the CDC?

Diseases reportable to the CDC include: Anthrax. Arboviral diseases (diseases caused by viruses spread by mosquitoes, sandflies, ticks, etc.) such as West Nile virus, eastern and western equine encephalitis. Babesiosis. Botulism. Brucellosis. Campylobacteriosis. Cancer. Candida auris, clinical.

Does influenza A need to be reported?

Influenza is a nationally notifiable disease.

Is influenza A reportable disease to CDC?

Human infection with a novel influenza A virus is a nationally notifiable condition reportable to CDC.

Is influenza A nationally notifiable disease?

Novel influenza A virus infection remains on the Nationally Notifiable Condition List using the following notification timeframe: immediately notifiable, urgent (within 24 hours).

How do I report influenza?

Surveillance and reporting Influenza is a nationally notifiable disease – these are diseases that present a risk to public health. Health authorities in each state and territory report new laboratory confirmed cases to us daily through the National Notifiable Diseases Surveillance System.

For pdfFiller’s FAQs

What is Influenza-associated Encephalopathy Case Reporting Form?

The Influenza-associated Encephalopathy Case Reporting Form is a standardized document used to collect information about cases of encephalopathy that are associated with influenza infection, enabling health authorities to monitor and study these rare but serious outcomes.

Who is required to file Influenza-associated Encephalopathy Case Reporting Form?

Healthcare providers, including physicians, nurses, and public health officials, are required to file the Influenza-associated Encephalopathy Case Reporting Form when they encounter a patient who has been diagnosed with encephalopathy linked to influenza.

How to fill out Influenza-associated Encephalopathy Case Reporting Form?

To fill out the Influenza-associated Encephalopathy Case Reporting Form, healthcare providers should provide patient demographic information, details of the influenza infection, clinical symptoms, laboratory results, and any treatments administered, ensuring all relevant sections of the form are completed accurately.

What is the purpose of Influenza-associated Encephalopathy Case Reporting Form?

The purpose of the Influenza-associated Encephalopathy Case Reporting Form is to facilitate the collection of consistent and comprehensive data on cases of encephalopathy related to influenza, aiding in the understanding of the incidence, risk factors, and outcomes associated with this condition.

What information must be reported on Influenza-associated Encephalopathy Case Reporting Form?

The information that must be reported on the Influenza-associated Encephalopathy Case Reporting Form includes patient identification details, symptoms experienced, diagnostic test results, treatment received, and any relevant medical history related to influenza and encephalopathy.