Get the free Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form - ideha dhmh maryland

This form collects patient information for surveillance of arboviral, encephalitis, and aseptic meningitis cases including clinical and laboratory data.

How to fill out arboviralencephalitisaseptic meningitis surveillance form

How to fill out Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form

1. Obtain the Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form from the health department or relevant agency.
2. Fill in the patient's personal information, including name, age, gender, and contact details.
3. Document the patient's clinical symptoms and the date of onset.
4. Include relevant travel history and any known exposure to vectors or infected animals.
5. Record laboratory test results, including blood tests and cerebrospinal fluid analysis.
6. Provide details on the patient's medical history and any previous infections.
7. Review the completed form for accuracy and completeness.
8. Submit the form to the designated public health authority.

Who needs Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form?

1. Public health agencies for monitoring and controlling Arboviral infections.
2. Healthcare providers for reporting cases of encephalitis and meningitis.
3. Research institutions for epidemiological studies on viral infections.
4. Emergency response teams in outbreak situations.

People Also Ask about

What is arboviral encephalitis?

These are the most common symptoms of encephalitis caused by arboviruses: Headache. Feeling unwell. Drowsiness. Fever. Vomiting. Stiff neck. Muscle soreness or trembling. Confusion.

Which are typical signs and symptoms of arboviral encephalitis?

Severe infection may produce a rapid onset of severe headache, high fever, muscle aches, stiffness in the back of the neck, problems with muscle coordination, disorientation, convulsions and coma. Symptoms usually occur five to 15 days after the bite of an infected mosquito.

What is the main cause of encephalitis?

Dengue. Causing 25,000 deaths a year, dengue is the most common arboviral disease. It's transmitted by Aedes mosquitoes. Infections are more common in Asia, South America, or Africa.

What is the most common cause of arboviral encephalitis?

What causes arbovirus encephalitis? The arboviruses that cause encephalitis are passed on to people and animals by insects. In rural areas, arboviruses that are carried by mosquitoes or ticks are the most common cause of arboviral infection. The infection is often mild.

For pdfFiller’s FAQs

What is Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form?

The Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form is a document used for reporting cases of arboviral infections, encephalitis, and aseptic meningitis to health authorities, helping monitor, track, and respond to outbreaks.

Who is required to file Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form?

Healthcare providers, laboratories, and public health officials are required to file the Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form when they encounter cases that meet specific surveillance criteria.

How to fill out Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form?

To fill out the form, provide patient demographic information, clinical details, date of onset, laboratory results, and any relevant risk factors or exposure history as outlined in the form's instructions.

What is the purpose of Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form?

The purpose of the form is to facilitate the collection and analysis of data on arboviral diseases and related conditions to inform public health responses, guide prevention efforts, and improve overall disease surveillance.

What information must be reported on Arboviral/Encephalitis/Aseptic Meningitis Surveillance Form?

The form must report patient identification, clinical symptoms, laboratory findings, exposure history, and any epidemiological links to other cases or vector activity in the area.