Get the free Varicella (Chickenpox) or Zoster (Shingles) Case Report Form - health state mn
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This form is used to report cases of chickenpox and shingles among children and staff in Minnesota child care facilities to the Minnesota Department of Health for surveillance purposes.
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How to fill out varicella chickenpox or zoster
How to fill out Varicella (Chickenpox) or Zoster (Shingles) Case Report Form
01
Start by obtaining the Varicella or Zoster Case Report Form from your local health authority or healthcare provider.
02
Fill out the patient's personal information, including full name, date of birth, and contact details.
03
Provide the date of the onset of symptoms and any relevant medical history.
04
Indicate whether the patient has a confirmed lab diagnosis or a clinical diagnosis.
05
Include information on any previous vaccination against varicella or zoster.
06
Document any complications experienced by the patient due to the infection.
07
Review all entries for accuracy and completeness.
08
Submit the completed form to the appropriate public health department.
Who needs Varicella (Chickenpox) or Zoster (Shingles) Case Report Form?
01
Healthcare providers who diagnose or treat patients with Varicella or Zoster.
02
Public health officials monitoring outbreaks of Chickenpox or Shingles.
03
Patients experiencing symptoms of varicella or zoster who require official documentation.
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People Also Ask about
What is the medical term for varicella zoster virus?
Chickenpox or varicella is a contagious disease caused by the varicella-zoster virus (VZV). The virus is responsible for chickenpox (usually primary infection in non-immune hosts) and zoster or shingles (following reactivation of latent infection).
How do you document chicken pox?
“All histories of varicella illness must be supported by a written statement from a physician or the child's/student's parent or guardian containing wording such as: “This is to verify that (name of student) had varicella disease (chickenpox) on or about (month/day/year) and does not need varicella vaccine” or by
How do you write varicella-zoster virus?
Varicella-Zoster Virus (VZV) Varicella-zoster virus (VZV) is a type of virus that causes chickenpox, shingles and other infections. The virus stays in your body and can reactivate years later. VZV infections can cause a painful or itchy rash, fever and other symptoms, depending on where you're infected.
How do you read varicella-zoster?
0.8 AI or less: Negative - No significant level of detectable varicella- zoster IgG antibody. 0.9-1.0 AI: Equivocal - Repeat testing in 10-14 days may be helpful. 1.1 AI or greater: Positive - IgG antibody to varicella-zoster detected, which may indicate a current or past exposure/immunization to varicella-zoster.
Is varicella and varicella-zoster the same?
Chickenpox or varicella is a contagious disease caused by the varicella-zoster virus (VZV). The virus is responsible for chickenpox (usually primary infection in non-immune hosts) and zoster or shingles (following reactivation of latent infection).
Does varicella need to be reported?
Cases should be reported immediately upon consideration of varicella in the differential diagnosis. zoster is not reportable.
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What is Varicella (Chickenpox) or Zoster (Shingles) Case Report Form?
The Varicella (Chickenpox) or Zoster (Shingles) Case Report Form is a standardized document used to collect essential data about confirmed cases of chickenpox and shingles for public health monitoring and epidemiological purposes.
Who is required to file Varicella (Chickenpox) or Zoster (Shingles) Case Report Form?
Healthcare providers, including physicians and clinics, are typically required to file the Varicella or Zoster Case Report Form when they diagnose a case of chickenpox or shingles in a patient.
How to fill out Varicella (Chickenpox) or Zoster (Shingles) Case Report Form?
The form should be filled out with accurate patient information, including demographics, clinical details, vaccination history, and the date of symptom onset. It must be submitted to the relevant public health authority.
What is the purpose of Varicella (Chickenpox) or Zoster (Shingles) Case Report Form?
The purpose of the form is to track the incidence of chickenpox and shingles, monitor outbreaks, guide public health interventions, and assess vaccine effectiveness.
What information must be reported on Varicella (Chickenpox) or Zoster (Shingles) Case Report Form?
Information that must be reported includes patient identifiers, date of birth, clinical symptoms, vaccination status, date of diagnosis, and any relevant epidemiological information such as possible exposure sources.
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