Get the free Influenza-Like Illness & Chickenpox Weekly Reporting Form - DHHR - dhhr wv
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8 Apr 2010 ... Information for Healthcare Providers on Varicella Exposure Management ... For people reporting a history of or presenting with atypical and/or mild cases, assessment by a ... http://www.cdc.gov/vaccines/vpdvac/varicella/survcollect
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How to fill out influenza-like illness amp chickenpox
01
To fill out the influenza-like illness and chickenpox forms, follow these steps:
1.1
Obtain the necessary forms from the relevant healthcare provider or organization.
1.2
Read the instructions carefully to understand the information and details required.
1.3
Start by providing the basic details such as your name, address, date of birth, and contact information.
1.4
Specify the symptoms or signs related to influenza-like illness (flu) that you are experiencing. This can include fever, cough, sore throat, body aches, headache, and fatigue.
1.5
Describe the onset and duration of each symptom, providing as much detail as possible.
1.6
If you have been diagnosed with the flu, mention the date of diagnosis and the healthcare provider who made the diagnosis.
1.7
In regards to chickenpox, list any symptoms you are experiencing such as itchy rash, fever, fatigue, or headache.
1.8
Provide information about when you first noticed the symptoms and how they have progressed.
1.9
If you have been diagnosed with chickenpox, include the date of diagnosis and the healthcare professional who confirmed it.
1.10
Finally, sign and date the form to acknowledge that the information provided is accurate to the best of your knowledge.
02
The influenza-like illness and chickenpox forms are typically required for individuals who:
2.1
Have symptoms that resemble the flu, such as fever, cough, sore throat, body aches, headache, and fatigue. These symptoms could indicate the presence of influenza or other respiratory illnesses.
2.2
Have been diagnosed with the flu by a healthcare professional and need to report their illness for tracking or monitoring purposes.
2.3
Are experiencing symptoms associated with chickenpox, including a characteristic itchy rash, fever, fatigue, or headache. Chickenpox is a viral infection caused by the varicella-zoster virus.
2.4
Have been diagnosed with chickenpox and need to provide information about their illness for documentation or public health reasons.
Note: It is important to consult with a healthcare professional if you suspect you have either the flu or chickenpox, as they can provide appropriate diagnosis, treatment, and guidance.
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What is influenza-like illness amp chickenpox?
Influenza-like illness (ILI) refers to a set of symptoms that resemble those of influenza, including fever, cough, and body aches. Chickenpox is a highly contagious viral infection characterized by an itchy rash and flu-like symptoms.
Who is required to file influenza-like illness amp chickenpox?
Healthcare providers and institutions are typically required to report cases of influenza-like illness and chickenpox to public health authorities to monitor and control outbreaks.
How to fill out influenza-like illness amp chickenpox?
To fill out reports for influenza-like illness and chickenpox, healthcare providers need to include patient demographics, clinical symptoms, diagnosis, treatment, and dates of symptom onset and reporting.
What is the purpose of influenza-like illness amp chickenpox?
The purpose of reporting influenza-like illness and chickenpox is to track disease outbreaks, monitor public health trends, and implement prevention measures to protect community health.
What information must be reported on influenza-like illness amp chickenpox?
Information that must be reported includes patient identification details, symptoms, onset dates, diagnoses, treatment plans, and any relevant travel history or exposure to infected individuals.
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