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Pertussis Surveillance Worksheet Appendix 11 NAME Last First Hospital Record No. Address Street and No. City County Zip Reporting Physician/Nurse/Hospital/Clinic/LabPhone Address Phone DETACH HERE and transmit only lower portion if sent to CDC CDC NETSS id Month Age Day Year 0-120 years 0-11 months 0-52 weeks 0-28 days Age Unknown Y Yes N No U Unk Ethnicity N Native Amer./Alaskan Native A Asian/Pacific Islander B African American Outbreak Associa...
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How to fill out pertussis surveillance worksheet
How to fill out Pertussis Surveillance Worksheet
01
Gather patient information, including name, age, and contact details.
02
Record the patient's vaccination history against pertussis.
03
Document symptoms the patient is experiencing, such as cough duration and other respiratory issues.
04
Indicate any recent exposures to individuals known to have pertussis.
05
Fill in the date of symptom onset and any treatments received.
06
Ensure to sign and date the form before submission.
Who needs Pertussis Surveillance Worksheet?
01
Healthcare professionals diagnosing or treating patients with suspected pertussis.
02
Public health officials requiring case tracking and epidemiological data.
03
Researchers studying the incidence and spread of pertussis.
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People Also Ask about
How do you screen for pertussis?
Diagnosis A nose or throat culture and test. Your healthcare professional takes a mucus sample from the back of the throat, where the nose and throat meet. Blood tests. A blood sample may be taken and sent to a lab. A chest X-ray. This test may be recommended to check for signs of pneumonia due to whooping cough.
What are the guidelines for pertussis?
Children should stay off nursery, school, or work until they have completed 48 hours of appropriate antibiotic treatment, or for 14 days from the onset of coughing if not treated.
Does pertussis need to be reported by law?
Both probable and confirmed pertussis cases should be reported to the National Notifiable Diseases Surveillance System (NNDSS) by the state health department via the National Electronic Telecommunications System for Surveillance (NETSS) or National Electronic Disease Surveillance System (NEDSS).
Do you have to report pertussis to the health department?
Pertussis is a nationally notifiable disease in the United States.
Does pertussis need to be reported to the CDC?
Pertussis is a nationally notifiable disease.
Do you have to report pertussis to health department?
Pertussis is a nationally notifiable disease in the United States.
Does whooping cough need reporting?
Health professionals have a duty of care to report all suspected and confirmed cases to public health to ensure that contacts are managed promptly. Pertussis is a highly contagious, vaccine- preventable, respiratory disease that is caused by the Bordetella pertussis bacterium.
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What is Pertussis Surveillance Worksheet?
The Pertussis Surveillance Worksheet is a tool used for collecting and documenting data on cases of pertussis (whooping cough) to monitor the incidence and spread of the disease.
Who is required to file Pertussis Surveillance Worksheet?
Healthcare providers and laboratories that diagnose pertussis cases are typically required to file the Pertussis Surveillance Worksheet with public health authorities.
How to fill out Pertussis Surveillance Worksheet?
To fill out the Pertussis Surveillance Worksheet, you need to provide information about the patient, including demographics, vaccination history, clinical symptoms, diagnostic test results, and exposure history.
What is the purpose of Pertussis Surveillance Worksheet?
The purpose of the Pertussis Surveillance Worksheet is to track pertussis cases to inform public health responses, implement control measures, and guide vaccination strategies.
What information must be reported on Pertussis Surveillance Worksheet?
The information that must be reported includes patient's name, address, date of birth, vaccination status, symptoms, test results, and any known exposure to pertussis.
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