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This form is used for reporting cases of pertussis, including details about the interview, demographics, clinical information, laboratory results, epidemiological factors, investigation of symptoms
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How to fill out pertussis supplemental reporting form
How to fill out Pertussis Supplemental Reporting Form
01
Obtain the Pertussis Supplemental Reporting Form from your local health department or relevant health authority.
02
Read the instructions carefully at the top of the form to understand the requirements.
03
Fill in the patient’s personal information, including name, date of birth, gender, and contact information.
04
Provide detailed information about the clinical presentation, including symptoms, duration, and onset date.
05
Include vaccination history of the patient regarding pertussis and other relevant vaccinations.
06
Record any laboratory results that confirm a pertussis diagnosis, such as PCR or culture results.
07
Fill in any historical information that could be relevant, such as recent exposures to respiratory illnesses.
08
Review the completed form for accuracy and completeness before submission.
09
Submit the filled form to the appropriate health department or agency as instructed.
Who needs Pertussis Supplemental Reporting Form?
01
Healthcare providers diagnosing or treating patients with suspected or confirmed pertussis.
02
Public health officials needing data for disease surveillance and control.
03
Researchers or epidemiologists analyzing pertussis trends.
04
School officials for reporting outbreaks in educational settings.
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People Also Ask about
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.
Is whooping cough reportable to public health?
Cases of pertussis should be reported to the local health authority.
Does whooping cough need to be reported to the CDC?
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).
Does pertussis get reported?
State health departments then report pertussis cases to CDC through the National Notifiable Diseases Surveillance System (NNDSS). NNDSS is useful for monitoring epidemiologic trends in disease over time.
Is Bordetella pertussis reportable?
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 health department?
Surveillance and reporting Pertussis is a nationally notifiable disease in the United States. Get information on: CDC's data systems.
Where do I report pertussis?
National Notifiable Diseases Surveillance System Diagnostic laboratories should notify health departments of all positive pertussis laboratory results. State health departments then report pertussis cases to CDC through the National Notifiable Diseases Surveillance System (NNDSS).
Does pertussis have to be reported?
Pertussis is a nationally notifiable disease and clinicians should report suspected or confirmed pertussis to the appropriate health department. Similarly, diagnostic laboratories should notify health departments of all positive pertussis laboratory results.
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What is Pertussis Supplemental Reporting Form?
The Pertussis Supplemental Reporting Form is a document used to collect additional data related to cases of pertussis (whooping cough) to help public health agencies monitor and control the disease.
Who is required to file Pertussis Supplemental Reporting Form?
Healthcare providers and institutions that diagnose or treat patients with pertussis are typically required to file the Pertussis Supplemental Reporting Form.
How to fill out Pertussis Supplemental Reporting Form?
To fill out the Pertussis Supplemental Reporting Form, you should gather patient information, including demographics, clinical details, and laboratory findings, and then accurately complete each section of the form as per the guidelines provided.
What is the purpose of Pertussis Supplemental Reporting Form?
The purpose of the Pertussis Supplemental Reporting Form is to gather comprehensive data on pertussis cases to identify trends, aid in outbreak investigation, and improve vaccination strategies.
What information must be reported on Pertussis Supplemental Reporting Form?
The information that must be reported includes the patient's name, contact information, date of onset of symptoms, vaccination history, clinical presentation, lab results, and any relevant epidemiological data.
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