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This document serves as a case report form to collect detailed information on individuals infected with a novel influenza A virus, including demographic information, symptoms, clinical course, treatment,
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How to fill out Human Infection with Novel Influenza A Virus Case Report Form

01
Begin by entering the date of the report at the top of the form.
02
Complete the patient's demographic information including name, age, sex, and address.
03
Provide contact information for the patient or a responsible party.
04
Document the patient's medical history relevant to the illness.
05
Record the date of symptom onset and any clinical signs observed.
06
Detail any recent travel history or known exposure to infected individuals.
07
Include laboratory test results confirming the presence of the Novel Influenza A Virus.
08
Indicate any treatment administered to the patient.
09
Provide additional notes or comments in the designated section.
10
Review the form for accuracy and completeness before submission.

Who needs Human Infection with Novel Influenza A Virus Case Report Form?

01
Public health officials need the Human Infection with Novel Influenza A Virus Case Report Form to track and investigate cases.
02
Healthcare providers should fill out the form when diagnosing a patient with novel influenza.
03
Epidemiologists require the data for research and to implement preventive measures.
04
Laboratories must use this form for reporting confirmed cases of the virus.
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People Also Ask about

From the CDC's (Flu) Viruses of Special Concern webpage: "A novel influenza A virus is one that has caused human infection, but is different from current seasonal human influenza A viruses that circulate among people. Novel influenza A viruses are usually influenza A viruses that circulate among animals.
Influenza A viruses are the only influenza viruses known to cause flu pandemics (i.e., global epidemics of flu disease). A pandemic can occur when a new and different influenza A virus emerges that infects people, has the ability to spread efficiently among people, and against which people have little or no immunity.
Flu can cause mild to severe illness, and at times can lead to death. Flu symptoms usually come on suddenly. People who have flu often feel some or all of these signs and symptoms: fever* or feeling feverish/chills.
Flu can cause mild to severe illness, and at times can lead to death.
ICD-10 Coding Tips for Influenza TypeCode Type A, H1N1 J09.X2 Type B J10.- Type C J10.- Unspecified J11.12 more rows

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The Human Infection with Novel Influenza A Virus Case Report Form is a standardized document used by public health authorities to collect and report cases of human infections caused by novel strains of the influenza A virus.
Healthcare providers, such as physicians and hospitals, are required to file the Human Infection with Novel Influenza A Virus Case Report Form when they diagnose a confirmed case of novel influenza A virus infection.
To fill out the form, healthcare providers should gather relevant patient information, including clinical details, laboratory results, travel history, and exposure history, and enter this information into the designated fields of the form.
The purpose of the form is to facilitate the surveillance and monitoring of novel influenza A virus infections, helping public health officials to identify outbreaks, detect patterns, and implement necessary control measures.
The report must include patient demographics, clinical symptoms, laboratory confirmation details, travel history, exposure to infected animals, and any other relevant epidemiological data.
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