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CDC logo. DHS logo. VARICELLA SURVEILLANCE WORKSHEET For Local Use Only Name State Case I.D. Number LAST / FIRST / MIDDLE Current Address NUMBER CITY / Telephone: Home / STREET / APT. NUMBER COUNTY
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How to fill out varicella surveillance worksheet

How to fill out varicella surveillance worksheet:
01
Begin by gathering all necessary information such as the patient's demographic details, including their name, age, and contact information.
02
Indicate the date of onset of varicella symptoms or rash. This includes noting the exact day and month when the symptoms first appeared.
03
Record any relevant details about the patient's medical history, such as previous varicella infection or vaccination history.
04
Document any complications or additional medical conditions that may be present, such as secondary bacterial infections or immune system disorders.
05
Include information on the duration of the varicella illness, noting the number of days the patient experienced symptoms.
06
Note any interventions or treatments that were provided to the patient, such as antiviral medications or supportive care measures.
07
Specify the patient's current status, whether they have recovered from varicella or if they are still experiencing symptoms.
08
Lastly, sign and date the surveillance worksheet to acknowledge its completion and accuracy.
Who needs varicella surveillance worksheet:
01
Healthcare professionals and medical researchers who are involved in monitoring and tracking varicella cases.
02
Public health agencies and departments responsible for disease surveillance and control.
03
Schools and childcare facilities that require documentation of varicella cases for the safety of their students and staff.
By using a varicella surveillance worksheet, these individuals and organizations can effectively gather and analyze data on varicella cases to inform public health strategies and interventions.
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What is varicella surveillance worksheet?
Varicella surveillance worksheet is a form used to monitor and track cases of chickenpox in a population.
Who is required to file varicella surveillance worksheet?
Healthcare providers, schools, and childcare facilities are required to file varicella surveillance worksheet.
How to fill out varicella surveillance worksheet?
To fill out the varicella surveillance worksheet, you need to provide information about the individuals affected by chickenpox, including symptoms, age, and vaccination history.
What is the purpose of varicella surveillance worksheet?
The purpose of varicella surveillance worksheet is to track and monitor the incidence of chickenpox in a specific population, identify trends, and implement control measures.
What information must be reported on varicella surveillance worksheet?
Information such as the number of cases, age of patients, vaccination status, and any complications must be reported on the varicella surveillance worksheet.
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