Get the free HANTAVIRUS PULMONARY SYNDROME SCREENING FORM - publichealth lacounty

This form is used for screening potential cases of Hantavirus Pulmonary Syndrome, gathering patient information, symptoms, laboratory values, and rodent exposure history.

How to fill out hantavirus pulmonary syndrome screening

How to fill out HANTAVIRUS PULMONARY SYNDROME SCREENING FORM

1. Begin by entering your personal information at the top of the form, including your name, date of birth, and contact details.
2. Fill out the section regarding your medical history, noting any previous illnesses or conditions that may be relevant.
3. Answer questions about recent symptoms, such as fever, muscle aches, and difficulty breathing, as these are key indicators of hantavirus infection.
4. Provide information about recent exposure to rodent habitats or contact with potentially infected animals.
5. Sign and date the form at the bottom, confirming that all information provided is accurate to the best of your knowledge.
6. Submit the completed form to the designated healthcare provider or testing facility as instructed.

Who needs HANTAVIRUS PULMONARY SYNDROME SCREENING FORM?

1. Individuals who have experienced symptoms consistent with hantavirus pulmonary syndrome.
2. People who have had direct or indirect exposure to rodent habitats, particularly in regions where hantavirus is known to occur.
3. Healthcare workers assessing patients with potential hantavirus exposure.
4. Anyone advised by a healthcare professional to seek screening based on their symptoms or exposure history.

People Also Ask about

When should you get tested for hantavirus?

Early symptoms such as fever, headache muscle aches, nausea, and fatigue are easily confused with influenza. If you suspect hantavirus disease, see a physician immediately and mention a potential rodent exposure. State laboratories and CDC can confirm a diagnosis through testing.

How serious is hantavirus pulmonary syndrome?

Hantavirus pulmonary syndrome can quickly become life-threatening. Severe disease can result in failure of the heart to deliver oxygen to the body. Each strain of the virus differs in severity. The death rate due to the strain carried by deer mice ranges from 30% to 50%.

How do you test for hantavirus pulmonary syndrome?

Because hantavirus resembles these infections, a blood test is often the only way to officially diagnose it.

How soon can you test for hantavirus?

Diagnosing hantavirus in a person who has been infected less than 72 hours is difficult. If the initial test is done before the virus can be found, repeat testing is often done 72 hours after symptom start. Early symptoms such as fever, headache muscle aches, nausea, and fatigue are easily confused with influenza.

Can HPS be passed from one person to another?

HPS in the United States cannot be transmitted from one person to another. You cannot get the virus from touching or kissing a person who has HPS or from a health care worker who has treated someone with the disease.

Will hantavirus pulmonary syndrome go away?

There is no specific treatment for hantavirus infection. However, if the virus is caught early and the patient receives medical care in an intensive care unit (ICU), they will likely improve.

How would I know if I had hantavirus?

In most recorded cases, symptoms develop 1 to 8 weeks after exposure. Early symptoms, such as fever, dry cough, body aches, headaches, diarrhea and abdominal pain, are similar to many other viral illnesses. This may prevent an HPS diagnosis before the illness progresses.

For pdfFiller’s FAQs

What is HANTAVIRUS PULMONARY SYNDROME SCREENING FORM?

The Hantavirus Pulmonary Syndrome Screening Form is a document used to gather information on individuals who may have been exposed to hantavirus and are exhibiting symptoms that could indicate hantavirus infection.

Who is required to file HANTAVIRUS PULMONARY SYNDROME SCREENING FORM?

Individuals who show symptoms of hantavirus infection and have a documented potential exposure, as well as healthcare providers diagnosing or treating patients exhibiting these symptoms, are required to file the form.

How to fill out HANTAVIRUS PULMONARY SYNDROME SCREENING FORM?

The form should be filled out by providing personal identification information, details about symptoms, history of potential exposures, and any relevant medical history as guided by the instructions on the form.

What is the purpose of HANTAVIRUS PULMONARY SYNDROME SCREENING FORM?

The purpose of the form is to facilitate the early detection and reporting of hantavirus pulmonary syndrome cases, allowing for timely medical intervention and control measures to prevent outbreaks.

What information must be reported on HANTAVIRUS PULMONARY SYNDROME SCREENING FORM?

The form requires reporting of personal information (name, age, contact details), symptoms experienced, potential exposure history (including locations and environmental factors), and any relevant medical conditions or test results.