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Get the free Febrile Respiratory Illness and Severe Respiratory Illness Report Form

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This form is intended to collect Emergency Room-based FRI and SRI information for surveillance in Ontario, encompassing details regarding patient symptoms, travel history, and emergency visits.
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How to fill out Febrile Respiratory Illness and Severe Respiratory Illness Report Form

01
Begin by downloading the Febrile Respiratory Illness and Severe Respiratory Illness Report Form from the appropriate health authority website.
02
Fill in the patient’s personal information, including name, age, gender, and contact details.
03
Record the date of symptoms onset.
04
Indicate the type of illness (Febrile or Severe) being reported.
05
Provide a detailed account of symptoms experienced by the patient.
06
Include any relevant travel history in the past 14 days.
07
List any known contact with individuals diagnosed or suspected of having a respiratory illness.
08
Fill in details of any hospital visits or treatments received.
09
Review the form for accuracy and completeness before submission.
10
Submit the form to the designated health authority according to their guidelines.

Who needs Febrile Respiratory Illness and Severe Respiratory Illness Report Form?

01
Health care providers who are diagnosing and treating patients with respiratory illnesses.
02
Public health officials for monitoring and managing outbreaks of respiratory illnesses.
03
Medical researchers collecting data on the spread of respiratory diseases.
04
Organizations involved in disease control and prevention efforts.
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People Also Ask about

Do get plenty of rest. drink lots of water to loosen any mucus and make it easier to cough up. drink a hot lemon and honey drink to help soothe a cough (not suitable for babies under 1 year old) gargle with warm salty water if you have a sore throat (children should not try this)
Symptoms and Causes Fever. Sore throat. Cough. Runny or stuffy nose. Sneezing. Hoarse voice or loss of voice. Fatigue. Facial pain.
Symptoms of a respiratory tract infection include: a cough – you may bring up mucus (phlegm) sneezing. a stuffy or runny nose. a sore throat. headaches. muscle aches. breathlessness, tight chest or wheezing. a high temperature.
Coughing up blood: If you are coughing up blood, it may be coming from your lungs or upper respiratory tract. Wherever it's coming from, it signals a health problem. Chronic chest pain: Unexplained chest pain that lasts for a month or more — especially if it gets worse when you breathe in or cough — also is a warning sign.
Most viral URIs have to run their course and go away on their own. They usually last one to two weeks. You can ease your symptoms by drinking plenty of water and taking over-the-counter medications. If you have a bacterial infection, your symptoms should start to improve a day or two after starting antibiotics.
How to care for someone with a respiratory illness Know what symptoms to expect. Make sure the patient drinks plenty of fluids and stays hydrated. Encourage the patient to rest. Treat symptoms using over-the-counter medicines as recommended by your health care provider. Watch for signs of an emergency:
When fewer people get sick, everyone's risk of getting sick from contagious diseases goes down. Stay home if you are sick. Avoid close contact with others. Cover coughs and sneezes. Wash your hands often. Get a flu shot.
Language switcher Shortness of breath. Fast breathing, or taking lots of rapid, shallow breaths. Fast heart rate. Coughing that produces phlegm. Blue fingernails or blue tone to the skin or lips. Extreme tiredness. Fever. Crackling sound in the lungs.

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The Febrile Respiratory Illness and Severe Respiratory Illness Report Form is a document used to report cases of respiratory illnesses characterized by fever and severe symptoms, which may indicate a public health threat.
Health care providers, hospitals, and laboratories are typically required to file the Febrile Respiratory Illness and Severe Respiratory Illness Report Form when they encounter cases that meet specific clinical or surveillance criteria.
To fill out the form, the reporter should gather relevant patient information, including clinical symptoms, demographic details, and laboratory findings, and then accurately complete each section of the form based on the patient's condition and medical history.
The purpose of the form is to facilitate the collection of data on respiratory illnesses to monitor trends, identify outbreaks, inform public health responses, and ensure timely intervention.
The report form must include patient demographics, clinical presentation, onset and duration of symptoms, any relevant travel history, laboratory results, and any potential exposure to infectious agents.
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