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Confidential for public health use only Outbreak Name: OUTBREAK INVESTIGATION CASE QUESTIONNAIRE Known or Unknown Pathogen Attempt Date Time Outcome 1 / / am / pm 2 / / am / pm 3 / / am / pm 4 / /
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What is outbreak investigation questionnaire?
An outbreak investigation questionnaire is a form used to collect information about suspected or confirmed outbreaks of infectious diseases.
Who is required to file outbreak investigation questionnaire?
Healthcare providers, public health agencies, and other relevant organizations are required to file outbreak investigation questionnaire.
How to fill out outbreak investigation questionnaire?
The questionnaire must be completed with details about the outbreak, including date of onset, symptoms, affected individuals, and potential sources of contamination.
What is the purpose of outbreak investigation questionnaire?
The purpose of the questionnaire is to identify and investigate outbreaks of infectious diseases in order to prevent further spread and protect public health.
What information must be reported on outbreak investigation questionnaire?
Information such as date of onset, symptoms, affected individuals, potential sources of contamination, and any control measures taken must be reported on the questionnaire.
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