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Botulism Case Report Form Confidential when completed PERSON REPORTING Health Authority: Date Report Received at HU (YYY/MM/DD): IRA FHA VIA NHA VCR Contact attempts (date and time) Name: Last Phone:
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Who needs botulism?
01
Botulism is a serious illness caused by a toxin produced by the bacterium Clostridium botulinum.
02
Anyone can potentially be affected by botulism if they consume contaminated food or drink.
03
However, certain individuals are more vulnerable to the effects of botulism, such as infants, young children, and older adults.
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People with compromised immune systems, certain medical conditions, or who have undergone gastrointestinal surgery may also be at a higher risk of developing botulism.
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It is important to handle and prepare food safely to prevent the growth of the bacteria that causes botulism and to avoid consuming improperly preserved or stored foods.
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If you suspect you or someone you know may have botulism, it is crucial to seek medical attention immediately as it can be a life-threatening condition.
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What is botulism?
Botulism is a rare but serious illness caused by a toxin produced by the bacterium Clostridium botulinum.
Who is required to file botulism?
Healthcare providers are required to file a report with the appropriate health department if they suspect a case of botulism.
How to fill out botulism?
To fill out a report on botulism, healthcare providers must gather information on the patient's symptoms, medical history, and laboratory test results.
What is the purpose of botulism?
The purpose of reporting botulism is to track and investigate cases in order to prevent further spread of the illness.
What information must be reported on botulism?
Information that must be reported on botulism includes the patient's demographics, symptoms, possible sources of exposure, and laboratory findings.
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