WA DOH 210-041 2012 free printable template

LBJ Use ID Reported to DOH Date / / LBJ Classification Confirmed Probable Suspect By: Lab Clinical EPI Link: Pertussis County REPORT SOURCE LBJ notification date / / Investigation start date / / Reporter

How to fill out WA DOH 210-041

How to fill out WA DOH 210-041

1. Begin by downloading the WA DOH 210-041 form from the Washington State Department of Health website.
2. Fill in the personal information section with your full name, address, and contact information.
3. Provide details about the service or request you are making in the designated section.
4. If applicable, include any supporting documentation or additional information required.
5. Review the form for accuracy and completeness before submission.
6. Submit the completed form via the specified method (mail, fax, or online portal) as indicated in the instructions.

Who needs WA DOH 210-041?

1. Individuals applying for a specific service or requesting information from the Washington State Department of Health.
2. Healthcare professionals who need to submit relevant information related to public health.
3. Organizations or facilities seeking to comply with state health regulations.

People Also Ask about

What is the period of communicability of pertussis?

When and for how long is a person able to spread pertussis? A person can transmit pertussis from 7 days following exposure to three weeks after the onset of coughing episodes. The period of communicability is reduced to 5 days with antibiotic therapy.

What is the rate of pertussis in Washington state?

The overall year‐to‐date incidence rate is 0.3 pertussis cases per 100,000 Washington residents from weeks 1 through 18, with an incidence rate among infants under one year of age of 2.2 cases per 100,000 (see Table 1). Infants under one year of age are among the most vulnerable to severe pertussis disease.

What is the clinical hallmark of pertussis?

Paroxysms of numerous, rapid coughs due to difficulty expelling thick mucus from the tracheobronchial tree. Long inspiratory effort accompanied by a high-pitched “whoop” at the end of the paroxysms. Cyanosis. Vomiting Exhaustion.

What are the three clinical stages of pertussis?

After an incubation period of 1 to 3 weeks, pertussis infection typically progresses through three distinct stages: the catarrhal phase, the paroxysmal phase, and the convalescent phase.

What are the clinical criteria for pertussis?

A case diagnosed as pertussis by a physician, or a person with a cough lasting ≥2 weeks with ≥1 of the following symptoms: paroxysms (ie, fits) of coughing. inspiratory “whooping” posttussive vomiting (ie, vomiting immediately after coughing) without other apparent cause.

What is a pertussis outbreak?

Whooping cough (pertussis) is an endemic (common) disease in the United States. It is a contagious respiratory illness and spreads easily from person to person. Outbreaks may occur in settings such as schools, child care centers, hospitals, or in large geographic areas.

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What is WA DOH 210-041?

WA DOH 210-041 is a form used by the Washington State Department of Health to collect data related to specific health-related information, possibly including disease reporting or health statistics.

Who is required to file WA DOH 210-041?

Typically, healthcare providers, facilities, or organizations involved in public health reporting may be required to file WA DOH 210-041, especially if they are mandated by law to report certain health conditions or events.

How to fill out WA DOH 210-041?

To fill out WA DOH 210-041, individuals or organizations should carefully read the instructions provided with the form, ensuring that all required fields are completed accurately, and submit the form according to the specified guidelines.

What is the purpose of WA DOH 210-041?

The purpose of WA DOH 210-041 is to facilitate the collection of vital health data to support public health initiatives, monitor disease outbreaks, or evaluate health services in Washington State.

What information must be reported on WA DOH 210-041?

Information that must be reported on WA DOH 210-041 may include patient demographic data, diagnosis information, treatment details, and other relevant health indicators as specified by the form guidelines.