Get the free Congenital Syphilis Case Investigation and Reporting Form ... - cdc

Revised 05/09/2013 Congenital Syphilis Case Investigation and Reporting Form Instructions Note: These instructions accompany the Congenital Syphilis Case Investigation and Reporting Form, CDC 73.126,

How to fill out congenital syphilis case investigation

How to fill out congenital syphilis case investigation?

1. Obtain the necessary forms or documents for the congenital syphilis case investigation. These may include a case investigation form, laboratory reports, and medical records.
2. Start by collecting the basic information about the patient. This should include their name, age, gender, contact information, and any relevant identification numbers or codes.
3. Record the details of the patient's medical history, including any previous diagnoses or treatments for syphilis. Note any symptoms that the patient is currently experiencing or has experienced in the past.
4. Collect information about the patient's mother, including her name, age, and contact information. Record any details about the mother's medical history and any pregnancies she has had.
5. Document the timing and results of any syphilis tests conducted on the mother during pregnancy. Include information about the type of test performed, the date it was conducted, and the results.
6. Record any information about the infant, including their name, date of birth, and contact information if applicable. Note any signs or symptoms of congenital syphilis that the infant may be experiencing.
7. Document the timing and results of any syphilis tests conducted on the infant. Include information about the type of test performed, the date it was conducted, and the results.
8. Record any treatment that has been provided to the patient or the infant for syphilis. Include the type of treatment, the dates it was administered, and any follow-up testing that has been conducted.
9. Finally, review and verify all the information you have collected to ensure its accuracy and completeness. Make sure all required fields have been filled out and any necessary signatures or approvals have been obtained.

Who needs congenital syphilis case investigation?

1. Healthcare professionals involved in the care of pregnant women or infants, particularly those at higher risk for syphilis, should conduct congenital syphilis case investigations.
2. Public health departments and agencies may also require congenital syphilis case investigations to monitor disease trends, implement prevention strategies, and ensure appropriate treatment and follow-up care.
3. In some cases, researchers and epidemiologists may also need access to congenital syphilis case investigation data to study the disease, understand its impact, and develop interventions to reduce its prevalence.

For pdfFiller’s FAQs

What is congenital syphilis case investigation?

Congenital syphilis case investigation is a process of gathering information about cases of syphilis in newborns and evaluating the potential sources and routes of transmission.

Who is required to file congenital syphilis case investigation?

Healthcare providers, hospitals, and laboratories are required to file congenital syphilis case investigation.

How to fill out congenital syphilis case investigation?

Congenital syphilis case investigation can be filled out by documenting detailed information about the mother, newborn, treatment, and follow-up care.

What is the purpose of congenital syphilis case investigation?

The purpose of congenital syphilis case investigation is to prevent the spread of syphilis, ensure proper treatment for affected newborns, and identify potential sources of infection.

What information must be reported on congenital syphilis case investigation?

Information such as maternal history of syphilis, newborn testing results, treatment received by both mother and newborn, and follow-up care must be reported on congenital syphilis case investigation.

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