Get the free Pertussis Surveillance Worksheet Appendix 11

Pertussis Surveillance WorksheetAppendix 11NAME (Last, First)Hospital Record No. Address (Street and No.) CityCountyZipReporting Physician/Nurse/Hospital/Clinic/LabPhoneAddressPhone PhoneDETACH HERE

How to fill out pertussis surveillance worksheet appendix

How to fill out pertussis surveillance worksheet appendix

1. To fill out the pertussis surveillance worksheet appendix, follow these steps:
2. Start by gathering the necessary information, such as the patient's name, age, and contact details.
3. Record the onset date of symptoms and the date the patient sought medical care.
4. Note any relevant medical history or pre-existing conditions that may be important for surveillance purposes.
5. Document the results of laboratory tests conducted to confirm the diagnosis of pertussis.
6. Include information about any contacts the patient may have had during the communicable period.
7. Provide details on the patient's vaccination history, including dates of previous pertussis immunizations.
8. Submit the completed pertussis surveillance worksheet appendix to the appropriate health authorities.

Who needs pertussis surveillance worksheet appendix?

1. The pertussis surveillance worksheet appendix is needed by healthcare professionals and public health agencies involved in monitoring and tracking pertussis cases. It helps in collecting and analyzing data related to pertussis infections for surveillance purposes.

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What is pertussis surveillance worksheet appendix?

The pertussis surveillance worksheet appendix is a document used to collect and report data on cases of pertussis, also known as whooping cough, in order to monitor outbreaks and assess the effectiveness of vaccination programs.

Who is required to file pertussis surveillance worksheet appendix?

Healthcare providers, laboratories, and public health officials are typically required to file the pertussis surveillance worksheet appendix when they diagnose or detect a case of pertussis.

How to fill out pertussis surveillance worksheet appendix?

To fill out the pertussis surveillance worksheet appendix, individuals must enter patient demographic information, clinical details of the case, laboratory test results if available, and any relevant epidemiological links.

What is the purpose of pertussis surveillance worksheet appendix?

The purpose of the pertussis surveillance worksheet appendix is to facilitate the systematic collection of data that aids in the public health response to pertussis outbreaks and helps inform vaccination strategies.

What information must be reported on pertussis surveillance worksheet appendix?

Information that must be reported includes patient demographics (age, sex, location), clinical symptoms and timeline, laboratory results, vaccination status, and contact history.