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Get the free ACUTE RESPIRATORY ILLNESS OUTBREAK REPORT FORM - cdph ca

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El formulario para reportar brotes de enfermedades respiratorias agudas en entornos comunitarios y congregados, incluyendo información sobre el brote, el entorno, la información clínica y los factores
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How to fill out ACUTE RESPIRATORY ILLNESS OUTBREAK REPORT FORM

01
Start with the title section and include the name of the reporting facility.
02
Fill in the date of the report submission.
03
Provide the contact information of the person completing the form.
04
Detail the outbreak's start date and the number of affected individuals.
05
Record symptoms observed in affected individuals.
06
Include demographic information of patients, such as age and gender.
07
Note any potential sources of infection or exposure.
08
Describe measures taken to control the outbreak.
09
Provide any laboratory test results if available.
10
Conclude with any additional comments or recommendations.

Who needs ACUTE RESPIRATORY ILLNESS OUTBREAK REPORT FORM?

01
Public health officials
02
Healthcare providers
03
Epidemiologists
04
Local health departments
05
Infection control practitioners
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General- An outbreak is defined as the occurrence of illness in a person or a. group of epidemiologically associated persons, with the rate of frequency. clearly in excess of normal expectations (IDPH Communicable Disease Rules. and Regulations)
Guidelines for writing outbreak investigation reports. Date: Date of report. Half page or less: - What was the problem? - What was done to address the problem? - What was found? - What conclusions were drawn? - What recommendations were made? - What public health actions were taken?
Confirmed Respiratory Infection Outbreak Definition • Two or more patient/resident casesa of test-confirmedb acute respiratory infections (ARI) with symptom onset within 48 hoursc and an epidemiological link (e.g. same unit/floor/service area) suggestive of transmission within the setting.
A disease outbreak is the occurrence of disease cases in excess of normal expectancy. The number of cases varies ing to the disease-causing agent, and the size and type of previous and existing exposure to the agent.
Confirmed Respiratory Infection Outbreak Definition • Two or more patient/resident casesa of test-confirmedb acute respiratory infections (ARI) with symptom onset within 48 hoursc and an epidemiological link (e.g. same unit/floor/service area) suggestive of transmission within the setting.
Outbreak: When there are more disease cases than what is usually expected: For a given time (e.g., within 2 weeks) Within a specific location (e.g., linked by institution, affiliation, exposure, small geographic area) For a target population (e.g., students, long-term care residents)

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The ACUTE RESPIRATORY ILLNESS OUTBREAK REPORT FORM is a standardized document used to report outbreaks of acute respiratory illnesses, collecting essential information to monitor and manage public health risks.
Healthcare providers, public health officials, and institutions such as schools, hospitals, and nursing homes are typically required to file the ACUTE RESPIRATORY ILLNESS OUTBREAK REPORT FORM when an outbreak is suspected or confirmed.
To fill out the form, provide the date of the outbreak, location details, number of cases, symptoms observed, demographic information of affected individuals, and any actions taken. Follow the specific instructions provided with the form.
The purpose of the form is to facilitate timely reporting of respiratory illness outbreaks, aid in tracking and investigating cases, and help public health authorities implement control measures to prevent further spread.
The report must include information such as the number of cases, onset dates, specific symptoms, affected demographics, geographic location, and any known exposure history related to the outbreak.
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