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PERTUSSIS CASE REPORT Vaccine Preventable Disease Control Program (PDC) 3530 Wilshire Blvd. Suite 700 Los Angeles, CA 90010 Phone: (213) 3517800, Fax: (213) 3512782PATIENT DEMOGRAPHICS Patients name
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How to fill out pertussis case report

01
Gather all necessary information about the pertussis case, including the patient's personal details, medical history, and symptoms.
02
Use the prescribed pertussis case report form, if available. Otherwise, create a new document or use a standardized format.
03
Start by entering the patient's name, contact information, and date of birth.
04
Provide details about the patient's immunization history, including dates of previous pertussis vaccinations.
05
Document the onset date of symptoms and describe the specific symptoms experienced by the patient, such as persistent coughing fits and characteristic whooping sounds.
06
Include any laboratory test results or diagnostic procedures conducted, along with their dates and details.
07
Record information about the patient's treatment, including medication administered and their response to treatment.
08
Specify any complications or conditions associated with the pertussis case, such as pneumonia or hospitalization.
09
Finally, ensure that the report is signed, dated, and filed according to the relevant regulations and reporting procedures in your jurisdiction.
10
Review the filled-out form for accuracy and completeness before submitting it.
11
Keep a copy of the pertussis case report for your records.

Who needs pertussis case report?

01
Healthcare professionals and medical practitioners who diagnose and treat patients with suspected or confirmed cases of pertussis need to fill out pertussis case reports.
02
Public health authorities and disease surveillance agencies also require pertussis case reports to monitor the incidence and spread of pertussis, plan public health interventions, and track immunization coverage.
03
Additionally, researchers and scientists studying pertussis may utilize pertussis case reports for epidemiological studies and to contribute to the existing knowledge about the disease.
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Pertussis case report is a form used to report confirmed or suspected cases of pertussis, also known as whooping cough.
Healthcare providers, hospitals, laboratories, and other healthcare facilities are required to file pertussis case reports.
Pertussis case report can be filled out by providing information such as patient demographics, symptoms, lab results, and treatment received.
The purpose of pertussis case report is to track and monitor the spread of pertussis in a community, and to implement control measures to prevent further transmission.
Information such as patient's name, age, address, date of onset of symptoms, vaccination history, lab results, and treatment received must be reported on pertussis case report.
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