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Listeriosis Enhanced Surveillance Form Page 1 of 3A. PATIENT DETAILS (NOTE: FOR NEONATAL CASES, RECORD MOTHERS DETAILS HERE) CIDR EVENT IDATE notified to Dept. PHASE ID HSE areaLHOCountyPatient forenamePatient

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How to fill out listeriosis enhanced surveillance form

01

Download the listeriosis enhanced surveillance form from the appropriate website or request a physical copy from your local health department.

02

Fill in the patient's demographic information, including name, date of birth, and contact information.

03

Provide details about the patient's medical history, including any underlying health conditions or recent illnesses.

04

Document the symptoms the patient is experiencing and when they first started.

05

Record any laboratory test results related to listeriosis or any other relevant health information.

06

Complete the form by including information about the healthcare provider who is treating the patient.

07

Submit the completed form to the appropriate health authority for further review and analysis.

Who needs listeriosis enhanced surveillance form?

01

Healthcare providers who suspect a patient may have listeriosis and need to report and track cases of the disease.

02

Public health officials who are responsible for monitoring and controlling the spread of listeriosis in a community or region.

03

Researchers who are studying listeriosis and need access to comprehensive and accurate data on cases of the disease.

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What is listeriosis enhanced surveillance form?

The listeriosis enhanced surveillance form is a document used to track and monitor cases of listeriosis.

Who is required to file listeriosis enhanced surveillance form?

Healthcare providers and public health authorities are required to file the listeriosis enhanced surveillance form.

How to fill out listeriosis enhanced surveillance form?

The form can be filled out electronically or manually with all relevant information and submitted to the appropriate authorities.

What is the purpose of listeriosis enhanced surveillance form?

The purpose of the form is to gather data on listeriosis cases and prevent future outbreaks.

What information must be reported on listeriosis enhanced surveillance form?

Information such as patient demographics, symptoms, lab results, and possible sources of infection must be reported on the form.

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