Get the free MEASLES SURVEILLANCE WORKSHEET - NJ.gov
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APPENDIX 10Measles Surveillance Worksheet NAME (Last, First)Hospital Record No.Address (Street and No.)CityCountyReporting Physician/Nurse/Hospital/Clinic/LabAddressZipPhone Phone DETACH HERE and
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How to fill out measles surveillance worksheet
How to fill out measles surveillance worksheet
01
Start by gathering necessary information such as patient demographics, travel history, vaccination status, and symptoms.
02
Record the date of onset of symptoms and date of diagnosis.
03
Fill out the specific sections of the worksheet related to clinical presentation, laboratory testing, and contact tracing.
04
Ensure all fields are completed accurately and legibly.
05
Submit the completed measles surveillance worksheet to the appropriate health authority.
Who needs measles surveillance worksheet?
01
Healthcare professionals responsible for reporting and monitoring cases of measles.
02
Public health officials and organizations involved in disease surveillance and control.
03
Laboratories conducting tests for measles diagnosis.
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What is measles surveillance worksheet?
The measles surveillance worksheet is a standardized form used for collecting and reporting data related to measles cases to monitor and control outbreaks of the disease.
Who is required to file measles surveillance worksheet?
Healthcare providers, public health officials, and laboratories that diagnose measles cases are typically required to file the measles surveillance worksheet.
How to fill out measles surveillance worksheet?
To fill out the measles surveillance worksheet, gather all pertinent patient information, including demographics, clinical data, vaccination history, and laboratory results, then complete each section of the worksheet accurately.
What is the purpose of measles surveillance worksheet?
The purpose of the measles surveillance worksheet is to ensure accurate tracking and reporting of measles cases, which helps in monitoring disease trends, implementing control measures, and preventing outbreaks.
What information must be reported on measles surveillance worksheet?
The information reported on the measles surveillance worksheet must include patient demographics, clinical symptoms, vaccination status, exposure details, and laboratory test results.
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