Get the free Guillain-Barré Syndrome Surveillance Case Report - cdph ca

This form is used to report cases of Guillain-Barré Syndrome (GBS) to the California Department of Public Health. It collects detailed patient information, symptoms, past medical history, infection

How to fill out guillain-barr syndrome surveillance case

How to fill out Guillain-Barré Syndrome Surveillance Case Report

1. Begin by providing patient identification details, including name, age, and date of report.
2. Specify the onset date of symptoms and the date of diagnosis.
3. Detail the clinical presentation, including symptoms such as weakness or paralysis.
4. Document any recent vaccinations or infections prior to the onset of symptoms.
5. Include laboratory and diagnostic tests results, if applicable.
6. Describe the patient's medical history, particularly any relevant neurological or autoimmune conditions.
7. Provide information about the treatment administered, including the duration and response.
8. Complete follow-up information to track the patient's recovery progress.
9. Ensure all sections are filled out accurately and in accordance with local health regulations.
10. Submit the report to the appropriate health department or surveillance program.

Who needs Guillain-Barré Syndrome Surveillance Case Report?

1. Healthcare providers diagnosing patients with Guillain-Barré Syndrome.
2. Public health officials monitoring disease trends.
3. Researchers studying the epidemiology of the condition.
4. Patients who require data for treatment history.

People Also Ask about

Who has had Guillain-Barre syndrome?

Rowdy Gaines, American Olympic Gold Medalist in swimming. Andy Griffith, an American actor best known for The Andy Griffith Show and Matlock, developed GBS in 1983. Joseph Heller, author, contracted GBS in 1981. This episode in his life is recounted in the autobiographical No Laughing Matter.

What do you monitor for Guillain-Barre Syndrome?

During the initial phase of GBS, all patients require close monitoring of motor, autonomic (ie, blood pressure, heart rate, and sphincter function), and respiratory function.

Can you live a long life with GBS?

Guillain-Barré syndrome life expectancy People who recover from Guillain-Barrésyndrome have a normal life expectancy. Less than 2% of people die from GBS in the acute phase — when symptoms are at their worst. Common causes of death related to GBS include: Pneumonia.

What are the findings of GBS investigation?

Most, but not all, patients with GBS have an elevated CSF protein level (>400 mg/L), with normal CSF cell counts. Elevated or rising protein levels on serial lumbar punctures and 10 or fewer mononuclear cells/mm3 strongly support the diagnosis.

What football player has Guillain-Barre syndrome?

Former NFL veteran Mark Schlereth talks with NFL Network's Lindsay Rhodes on the struggles he dealt with when diagnosed with Guillain-Barre syndrome, similar to Dallas Cowboys center Travis Frederick, who has taken an indefinite leave of absence from the team.

What singer has Guillain-Barre syndrome?

Singer Sufjan Stevens 'learning to walk again' after rare Guillain-Barré Syndrome diagnosis.

What famous person has GBS?

American actor Andy Griffith developed Guillain–Barré syndrome in 1983. Griffith is seen here receiving an award at the White House in 2005. Ryūtarō Arimura, vocalist for Japanese rock band Plastic Tree: His case was detected and treated early, and Arimura was able to return to touring within three months.

For pdfFiller’s FAQs

What is Guillain-Barré Syndrome Surveillance Case Report?

A Guillain-Barré Syndrome Surveillance Case Report is a standardized document used to collect and report data on cases of Guillain-Barré Syndrome (GBS) for surveillance and research purposes.

Who is required to file Guillain-Barré Syndrome Surveillance Case Report?

Healthcare providers, public health officials, and facilities that diagnose or treat Guillain-Barré Syndrome cases are typically required to file the surveillance report.

How to fill out Guillain-Barré Syndrome Surveillance Case Report?

To fill out the report, healthcare providers should complete all required fields, including patient identification, clinical presentation, diagnostic details, and outcomes, following the specific guidelines provided with the report form.

What is the purpose of Guillain-Barré Syndrome Surveillance Case Report?

The purpose of the report is to monitor trends, understand the epidemiology of Guillain-Barré Syndrome, assess potential associations with vaccines or infections, and support public health responses.

What information must be reported on Guillain-Barré Syndrome Surveillance Case Report?

The report must include patient demographics, clinical symptoms, laboratory findings, treatment details, onset timing, and any relevant medical history associated with Guillain-Barré Syndrome.