Case name (last, first) Birth date / / Age at symptom onset YearsMonthsAlternate name PertussisPhone Address typeHomeMailingOtherEmail TemporaryWorkStreet address Countywide/State/Zip/County.
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How to fill out the WA DOH 210-041 online
The WA DOH 210-041 form is essential for reporting cases of pertussis. This guide offers comprehensive instructions to help users accurately complete the form online, ensuring all necessary details are provided for effective public health response.
Follow the steps to complete the WA DOH 210-041 form online.
- Click ‘Get Form’ button to access the WA DOH 210-041 form and open it for completion.
- Begin by entering the case name (last, first) and the birth date in the specified format.
- Indicate the age at symptom onset by filling in the years and months.
- Provide any alternate names if applicable.
- Fill in the information regarding pertussis, including phone number and address type (home, mailing, other).
- Complete the demographic section, including the email and residence details.
- In the administrative section, indicate if there is an investigator, the LHJ case ID, and the LHJ notification date.
- Classify the case status as confirmed, investigation in progress, or other applicable status.
- Document the report source, including the reporter organization and name.
- Provide demographic information, including sex at birth, ethnicity, race, and preferred language.
- Complete the employment and school section, indicating if the individual is employed or in school.
- Fill in the communications section with details of the primary healthcare provider and any alternate contacts.
- Document the clinical information regarding symptoms, illness duration, and diagnosis.
- Provide vaccination history and hospitalization details if applicable.
- Complete the risk and exposure section regarding contact history and public health issues.
- Submit all components and ensure that all required fields are completed appropriately.
- After finishing, you can save changes, download, print, or share the completed form.
Start filling out your WA DOH 210-041 form online today to ensure accurate reporting!
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What are the diagnostic criteria for pertussis?
Pertussis classically progresses through three identifiable stages: catarrhal, paroxysmal, and convalescent. Initial symptoms suggesting a mild upper respiratory tract infection are followed by episodes of severe coughing, often accompanied by an inspiratory whoop and posttussive emesis. Cough may persist for weeks.
What are the guidelines for pertussis?
CDC routinely recommends DTaP at 2, 4, and 6 months, at 15 through 18 months, and at 4 through 6 years. CDC routinely recommends Tdap for children ages 7 through 10 years who are not fully vaccinated (see note 1) against pertussis: Single dose of Tdap for those not fully vaccinated (see note 1) or.
What is the gold standard investigation for pertussis?
Culture. Bacterial culture is a highly specific CDC-recommended laboratory test and is considered the gold standard for pertussis diagnosis because it enables strain identification and antimicrobial resistance testing.
Is pertussis reportable?
Pertussis is nationally notifiable and clinicians should notify the appropriate health department of all patients with suspected pertussis. Similarly, diagnostic laboratories should notify health departments of all positive pertussis laboratory results.
Is whooping cough in Washington state?
Recent Washington trends: The number of cases reported each year varies considerably, ranging from 184 to 1026 cases a year since 1995. There is also variation in the rate of reported disease among health jurisdictions, reflecting local outbreaks.
What blood test results for pertussis?
With blood testing, pertussis IgG antibodies will be present in those who have been vaccinated or have had a past infection. IgM and IgA antibodies may indicate recent vaccination or infection and will only be present for a short period of time (2-3 months).
What is the investigation for pertussis?
Polymerase chain reaction (PCR) is an important tool for timely diagnosis of pertussis and is increasingly available to clinicians. PCR is a molecular technique used to detect DNA sequences of the Bordetella pertussis bacterium and unlike culture, does not require viable (live) bacteria present in the specimen.
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