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Get ACUTE FEBRILE RESPIRATORY ILLNESS OUTBREAK REPORT ...

TORY ILLNESS OUTBREAK REPORT FORM COMMUNITY AND CONGREGATE SETTINGS OUTBREAK INFORMATION Outbreak classi cation Con rmed Probable Suspect Pathogen/s identi ed? Yes No Local outbreak tracking number Unknown First onset date Last onset date If yes, specify pathogen/s SETTING INFORMATION Setting type/s (check all settings where illnesses occurred) Community/Non-congregate Congregate/Institution Specify setting type/s (e.g. skilled nursing, jail, school.

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