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Get Pertussis Case Report Form
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How to fill out the Pertussis Case Report Form online
This guide provides detailed instructions on how to effectively complete the Pertussis Case Report Form online. By following these steps, users can ensure accurate and thorough reporting of pertinent information related to pertussis cases.
Follow the steps to accurately complete the form online.
- Press the ‘Get Form’ button to access the form and open it for editing.
- Begin by entering the case name in the designated fields, including first name, surname, and date of birth. Ensure that the information matches official records.
- Fill out the notification section, including the Notification ID, date of initial response, and details of the notifier and their organization.
- Complete the case details section by providing personal information, including age, sex, and language preference. Specify if the individual identifies as Aboriginal or Torres Strait Islander.
- In the clinical details section, record the symptoms experienced, their onset dates, and cough duration. Indicate whether treatment occurred and if complications arose.
- Provide laboratory test results, including date of the first specimen and the findings associated with pertussis.
- Outline exposure periods and ascertain if there was contact with confirmed or suspected cases. Include names and contact types where required.
- State the vaccination details, including doses received and the source of vaccination history.
- Document the infectious period and list any antibiotics administered if applicable.
- Indicate attendance at any childcare, school, or healthcare facilities during the infectious period, and mention if exclusions were enforced.
- Complete the notification decision and provide details for contact management, including the types and numbers of contacts for any recommended antibiotics.
- Finally, review all the entered information for accuracy and completeness. Save changes, download, print, or share the completed form as needed.
Start completing the Pertussis Case Report Form online today to ensure timely reporting and management.
The best sample for diagnosing pertussis is a nasopharyngeal aspirate, as it yields the most reliable results. This type of specimen captures the bacteria effectively during the illness's early stages. Always document the sample collection in the Pertussis Case Report Form to maintain accurate records.
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