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close this bookCommunicable Disease Control in Emergencies - A Field Manual (WHO - OMS, 2003, 223 p.)
View the document(introduction...)
View the documentACKNOWLEDGEMENTS
View the documentINTRODUCTION
Open this folder and view contentsCHAPTER 1: RAPID ASSESSMENT
Open this folder and view contentsCHAPTER 2: PREVENTION
Open this folder and view contentsCHAPTER 3: SURVEILLANCE
Open this folder and view contentsCHAPTER 4: OUTBREAK CONTROL
Open this folder and view contentsCHAPTER 5: DISEASE PREVENTION AND CONTROL
View the documentANNEX 1: WHO REFERENCE VALUES FOR EMERGENCIES
View the documentANNEX 2: SAMPLE HEALTH SURVEY FORMS
View the documentANNEX 3: NCHS/WHO NORMALIZED REFERENCE VALUES FOR WEIGHT FOR HEIGHT BY SEX
View the documentANNEX 4: SAMPLE WEEKLY SURVEILLANCE FORMS
View the documentANNEX 5: RECOMMENDED CASE DEFINITIONS
View the documentANNEX 6: OUTBREAK INVESTIGATION FORMS
View the documentANNEX 7: ORGANIZATION OF AN ISOLATION CENTRE
View the documentANNEX 8: BASIC LABORATORY SERVICES
View the documentANNEX 9: LABORATORY INVESTIGATION KIT
View the documentANNEX 10: TREATMENT GUIDELINES
View the documentANNEX 11: MANAGEMENT OF THE CHILD WITH COUGH OR DIFFICULTY IN BREATHING6
View the documentANNEX 12: ASSESSMENT AND TREATMENT OF DIARRHOEA
View the documentANNEX 13: FLOW CHARTS FOR SYNDROMIC MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS
View the documentANNEX 14: SAMPLE HEALTH CARD
View the documentANNEX 15: LIST OF WHO GUIDELINES ON COMMUNICABLE DISEASES
View the documentANNEX 16: LIST OF PUBLISHERS
View the documentANNEX 17: GENERAL REFERENCES

ANNEX 6: OUTBREAK INVESTIGATION FORMS

1. Line listing form for suspected cases

Health facility:_____________________

Town/District:_________________________

Date: _____________________


Serial No.

Age

Sex

Location

Date of onset

Laboratory specimen taken (yes/no)

Treatment given

Outcome

Final classificationa


















































































a Final classification: S = suspected case with clinical diagnosis, C = confirmed case with laboratory diagnosis.

2. Outbreak alert form

NAME OF SURVEILLANCE OFFICER:______________________________________

CAMP:_______________

HEALTH CENTRE:_____________

DATE OF REPORT: _______


PLEASE TICK THE DISEASE YOU SUSPECT (If OTHER, specify)


CHOLERA

MEASLES

MENINGITIS

PLAGUE

SHIGELLOSIS

TYPHUS

YELLOW FEVER

OTHER



Suspected

Confirmed


NAME OF PATIENT

_______________________________________

LOCATION

_______________________________________

DATE OF ONSET

_______________________________________

OUTCOME

_______________________________________

SAMPLES TAKEN

_______________________________________

NAME OF LAB WHERE SAMPLES SENT

______________________________________

3. Case investigation form

Health facility:_____________________

Sector:________________________________

Date: _____________________

Province:________________________________


1. IDENTIFICATION

Case No:_______________

Name: _______________

Location: _______________

Date of birth: __/__ /___

Age:____________

Sex:

M

F


2. CLINICAL DATA


Rash:

Y

N


Fever:

Y

N


Cough:

Y

N


3. LABORATORY DATA

Sample:_____________

Date taken: __/__ /___

Lab. received: __/__ /___

Type of test__________

Date of results: __/__ /___

Result:

Pos.

Neg.


4. FINAL CLASSIFICATION

Confirmed:

Laboratory

Date of final diagnosis: __/__ /__


Clinical case

Discarded final diagnosis:________________


5. FIELD INVESTIGATOR

Name:_________________________


Position:________________________

Signature:____________________________