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Class A Report Immediately |
Diseases of major public health concern because of the severity of disease or potential for epidemic spread - report by telephone immediately upon recognition that a case, a suspected case, or a positive laboratory result exists. Anthrax Rabies, human Botulism, Food borne Rubella (not congenital) Cholera SARS Diphtheria Smallpox Influenza A - novel virus Tularemia Measles Viral Hemorrhagic Fever Meningococcal Disease Yellow Fever Plague As well as any unexpected pattern of cases, suspected cases, deaths or increased incidence of any other disease of major public health concern, because of the severity of disease or potential for epidemic spread, which may indicate a newly recognized infectious agent, outbreak, epidemic, related public health hazard or act of bioterrorism. A physician's office or hospital can report after normal business hours by dialing the 24 x 7 emergency illness / disease outbreak reporting pager at: (440) 231-4650. |
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Class B(1) Report by the end of the next business day |
Diseases of public health concern needing timely response because of potential for epidemic spread - report by the end of the next business day after the existence of a case, a suspected case or positive laboratory result is known | |
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Class B(2) Report by the end of the work week |
Diseases of significant public health concern - report by the end of the work week after the existence of a case, a suspected case, or a positive laboratory result is known | |
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Class C Report by the end of the next working day |
Report an outbreak, unusual incidence or epidemic (e.g., histoplasmosis, pediculosis, scabies, staphylococcal infections) by the end of the next business day Outbreaks: |
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Community Foodborne Healthcare-associated |
Institutional Waterborne Zoonotic |
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| HIV or STD's | Cases of AIDS (acquired immune deficiency syndrome), AIDS-related conditions, HIV (human immunodeficiency virus) infection, perinatal exposure to HIV, and CD4 T-lymphocytes counts <200 or 14% must be reported on forms and in a manner prescribed by the Director of Health. | |
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The following illness complaint and disease reporting forms are available in Microsoft Word© and Adobe PDF©. Select Microsoft Word if you have Microsoft Office and would like to complete the form on a personal computer. Select PDF to print and fill out the form for faxing to our office. |
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| Illness / Complaint General Questionnaire |
Use this form to report illness symptoms and exposures Fillable PDF |
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| Confidential Communicable Disease Report | This report accompanies the General Questionnaire above when an individual has a suspected,probable, or confirmed communicable disease Microsoft Word PDF | |
| Food History Report |
This report accompanies the General Questionnaire above when the illness or complaint warrants a three to eight-day food history Microsoft Word PDF |
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| Varicella Reporting Form |
Use to report Varicella (chicken pox) incidence Microsoft Word PDF |
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| Other helpful information: |
Flowchart of Epidemiological Reponse CDC - Diseases & Conditions |
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Please fax illness / disease outbreak reports 24x7 to: (440) 285-4305 |
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