Clearinghouse Tool

Campylobacter Case Report Form

For surveillance of a confirmed or probable case of campylobacteriosis. 3 page Word Document. Includes a case definition of campylobacteriosis, clinical description, laboratory criteria for diagnosis, and case classification. Content: patient information, source of report, present illness, symptoms, laboratory testing, possible sources of infection during exposure period, and case management information.

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Author WY DOH

Tool Type Epi Questionnaires, Forms/Templates/Checklists

Topic Area Pathogen-Specific Surveillance, Epidemiology Investigation

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