Guidelines for the Early Clinical and Public Health Management of ...
Guidelines for the Early Clinical and Public Health Management of ...
Guidelines for the Early Clinical and Public Health Management of ...
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<strong>Guidelines</strong> <strong>for</strong> <strong>the</strong> <strong>Early</strong> <strong>Clinical</strong> <strong>and</strong> <strong>Public</strong> <strong>Health</strong> <strong>Management</strong> <strong>of</strong> Bacterial Meningitis (including Meningococcal Disease)<br />
Contacts’ recording <strong>for</strong>m (sample)<br />
Name <strong>of</strong> index case _____________________________________________________<br />
Address ________________________________ Telephone ________________ CIDR ID number ________________________<br />
Locations assessed – Home Crèche School College dormitory/residence Recreational activity (with close contact)<br />
O<strong>the</strong>r Specify _______________________________________________________________<br />
Contact name Type contact<br />
(household, o<strong>the</strong>r)<br />
Chemoprophylaxis<br />
recommended<br />
(yes/no)<br />
Who administered<br />
(GP/PH/Hospital)<br />
Vaccination<br />
recommended<br />
(yes/no)<br />
Address Telephone number Mobile number O<strong>the</strong>r comment<br />
-93-
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