Form

Diphtheria: surveillance forms for follow-up of toxigenic cases

HPTs and healthcare practitioners must complete these forms and send them to UKHSA to enable monitoring of diphtheria cases in England.

Applies to England

Documents

Diphtheria: data collection form for asylum seekers (for HPTs)

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@ukhsa.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Diphtheria: national surveillance form for follow-up of confirmed toxigenic cases (for HPTs)

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@ukhsa.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Diphtheria: follow-up of confirmed toxigenic cases for patient outcome (for GPs)

Request an accessible format.
If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@ukhsa.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Diphtheria: follow-up of use of anti-toxin (for clinicians)

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@ukhsa.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

Surveillance forms for follow-up of confirmed toxigenic cases of Corynebacterium diphtheriae, C. ulcerans/C. pseudotuberculosis. Each one is to be filled in by a different category of reporter:

  1. For health protection teams (HPTs) – data collection form for asylum seekers.

  2. For HPTs, as part of the management of toxigenic cases – the national surveillance form for follow-up of confirmed toxigenic cases.

  3. For the registered GP 6 to 8 weeks after confirmation of a toxigenic case – the GP follow-up of confirmed toxigenic cases for patient outcome form.

  4. For clinicians in charge of toxigenic cases that have been administered diphtheria anti-toxin (DAT) – the follow-up of use of diphtheria anti-toxin form.

Further information is available in ‘Public health control and management of diphtheria in England’ and the ‘Supplementary guidance for cases and outbreaks in asylum seeker accommodation settings’.

Updates to this page

Published 1 April 2014
Last updated 14 August 2023 + show all updates
  1. Updated email addresses on forms.

  2. Updated data collection form for asylum seekers.

  3. Added the national surveillance form for asylum seekers.

  4. Replaced forms.

  5. First published.

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