Form

Haemophilus influenzae: enhanced surveillance forms

These forms are for GPs or other clinicians to fill out, to follow up cases of invasive haemophilus influenzae disease.

• From: Public Health England
• Published: 1 April 2013

Documents

Haemophilus influenzae: serotype b follow up form

PDF, 15.6 KB, 2 pages

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Haemophilus influenzae: adult follow up form

PDF, 14.3 KB, 2 pages

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Haemophilus influenzae: child follow up form

PDF, 14.9 KB, 2 pages

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Haemophilus influenzae: infant follow up form

PDF, 15.3 KB, 2 pages

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Haemophilus influenzae: women follow up form

PDF, 15.6 KB, 2 pages

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Details

A case of H. influenzae infection is considered invasive if the organism was isolated from a normally sterile site, such as blood culture, cerebrospinal fluid (CSF), joint fluid, pleural fluid, or similar.

See the age and gender appropriate questionnaires requesting information on clinical presentation, risk factors, complications and outcome. The patient’s general practitioner (GP) or other clinician can complete the form.

The follow up form for women includes questions specific to women of childbearing age regarding pregnancy.

Published 1 April 2013