Purpose
These standardized worksheets assist jurisdictions with case/outbreak reporting, investigation, and notification. Use and modify these worksheets as a resource to aid with collection of surveillance data.
Overview
Disease surveillance worksheets have been developed as standard tools to assist jurisdictions with case/outbreak reporting, investigation, and notification. These worksheets are intended as a resource to aid with collection of the surveillance data associated with the HL7 message mapping guides (MMGs). Jurisdictions may modify these worksheets as needed, to best support surveillance needs. The worksheets are not required.
The worksheets listed below are presented both with and without annotations; the annotations show applicable HL7 MMG data element (DE) identifiers for easier mapping into surveillance systems. In addition, the most recent versions (e.g., 2019 for measles) of the worksheets incorporate the additional data elements that are included in the HL7 MMGs, both with and without annotations.
Worksheets may be used and modified to meet specific needs, adding and omitting data elements as might be most helpful within the jurisdiction. [Note that the legionella document is a form and therefore may not be modified without OMB approval.] The MMGs, however, are the definitive source for documentation for data elements, valid values, data structure, and other technical issues related to NNDSS data collection.
Vaccine-Preventable Diseases
For the most recent vaccine-preventable disease worksheets, please visit the appendices section of the Manual for the Surveillance of Vaccine-Preventable Diseases.
Non-Vaccine Preventable Diseases
Legionellosis
- Legionellosis CRF – 2020 version [2 PAGES]*
- Legionellosis CRF – 2020 version annotated [2 PAGES]
- Legionella Worksheet – 2020 version [5 PAGES]
- Legionella Worksheet – 2020 version annotated [5 PAGES]
*The legionella document is a form and therefore may not be modified without OMB approval.