Attachment 4. Visual Diagram or Story Board of the Case Symptom Time Course and Household Member Exposures
Use magnetic, dry erase whiteboard. Affix a drawing of a symptom, event, exposure, protective step, etc. to a magnet and place in appropriate location on grid.
First complete the case section, then confirm with the informant. Next complete the household contact section for each household member, keeping information on Case in place.
Case Section |
Phase |
Incubation |
Early |
Wet (bleeding, vomiting , or diarrhea) |
Death or removal |
Ebola Symptom |
(none) |
|
|
|
|
Major events |
|
(eg. Prayer day) |
|
(eg. Case removed by ambulance) |
|
Was Case in HH? |
|
|
|
|
|
Dates (if possible) |
|
|
|
|
|
HH contact Section |
Outside exposures? |
|
|
|
|
In HH? |
|
|
|
|
|
Specific Exposures |
|
|
|
|
|
Protective steps |
|
|
|
|
* This is an interview aid to increase information quality. Its use is included in the burden estimates for Attachment 1 and Attachment 3.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | CDC |
| File Modified | 0000-00-00 |
| File Created | 2021-01-25 |