Weekly Active Monitoring Report - word

Weekly Monitoring Report Template
	Low Risk			Some Risk	High Risk
	Travelers	US healthcare workers	Other low risk
Number of persons required to be monitored at any time during the reporting period
Number of persons required to be under monitoring on the first day (Monday) of the reporting period
Number of persons who were added to those requiring monitoring at any time during the reporting period
Number of persons who completed their 21 days of monitoring during the reporting period
Number of persons who were being monitored but were transferred to another U.S. jurisdiction for monitoring during the reporting period
Number of persons who were being monitored but left the U.S. during the reporting period
Number of persons with whom initial contact was never established (i.e. missing or incorrect contact information; unable to contact) during the reporting period
Number of persons who were reported as "no initial contact" in a previous reporting period but were found during this reporting period
Number of persons who were lost to follow up at any time during the reporting period (i.e. did not report for 48 hours or longer)
Number of persons who were reported as "lost to follow up" but were found during this reporting period
Number of persons who reported fever and/or other compatible Ebola symptoms (severe headache, muscle pain, weakness, diarrhea, vomiting, stomach pain, or unexplained bleeding or bruising) during the reporting period
Number of persons under monitoring who were laboratory tested for EVD during the reporting period
Number of persons under monitoring who became laboratory-confirmed cases of EVD during the reporting period

Submit weekly reports at: http://phprsurveys.cdc.gov/mrIWeb/mrIWeb.dll?I.Project=WEEKLYREPORT_V2_LOWEBOLARISKEXPOSURE