| Document Date: 2015-01-23 12:17:32
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Facility hospital ED / e.g. hospital / / / IndustryTerm risk groups / / MedicalCondition season’s influenza / Secondary bacterial infection / Pneumonia / laboratory-confirmed influenza / Pulmonary embolus / e.g. hypertension / Cardiac disease / Chronic pulmonary disorder / e.g. diabetes mellitus / Encephalitis/encephalopathy / Hemoglobinopathy / Metabolic disorder / Neurological disorder / e.g. cerebral palsy / Genetic disorder / e.g. cancer / influenza / Acute renal failure / Sepsis / e.g. sickle cell disease / hyperlipidemia / / MedicalTreatment hemodialysis / chemotherapy / Immunosuppression / / MusicGroup DFA / / Organization California Department of Public Health State of California / California Department of Public Health / / Position reporter / / ProvinceOrState ARDS / California / / Technology chemotherapy / /
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Acute Ferbrile Respiratory Illness and/or Acute Infectious Pneumonia Community-Based Settings Outbreak Report Form