Year Eaten Any / Game Describe Where / Year Eaten CDPH / Case / Pork Describe Where / Beef Describe Where / /
Continent
Africa / Europe / /
Country
American Samoa / Nepal / Guam / Bangladesh / Cambodia / Thailand / Indonesia / Malaysia / Japan / Pakistan / United States / Vietnam / Korea / China / India / /
Facility
Laboratory CDPH / Other Residential Facility / Acute Care Facility / Correctional Facility / LABORATORY CRITERIA FOR DIAGNOSIS Confirmed / Military Facility / LABORATORY INFORMATION LABORATORY RESULTS SUMMARY Specimen Type / Homeless Shelter / Long Term Care Facility / /
NOTES/REMARKS REPORTING AGENCY / Public Health Center / Food Service / California Department / Drug Treatment Center / Infectious Diseases Division of Communicable Disease Control Infectious Diseases Branch Surveillance and Statistics Section / California Department of Public Health CYSTICERCOSIS / /
Person
Patient / /
Position
Investigator / farm worker / Manager / official / dental health worker / veterinarian / Sex worker / Drug dealer / pharmacist / field worker / health care worker / Physician / paramedic / Manicurist / Laboratory technologist / emergency medical technician / technician / hostess / proprietor / seasonal worker / Teacher / instructor / Police officer / sales worker / Teacher / Dentist / food preparation worker / medical assistant / animal control worker / nurse / Homemaker / surgeon / prevention worker / child care worker / physician assistant / unskilled worker / Craftsman / foreman / Adult film actor / actress / /
ProvinceOrState
Alaska / Hawaii / California / /
Region
North America / Middle East / North Africa / Central America / South America / Southeast Asia / Far East / /
State of California—Health and Human Services Agency Local ID Number ___________________________ California Department of Public Health Center for Infectious Diseases