| Document Date: 2014-07-15 22:54:18
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Facility Hospital UR# / Yes No Hospital / / IndustryTerm dairy products / uncooked meat products / healthcare / food samples / food / / MedicalCondition Vomiting / Chronic lung disease / Cancer / Bacteremia / sepsis Bacteremia / miscarriage / Headache / kidney disease / Infectious Diseases / Chills / illness / Liver disease / Other renal disease / Heart disease / Doctor (response) Illness / Body Aches / Blood disorder / asthma / / MedicalTreatment Radiation therapy / Chemotherapy / Organ transplant / dialysis / Antibiotics / / Organization Hospital Hospital / Department of Human Services / No Hospital / / Person Deli Yes / / Position Airline/coach / Prime Minister / healthcare worker / / Product Zantac / Antidiarrhoeal medication / prednisone / Cyclosporine / Tagamet / Imodium / Lomotil / / Technology Radiation / Chemotherapy / dialysis / /
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Sporadic case ListeriaCase part of outbreak - Outbreak ref________________ Case Questionnaire 401764586360Call Outcomes OC1 – No Answer OC2 – Subject not home, call back OC3 – Appointment to call