Behavioural Social Risk Factors in Response Details the 3-25 days prior to onset of (e.g., Brand name, purchase/consumption location, illness product details, date of exposure) asked No Yes iPHIS character limit: 50. Zoonotic Not Unknown Contact with animals, e.g., pets, farm animals or (petting) zoo Other Modes of Transmission Anal-oral contact Close contact with case Poor hand hygiene Other (specify) for all modes of transmission Unknown → For iPHIS data entry – check Yes for Unknown if all other Behavioural Risk Factors are No or Unknown. ♦ Create Exposures Identify Exposures to be entered in iPHIS. → For iPHIS data entry – record details of exposure(s) in iPHIS Case Exposure Form as required. Premises Referral Has a food premise(s) been identified as a Yes If yes, refer premises to the Food Safety Program and create an possible source? exposure as appropriate. No High Risk Occupation/High Risk Environment Are you/ your child in a high risk Yes Child care/kindergarten staff or attendees occupation or high risk No Food handler environment (including paid and Health care provider unpaid/volunteer position)? Other (specify) Occupation: Name of Child care/Kindergarten/Employer
Behavioural Social Risk Factors in the 3-25 days prior to onset of illness Zoonotic Response Details (e.g., Brand name, purchase/consumption location, product details, date of exposure) iPHIS character limit: 50. Yes No Unknown Not asked Contact with animals, e.g., pets, farm animals or (petting) zoo Other Modes of Transmission Anal-oral contact Close contact with case Poor hand hygiene Other (specify) for all modes of transmission Unknown → For iPHIS data entry – check Yes for Unknown if all other Behavioural Risk Factors are No or Unknown. ♦ Create Exposures Identify Exposures to be entered in iPHIS. → For iPHIS data entry – record details of exposure(s) in iPHIS Case Exposure Form as required. Premises Referral Has a food premise(s) been identified as a possible source? Yes No If yes, refer premises to the Food Safety Program and create an exposure as appropriate. High Risk Occupation/High Risk Environment Are you/ your child in a high risk occupation or high risk environment (including paid and unpaid/volunteer position)? Yes No Child care/kindergarten staff or attendees Food handler Health care provider Other (specify) Occupation: Name of Child care/Kindergarten/Employer
Giardiasis%20Investigation%20Tool.docx