Child care/Kindergarten/Employer Contact Information (name, phone number, etc.) Address High Risk Occupation/High Risk Environment Last day case attended child Are you/ your child still Yes care/kindergarten/work: experiencing diarrhea? No Case/Parent/Guardian advised that Exclusion required from child Yes Yes public health unit will contact child care/kindergarten/work? No No care/ kindergarten/work? Could we have your permission to Yes release your/ your child’s diagnosis No to child care/kindergarten/work? Refer to the current Infectious Diseases Protocol, Giardiasis chapter, Appendix A, Management of Cases section for exclusion pertaining to day care staff and attendees, food handlers, and health care providers. → For iPHIS data entry – if the case is excluded from work or child care/kindergarten enter information under Interventions. Symptomatic Contact Information Yes Are you aware of anyone who experienced similar symptoms before, during, or after you No (or your child) became ill? This includes those in your family, household, child care or N/A kindergarten class, sexual partner(s), friends or coworkers. Contact 1 Name Relation to case Contact information (phone, address, email) Notes Recommend contact seek medical attention/testing? Yes No N/A Contact 2
Child care/Kindergarten/Employer Contact Information (name, phone number, etc.) Address High Risk Occupation/High Risk Environment Are you/ your child still experiencing diarrhea? Yes No Last day case attended child care/kindergarten/work: Exclusion required from child care/kindergarten/work? Yes No Case/Parent/Guardian advised that public health unit will contact child care/ kindergarten/work? Yes No Could we have your permission to release your/ your child’s diagnosis to child care/kindergarten/work? Yes No Refer to the current Infectious Diseases Protocol, Giardiasis chapter, Appendix A, Management of Cases section for exclusion pertaining to day care staff and attendees, food handlers, and health care providers. → For iPHIS data entry – if the case is excluded from work or child care/kindergarten enter information under Interventions. Symptomatic Contact Information Are you aware of anyone who experienced similar symptoms before, during, or after you (or your child) became ill? This includes those in your family, household, child care or kindergarten class, sexual partner(s), friends or coworkers. Yes No N/A Contact 1 Name Relation to case Contact information (phone, address, email) Notes Recommend contact seek medical attention/testing? Yes No N/A Contact 2
Giardiasis%20Investigation%20Tool.docx