Scribd
Upload
36 views1 page

Weekly Notifiable Disease Report Form

The document outlines the requirements of Republic Act 3573 for reporting notifiable diseases in the Philippines. It includes a Weekly Notifiable Disease Report from PAGATPATAN HEALTH CENTER, indicating no cases of various diseases were reported. The report emphasizes the importance of timely notification to public health authorities to prevent epidemics.

Uploaded by

marolegaspi2021
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
36 views1 page

Weekly Notifiable Disease Report Form

The document outlines the requirements of Republic Act 3573 for reporting notifiable diseases in the Philippines. It includes a Weekly Notifiable Disease Report from PAGATPATAN HEALTH CENTER, indicating no cases of various diseases were reported. The report emphasizes the importance of timely notification to public health authorities to prevent epidemics.

Uploaded by

marolegaspi2021
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Philippine Integrated Disease Republic Act 3573 (Law Reporting of

Communicable
Surveillance and Response Disease), requires all individuals and health
facilities to report notifiable diseases
to local and national public health authorities.

Weekly Notifiable Disease Report


Summary Page

Name of Disease Reporting Unit: PAGATPATAN HEALTH CENTER


Type of Facility:□ Gov’t Hospital □Private Hospital ■ Rural health Unit □ Clinic
□ City Health Office □Gov’t Laboratory□ Private Laboratory □ Seaport/Airport
Address:______PUROK 4 ORCHIDS, PAGATPATAN , BUTUAN CITY

This report was prepared by: MA. ROWENA R. LEGASPI, RN Date: 06/20/ 2025
(signature over printed name)
This report was submitted to: ________________________________ Date: __/ __ / ____
(Name of RHU/CHO/PHO/CHD)
This report was approved by: __________________________ __ Date: ___/ ___ / ____
(Name and signature of Head of Office)

List of Notifiable diseases/syndromes


Indicate the numer of case/s in the corresponding line for case/s of disease syndrome
seen and “(0)” if no cases seen

Category I (Immediately Notifiable) Category II (Weekly Notifiable)

_0 Acute Bloody Diarrhea


_0 Acute Flaccid Paralysis
_0 Acute Encephalitis Syndrome
_0 Adverse Effect Following Immunization (AEFI)
_0 Acute Viral Hepatitis
_0 Anthrax
_0 Bacterial Meningitis
_0 Human Avian Influenza
_0 Cholera
_0 Meningococcal Disease
_0 Chikungunya
_0 Neonatal Tetanus
_0 Dengue
_0 Paralytic Shellfish Poisoning
_0 Diphtheria
_0 Rabies
_0 Influenza-like illness
_0 Severe Acute Respiratory Syndrome (SARS)
_0 Leptospirosis
_0 Outbreaks
_0 Malaria
 Cluster of Diseases
_0 Non Neonatal Tetanus
 Unusual Disease of Threats
_0 Pertussis
_0 Typhoid and Paratyphoid Fever

Category I:Notify simultaneously the PHO, CHD and NEC within 24 hours of detection and send advanced copy of the Case
Investigation Form (CIF) as soon as possible.
Category II:Report all cases of notifiable diseases/syndromes every FRIDAY of the week to the next higher level using the
case Report Form (CRF).
“Let’s help prevent epidemics”

You might also like