Form

Diphtheria: surveillance forms for follow-up of toxigenic cases

HPTs and healthcare practitioners must complete these forms and send them to UKHSA to enable monitoring of diphtheria cases in England.

• From: UK Health Security Agency
• Published: 1 April 2014
• Last updated: 14 August 2023 — See all updates

Applies to England

Documents

Diphtheria: data collection form for asylum seekers (for HPTs)

Ref: GOV-13762

MS Word Document, 48.1 KB

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Diphtheria: national surveillance form for follow-up of confirmed toxigenic cases (for HPTs)

Ref: GOV-15224

MS Word Document, 117 KB

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Diphtheria: follow-up of confirmed toxigenic cases for patient outcome (for GPs)

Ref: GOV-15224

MS Word Document, 121 KB

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Diphtheria: follow-up of use of anti-toxin (for clinicians)

Ref: GOV-15224

MS Word Document, 103 KB

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Details

Surveillance forms for follow-up of confirmed toxigenic cases of Corynebacterium diphtheriae, C. ulcerans/C. pseudotuberculosis. Each one is to be filled in by a different category of reporter:

1. For health protection teams (HPTs) – data collection form for asylum seekers.

2. For HPTs, as part of the management of toxigenic cases – the national surveillance form for follow-up of confirmed toxigenic cases.

3. For the registered GP 6 to 8 weeks after confirmation of a toxigenic case – the GP follow-up of confirmed toxigenic cases for patient outcome form.

4. For clinicians in charge of toxigenic cases that have been administered diphtheria anti-toxin (DAT) – the follow-up of use of diphtheria anti-toxin form.

Further information is available in ‘Public health control and management of diphtheria in England’ and the ‘Supplementary guidance for cases and outbreaks in asylum seeker accommodation settings’.

Published 1 April 2014
Last updated 14 August 2023 + show all updates

1. 14 August 2023

   Updated email addresses on forms.

2. 30 November 2022

   Updated data collection form for asylum seekers.

3. 11 November 2022

   Added the national surveillance form for asylum seekers.

4. 23 September 2022

   Replaced forms.

5. 1 April 2014

   First published.