OPRP - Forms

Sample GI Surveillance Logs
The sample GI logs are based on the requirements set forth in the VSP Operations Manual 2005, Annex 13.2, page 163, and include all symptoms that are a part of the operational case definition.

Format	Dimensions	Comments
MS Word	8.5" x 11" [66 KB]	Standard page size; suitable for electronic entry
Adobe PDF	8.5" x 11" [11 KB]	Standard page size; suitable for hand entry
MS Word	8" x 14" [66 KB]	Suitable for hand or electronic entry
Adobe PDF	8" x 14"	Suitable for hand or electronic entry
MS Word	A4 [66 KB]	European format
Adobe PDF	A4	European format
MS Word	11" x 17"	Large size for electronic entry
Adobe PDF	11" x 17"	Large size for hand entry

Sample Standard Food and Activities History Questionnaire [DOC - 179 KB]
A sample of the food and activities questionnaire to be completed by all passengers and crew members with symptoms of acute gastroenteritis. This form is also found in the VSP Operations Manual 2005, Appendix 13.2, pages 164-5.

CDC Epi Form for Cruise Ships [PDF - 4.8 MB]
This form is to be used when submitting clinical specimens to the CDC Bacterial or Viral Labs.

Sample GI Illness Public Incidence Response Log [DOC - 40 KB]
A sample of a log used to track public incidence of diarrhea or vomiting responses on board cruise ships. The data captured by this form have proven useful in some acute gastroenteritis outbreak investigations.