Dhhs 2124-2026

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The document outlines the reporting requirements for communicable diseases in North Carolina, specifically through the NC Electronic Disease Surveillance System (NC EDSS). It provides a detailed form for healthcare providers to report patient information, clinical findings, and diagnostic testing related to disease events. The document emphasizes the importance of timely reporting to local health departments and lists various reportable diseases along with their respective reporting timeframes.

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Click ‘Get Form’ to open the dhhs 2124 in the editor.
Begin by entering the NC EDSS EVENT ID# at the top of the form. This is crucial for tracking the disease event.
Fill in patient details including their last name, first name, middle name, sex, birthdate, and age type. Ensure accuracy as this information is vital for health records.
Indicate the patient's race and any associations with specific settings such as child care or health care. Check all applicable boxes to provide comprehensive data.
Complete the clinical information section by noting if the patient was symptomatic and specifying symptoms if applicable. Include treatment details for sexually transmitted diseases.
Provide diagnostic testing information, including lab results and specimen details. This ensures that local health departments have all necessary data for follow-up.
Finally, review all entries for accuracy before submitting your completed form to ensure compliance with reporting requirements.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (202 Votes)
2009	4.4 Satisfied (580 Votes)

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What is the best way to send my communicable disease report for eSignature?

Upload your communicable disease report to DocHub (once you’ve created an account for this). If you need to fill out fields in it, use proper tools from the top pane. For instance, add Signature Fields, assign each to specific party, and click on Sign → Request signatures from others. Personalize your message for your recipients and click Send Request. You can also send your form by fax or as a Signing link instead of using email (you’ll find these options by navigating to the Menu → Send)

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What is the process for reporting notifiable diseases from individuals to the CDC?

Case Reporting A doctor diagnoses and/or a laboratory confirms a reportable disease. The hospital, healthcare provider, or laboratory sends information about this case to the public health department. The NNDSS team receives, secures, processes, and provides de-identified data to disease-specific programs across CDC.

Which STD is not reportable in all states?

Non-reportable Sexually Transmitted Infections Include: Bacterial Vaginosis (BV) Genital Herpes. Human Papillomavirus (HPV) Pediculosis (Pubic Lice) Trichomoniasis.

How are communicable diseases reported?

A communicable disease can be reported by phone, fax, or e-mail through the Communicable Disease Reporting System (CDRS).

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What are reportable diseases in NC?

Reportable Diseases AIDS. Anthrax* Botulism. Brucellosis. Campylobacter. Cholera. Chlamydia. COVID-19.

Is salmonella reportable in NC?

North Carolina law mandates healthcare providers and laboratories to report over 70 diseases or conditions to their local health department. Some examples of the reportable communicable diseases include Hepatitis A, B C, coronavirus, influenza, measles, and salmonella and other food borne illnesses.

What is the process of reporting a communicable disease?

A communicable disease can be reported by phone, fax, or e-mail through the Communicable Disease Reporting System (CDRS).

What pathogens should be reported?

Infection with Salmonella, Shiga-toxin producing Escherichia coli (STEC, including O157 and other serogroups), Listeria, Shigella, Vibrio, and hepatitis A virus, as well as botulism, are reportable almost everywhere in the United States.

Is chlamydia a reportable disease?

Syphilis (including congenital syphilis), gonorrhea, chlamydia, chancroid, and HIV are reportable diseases in every state.

Dhhs 2124-2026

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