Information for State and Local Health Departments
Generic pool-related cryptosporidiosis outbreak case and control (adult and pediatric) questionnaires
These questionnaires are provided only as examples. They are not intended to be used directly for your outbreak. Each outbreak is unique, requiring its own questionnaire, but many of the questions or blocks of questions could be inserted into your outbreak-specific questionnaire. If your health department uses modules from these questionnaires, they may need to be modified to make them applicable to your heath department’s outbreak.
These questionnaires in particular were used in an outbreak during the summer of 2004, and their design and content reflect the circumstances involved in that outbreak. They include an informed consent portion at the beginning. The case definition and control population definitions are specific to this outbreak, and may not be appropriate for other outbreaks.
Case Questionnaire
Adult
(
Word document, 368 KB) (
PDF document, 391 KB)
Pediatric ( Word document, 330 KB) ( PDF document, 312 KB)
Control Questionnaire
Adult ( Word document, 323 KB) ( PDF document, 340 KB)
Pediatric ( Word document, 296 KB) ( PDF document, 269 KB)
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Page last modified: May 2, 2007