Division of Disease Control and Health Protection

Investigation Tools and Information

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Environmental health Program Manual- Chapter G- Food and Waterborne Disease Surveillance and Investigation

Appendix A- Investigation Equipment List

Appendix B- Sample Policies and Procedures

Appendix C- Outbreak Investigation Tools and Resources

• Foodborne Illness Environmental health Assessment Report
• Foodborne Illness Epidemiological Investigation Checklist
• Foodborne Illness Investigation: Foodworker Interview
• Foodborne Illness Investigation: Food Preparation Review Worksheet

Appendix E- Sample Foodborne Outbreak Questionnaire

Foodborne Outbreak Investigations (CDC)

Foodworker Exclusion Guidelines (FLDOH)

Guide to Traceback of Fresh Fruits and Vegetables (FDA)

Guidelines for Collection and Submission of Food Samples (FLDOH)

• Food Sample Form - Product Complaint Incident Form (FLDOH)

Guidelines for Determination of a Joint Investigation (FLDOH)

Guidelines for Foodborne Disease Outbreak Response (CIFOR)

Guidelines for the Surveillance, Investigation, and Control of Legionnaires Disease in Florida (FLDOH)

Interagency Agreement Between the Department of Business and Professional Regulation and Department of Health

Norovirus Investigation Information

Reportable Disease List

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Forms

Note:  All of the following resources supplied in Adobe PDF and Microsoft Word will open in a new window and are under 2 MB.  To view PDF files you will need the free Adobe Acrobat Reader available from Adobe.  To view Microsoft Word files you will need the free Word Viewer available from Microsoft.

Outbreak Investigation Forms

NORS Foodborne Outbreak Form (CDC 52.13)

NORS Foodborne Outbreak Form Appendix
(CDC 52.13)

NORS Foodborne Outbreak Form Guidance Document (CDC 52.13)

Environmental Health Assessment Report (FLDOH)

Food and Waterborne Outbreak Summary Report
Form (FLDOH)

Foodborne Illness Survey/Complaint Form (FLDOH)

Food Preparation Review Worksheet (FLDOH)

Food Worker Exclusion Form (FLDOH)

Food Worker Interview Form (FLDOH)

NORS Waterborne Outbreak Form Complete Version
(CDC 52.12)

NORS Waterborne Outbreak Form Guidance Document (CDC 52.12)

Recreational Water - Treated (CDC 52.12)

Recreational Water - Un-Treated (CDC 52.12)

Water Intended for Drinking (CDC 52.12)

Water Not Intended for Drinking or Water of Unknown Intent (CDC 52.12)

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Case Investigation Forms

Arsenic Poisoning Case Report Form (FLDOH)

Botulism Alert Summary (CDC 52.50)

Brucellosis Case Surveillance Report (CDC 52.25)

Ciguatera Case Report Form (FLDOH)

Cholera and Other Vibrio Illness Surveillance Report
(CDC 52.79)

Vibrio vulnificus Additional Data Collection Form - Interstate Shellfish Sanitation Conference

Cryptosporidium Risk Factor Questions (FLDOH)

Cyclosporiasis Case Report Form (CDC)

E. coli Case Report Form (FLDOH)

Hepatitis A Case Report Form (CDC)

Legionellosis Case Report (CDC 52.56)

Legionellosis Investigation Worksheet (FLDOH)

Listeria Case Report Form (CDC)

Mercury Poisoning Case Report Form (FLDOH)

Primary Amebic Meningoencephalitis Case Report
Form (CDC)

Salmonellosis Case Report Form (FLDOH)

Surveillance Case Definitions for Select Reportable Diseases in Florida

Trichinosis Surveillance Case Report (CDC 54.7)

Typhoid Fever Surveillance Report (CDC 52.5)

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Other Forms

Clinical Lab Submission Form DH 1847 (FLDOh)

Food Sample Form - Product Complaint Incident Form (FLDOH)

CDC Lab Form (CDC 50.34)

Stop Sale Notice (FLDOH)

Interstate Reciprocal Notification of Disease (CDC 42.1)

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