List of Appendices

Manual for the Surveillance of Vaccine-Preventable Diseases

Below is a list of appendices for the Manual of Surveillance of Vaccine-Preventable Diseases.

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• Appendix 1: Collection of Specimens for Isolation of C. diphtheriae pdf icon[2 pages] (Ch. 1)
• Appendix 2: Guidelines for managing a suspected case of diphtheria and for managing close contacts pdf icon[3 pages] (Ch. 1)
• Appendix 3: CDC Diphtheria Worksheet pdf icon[3 pages] (Ch. 1)
• Appendix 4: Haemophilus influenzae Surveillance Worksheets (Ch. 2)
  • Hflu Worksheet Abbreviated Option (2010) pdf icon[1 page] Nov 2010
  • Hflu Worksheet Abbreviated Option (2010) Annotated pdf icon[1 page] Nov 2010
  • Hflu Worksheet Expanded Option (2010) pdf icon[3 pages] Nov 2010
  • Hflu Worksheet Expanded Option (2010) Annotated pdf icon[3 pages] Jun 2019
  • Hflu Worksheet HL7-MMG version (2019) pdf icon[5 pages] Jun 2019
  • Hflu Worksheet HL7-MMG version (2019) Annotated pdf icon[5 pages] Feb 2019

• Appendix 5: Haemophilus influenzae type b Vaccine and Extended Information Worksheet (Ch. 2) removed – Haemophilus influenzae type b Worksheet is no longer in use.
• Appendix 6: Hepatitis Data Collection Worksheet pdf icon[6 pages] (Ch. 3 and 4) Feb 2009
• Appendix 7: Measles Virus Isolation Instructions pdf icon[2 pages] (Ch. 7) Jan 2009
• Appendix 8: Measles Surveillance Worksheet (Ch. 7)
  • Instructions pdf icon[2 pages] Jan 2009
  • Worksheet pdf icon[2 pages] Jan 2009
  • Measles Worksheet – 2009 version annotated pdf icon[2 pages] Feb 2009
  • Measles Worksheet – 2019 version pdf icon[4 pages] Mar 2019
  • Measles Worksheet – 2019 version annotated pdf icon[4 pages] Mar 2019
• Appendix 9: Meningococcal Disease Surveillance Worksheet (Ch. 8)
  • Version 1 (formerly NETSS) pdf icon[1 page] Apr 2017
  • Abbreviated Worksheet Option – 2017 version annotated pdf icon[1 page] May 2019
  • Version 2 (formerly NEDSS) pdf icon[1 page] Apr 2017
  • Expanded Worksheet Option – 2017 version annotated pdf icon[3 pages] May 2019
  • Meningococcal Disease Worksheet – 2019 version pdf icon[5 pages] May 2019
  • Meningococcal Disease Worksheet – 2019 version annotated pdf icon[5 pages] May 2019
• Appendix 10: Mumps Surveillance Worksheet (Ch. 9)
  • Instructions pdf icon[2 pages] Jan 2009
  • Mumps Worksheet – 2009 version pdf icon[2 pages] Jan 2009
  • Mumps Worksheet – 2009 version annotated pdf icon[2 pages] Jan 2009
  • Mumps Worksheet – 2018 version pdf icon[4 pages] Jul 2018
  • Mumps Worksheet – 2018 version annotated pdf icon[4 pages] Jul 2018
• Appendix 11: Pertussis Surveillance Worksheet (Ch. 10)
  • Instructions pdf icon[4 pages] May 2015
  • Pertussis Worksheet 2009 version pdf icon[2 pages] Jan 2009
  • Pertussis Worksheet 2009 version annotated pdf icon[2 pages] Jan 2020
  • Pertussis Worksheet 2019 version pdf icon[5 pages] Jan 2020
  • Pertussis Worksheet 2019 version annotated pdf icon[4 pages] Jan 2020
• Appendix 12: Pertussis Death Worksheet (Ch. 10)
  • Instructions (Aug 2018)
    PDF pdf icon[11 pages] | Word word icon[21 pages]
  • Work Sheet (Mar 2019)
    PDF pdf icon[3 pages]| Word word icon[7 pages]
• Appendix 13: Streptococcus pneumoniae Surveillance Worksheet (Ch. 11)
  • Streptococcus pneumoniae Worksheet 2010 version pdf icon[2 pages] Aug 2017
  • Streptococcus pneumoniae Worksheet 2010 version annotated pdf icon[2 pages] Aug 2017
  • Streptococcus pneumoniae Worksheet 2019 version pdf icon[4 pages] Jul 2019
  • Streptococcus pneumoniae Worksheet 2019 version annotated pdf icon[4 pages] Jul 2019
• Appendix 14: Suspected Polio Case Worksheet -Investigation of Suspected Case of Poliomyelitis (Ch. 12)
  • Worksheet pdf icon[3 pages] May 2010
• Appendix 15: Collection of Specimens for Typing of Rubella Virus pdf icon[2 pages] (Ch. 14) Jan 2009
• Appendix 16: Rubella Surveillance Worksheet (Ch. 14)
  • Instructions pdf icon[2 pages] Apr 2018
  • Worksheet pdf icon[2 pages] Feb 2009
  • Rubella Worksheet 2009 version annotated pdf icon[2 pages] Feb 2009
  • Rubella Worksheet 2019 version pdf icon[6 pages] Mar 2019
  • Rubella Worksheet 2019 version annotated pdf icon[5 pages] Mar 2019
• Appendix 17: Congenital Rubella Syndrome Case Report pdf icon[2 pages] (Ch. 15) Feb 2009
  • CRS Worksheet 2009 version annotated pdf icon[2 pages] Feb 2009
  • CRS Worksheet 2019 version pdf icon[6 pages] Mar 2019
  • CRS Worksheet 2019 version annotated pdf icon[6 pages] Mar 2019
• Appendix 18: Tetanus Surveillance Worksheet (Ch. 16)
  • Instructions pdf icon[2 pages] Feb 2009
  • Worksheet pdf icon[2 pages] Feb 2009
• Appendix 19: Varicella Death Investigation Worksheet (Ch. 17)
  • Instructions pdf icon[2 pages] Nov 2012
  • Worksheet pdf icon[4 pages] Nov 2012
• Appendix 20: Varicella Outbreak Reporting & Surveillance Worksheets (Ch. 17)
  • Outbreak Reporting Worksheets –
    • Aggregate Varicella Outbreak Reporting Worksheet pdf icon[1 page] Apr 2012
    • Reporting Line List for Varicella Outbreak Surveillance excel icon[3 pages] Apr 2017
    • Instructions for Completing the Varicella Outbreak Surveillance Reporting Worksheetpdf icon[2 pages] Apr 2017
  • Surveillance Worksheets –
    • Varicella Worksheet – 2005 version pdf icon[3 pages] May 2005
    • Varicella Worksheet – 2005 annotated version pdf icon[3 pages] Aug 2018
    • Varicella Worksheet – 2018 version pdf icon[4 pages] Oct 2018
    • Varicella Worksheet – 2018 annotated version pdf icon[4 pages] Oct 2018
• Appendix 21: Updated Guidelines for Evaluating Public Health Surveillance Systems pdf icon[1 page] (Ch. 18) Jan 2009
• Appendix 22: VAERS Form pdf icon[1 page] (Ch. 21) Jan 2009
• Appendix 23: CDC Specimen Submission Form (50.34)(Ch. 22) Jan 2013
  Link to page describes updated form and protocols in effect Feb 4, 2013.
• Appendix 24: Interstate Shipment of Etiologic Agents / Packaging and Shipping of Biomedical Material pdf icon[4 pages] (Ch. 22) Feb 2009