Appendices of the Strategies for the Control and Investigation of Varicella Outbreaks Manual

Appendix A

Varicella Outbreak Reporting Worksheet

• Reporting Line List for Varicella Outbreak Surveillance worksheet
• Instructions for Completing the Varicella Outbreak Surveillance Reporting Worksheet [2 pages]

Appendix B

Exposure Letters

• Sample chickenpox exposure letter from the Utah Department of Health [1 page] Jun 2015
• Sample shingles exposure at daycare letter [1 page] Jun 2008

Appendix C

Survey to Identify Cases of Varicella in Outbreak Setting

• Sample survey for parents/guardians of children attending school/daycare [3 pages]
  This survey is to be filled out by parents and/or guardians. The child can return it to his or her teacher.

Appendix D

Letters of Notification of Varicella Outbreak

• Sample letter of notification of varicella outbreak from Connecticut Dept. of Health [1 page] Feb 2007
• Sample letter of varicella exposure at daycare [1 page] Feb 2008

Appendix E

Varicella Case Investigation Form

• Sample varicella case investigation form [5 pages]

Appendix F

Varicella Surveillance Worksheet

• Sample varicella surveillance worksheet [3 pages]

See table of contents for Strategies for the Control and Investigation of Varicella Outbreaks 2008.

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