Revised IRR of RA 11332: Mandatory Reporting of Notifiable Diseases

The 2020 Revised Implementing Rules and Regulations of Republic Act No. 11332, or the Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act RULEI GENERAL PROVISIONS Section 1. Title.

• These rules and regulations shall be known as the 2020 Revised Implementing Rules and Regulations (IRR) of Republic Act No. 11332, or the “Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act” (hereinafter referred to as the Act). Section 2. Declaration ofPolicy. - It is hereby declared the policy of the State to protect and promote the rightto health of the people andinstill health consciousness among them.It shall endeavorto protect the people from public health threats through the efficient and effective disease surveillance of notifiable diseases including emerging and reemerging infectious diseases, diseases for elimination and eradication, epidemics, and health events including chemical, biological, radioactive, nuclear and environmental agents of public health concern and provide an effective response system in compliance with the 2005 International Health Regulations (IHR) ofthe World Health Organization (WHO), and its amendments. The State recognizes epidemics and other public health emergencies as threats to public health and national security, which can undermine the social, economic, andpolitical functions ofthe State. The State also recognizes disease surveillance and response systems of the Department of Health (DOH) and its local counterparts as the first line of defense to epidemics and health events of public health concern that pose risk to public health and security. Section 3. Objectives. - This IRR shall have the following objectives: a.) To continuously develop and upgrade the list of nationally notifiable diseases and health events of public health concern with their corresponding case definitions and laboratory confirmation; b.) To ensure the establishment and maintenance of relevant, efficient and effective disease surveillance and response system at the national andlocallevels; c.) To expand collaborations beyond traditional public health partners to include others who maybe involved in the disease surveillance and response suchas,but notlimited to, agricultural agencies, veterinarian, environmental agencies, law enforcement entities, the hotel industry and other accommodation establishments, transportation (road, rail, maritime and aviation sectors), population and development agencies and information and communication technology companies, and other private establishments; CERTIFIED TRUE COPY ae | raezat AUG 28 2020. ap age 1 of 31 CORAZat oNia KMITS RECOR PieaithUG ee oftfea a

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d.) To provide accurate and timely health information about notifiable diseases, and health-related events and conditionsto citizens and health providers as an integral part ofresponse to public health emergencies; e.) To establish effective mechanisms for strong collaboration with national and local government health agencies to ensure proper procedures are in place to promptly respond to reports of notifiable diseases and health events of public health concern, including case investigations, treatment, and control and containment, including follow-up activities; f.) To ensure that public health authorities have the statutory and regulatory authority to ensure the following: i. Mandatory reporting of reportable diseases and health events of public health concem; ii. Epidemic/outbreaks and/or epidemiologic investigation, case investigations, patient interviews, review of medical records, contact tracing, specimen collection and testing, risk assessments, laboratory investigation, population surveys, and environmentalinvestigation; iii. Implement quarantine and isolation procedures; and iv. Rapid containment and implementation of measures for disease prevention and control; g.) To provide sufficient funding to support operation requirements to establish and maintain Epidemiology and Surveillance Units (ESU) at the DOH,health facilities, Local Government Units (LGUs), offices and/or agencies; efficiently and effectively investigate epidemics and health events of public health concern; validate, collect, analyze and disseminate disease surveillance information to relevant agencies or organizations; and implementappropriate epidemiologic response; h.) To require public and private physicians, allied medical personnel, professional societies, hospitals, clinics, health facilities, laboratories, pharmaceutical companies, private companies and institutions, workplaces, schools, prisons, jails, and detention centers, ports, airports, establishments, communities, other government agencies, and non-governmental organizations (NGOs)to actively participate in disease surveillance and response; and i.) To respectto the fullest extent possible, the rights of people to liberty, bodily integrity, and privacy while maintaining and preserving public health and security. Section 4. Definition of Terms. - For the purposes of this IRR, the following terms are defined as such: a.) Confirmedcase refers to a casethatis classified as confirmed for reporting purposes, as may be defined by the DOHspecific to a disease. Case definitions for this case classification are commonly based on clinical, laboratory, and other epidemiological criteria but may only be based on current/existing recommendations asto confirming laboratory test; CERTIFIED TRUE COPY Bela ‘ ast AUG 2g 2020 CORAZON S. DeLA CRUZ” KMITS - RECORDS SECTION h Department-of Health 2 of 31

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b.) Contact tracing refers to the process of identification, listing, assessment, and monitoring of persons who may have comeinto contact with an infected person and subsequent collection of further information about these contacts. It is a major public health intervention to interrupt ongoing transmission and reduce spread of an infection; c.) Disease refers to anillness due to a specific toxic substance, occupational exposure or infectious agent, which affects a susceptible individual, either directly or indirectly, as from an infected animal or person, or indirectly through an intermediate host, vector, or the environment; d.) Disease control refers to the reduction of disease incidence, prevalence, morbidity, or mortality to a locally acceptable level as a result of deliberate efforts and continued intervention measures to maintain the reduction; e.) Disease responserefers to the implementation of specific activities to control further spread of infection, outbreaks or epidemics and to prevent reoccurrence. It includes verification, contact tracing, rapid risk assessment, case measures, treatment of patients, risk communication, conduct of prevention activities, and rehabilitation and reintegration. Disease response activities shall include the imposition of minimum public health standards including, but not limited to, movementrestrictions, partial or complete closure of schools and businesses, imposition of quarantine in specific geographic areas and international or domestic travel restrictions, construction of facilities for the quarantine of health and emergency front liners, and the prepositioning and distribution of personal protective equipment for health workers; f.) Disease surveillance refers to the ongoing systematic collection, analysis, interpretation, and dissemination of outcome-specific data for use in the planning, implementation, and evaluation of public health practice in terms of epidemics, emergencies, and disasters. A disease surveillance system includes the functional capacity for data analysis as well as the timely dissemination of these data to persons whocan undertake effective prevention and control activities; g.) Emerging or re-emerging infectious diseases refer to diseases that: i. Have not occurred in humansbefore; ii. Have occurred previously but affected only small numbers of people in isolated areas; iii, Have occurred throughout human history but have only recently been recognizedas a distant disease dueto an infectious agent; iv. Are caused by previously undetected or unknowninfectious agents; v. Are due to mutantorresistant strains of a causative organism; or vi. Once were major health problems in the country, and then declined dramatically, but are again becoming health problems for a significant proportion ofthe population; CERTIFIED TRUE COPY #3 Mas 2020 yen3088 h CORAZON -S. DELA CRUZN KMITS - RECORDS SECTION Department of Health

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h.) Epidemic or outbreak refers to an occurrence of more cases of disease than normally expected within a specific place or group of people over a given period of time; i.) Epidemiologic investigation refers to an inquiry to the incidence, prevalence, extent, source, mode of transmission, causation of, and other information pertinent to a disease occurrence; j.) Health event of public health concern refers to either a public health emergency or a public health threat due to biological, chemical, radio-nuclear, and environmental agents; k.) Infectious disease refers to a clinically manifested disease of humans or animals resulting from an infection; 1.) Isolation refers to the separation ofill or contaminated persons or affected baggage, containers, conveyances, goods or postal parcels from others in such a manneras to preventthe spread of infection or contamination; m.) Local counterparts of the DOHrefer to governmentoffices and agencies performing the same purposes, mandates, and/or functions as the DOH within the provinces, cities, or municipalities; n.) Mandatory reporting refers to the obligatory reporting to the DOH Epidemiology Bureau (EB)or their local counterparts, as required for notifiable diseases, epidemics or health events of public health concern; 0.) Non-cooperation refers to the failure to fully comply with a duty required under the provisions of the Act and this IRR, or to abide by guidelines, orders, issuances, or ordinances issued pursuant to, and to implement the provisions of, the Act orthis IRR; p.) Notifiable disease refers to a disease enumeratedor maybelisted pursuantto RuleII herein, which must be reported to public health authorities in accordance with Rule VI, Section 4 of this IRR; q.) Probablecase refers to a case that is classified as probable for reporting purposes, as may be defined by the DOH specific to a disease. Case definitions for this case classification are commonly based on clinical, laboratory, and/or other epidemiological criteria; r.) Public health authorities refers to the DOH, specifically, the EB, Disease Prevention and Control Bureau (DPCB), Bureau of Quarantine and International Health Surveillance, Health Emergency Management Bureau (HEMB), Food and Drug Administration (FDA), Government hospitals, Research Institute for Tropical Medicine (RITM)and other National Reference Laboratories, and Centers for Health Development (CHD) or DOH Regional Offices, the local health offices (provincial, city or municipality), or any person directly authorized to act on behalf of the DOH ICERTIFIED TRUE COPY AUG 28 2020“. CORAZOM"S. _DELA CRUZ KNITS - RECORDS SECTION Department .of Health 4of31

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and/or the local health offices. For this purpose, Local Chief Executives shall be considered public health authorities; s.) Public health emergency refers to an occurrence or imminentthreat of anillness or health condition that: i. Is caused by any ofthe following: (1) Bioterrorism; (2) Appearance of a novel or previously controlled or eradicated infectious agent or biological toxin; (3) A natural disaster; (4) A chemical attack or accidental release; (5) A nuclear attack or accident; or (6) An attack or accidental release of radioactive materials; and ii. Poses a high probability of any of the following: (1) A large numberof deaths in the affected population; (2) A large numberof serious injuries or long-term disabilities in the affected population; (3) Widespread exposure to an infectious or toxic agent that poses a significant risk of substantial harm to a large numberof people in the affected population; (4) International exposure to an infectious or toxic agent that poses a significant risk to the health of citizens of other countries; or (5) Trade andtravel restrictions; t.) Public health threat refers to any situation or factor that may represent a danger to the health of the people; u.) Quarantine refers to the restriction of activities and/or separation from others of suspect persons whoarenotill, or of suspect baggage, containers, conveyances, or goods, in such a manner as to prevent the possible spread of infection or contamination; and v.) Suspect case refers to a case that is classified as suspect for reporting purposes, as may be defined by the DOH specific to a disease. Case definitions for this case classification are commonly based on clinical and other epidemiological criteria. Section 5. Acronyms. - As used in this IRR, the following terms shall mean: a.) “BOQ”- Bureau of Quarantine of the DOH; b.) “CESU”- City Epidemiology and Surveillance Unit; c.) “CHD” - Center for Health Developmentor Regional Offices of the DOH; d.) “CIF” - Case Investigation Form; e.) “COVID-19” - Coronavirus Disease-2019; f.) “CRF” - Case Report Form; CERTIFIED TRUE COPY .) “DOH”- Department of Health; g-) Pp A AUG 020

. ys . , Gonazow peta’ Cruz i.) “ESU” - Epidemiology and Surveillance Unit; KMITS - RECORDS SECTION. ~Department of Health ~ h.) “EB”- Epidemiology Bureau of the DOH; ——— -_ ws

j.) “FHSIS”- Field Health Services Information System; aan pero}

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k.) “HSSS”- Hospital Sentinel Surveillance System; 1.) “IATA”- International Air Transport Association; m.) “IATF-MEID”- Inter-Agency Task Force for the Managementof Emerging or Re-Emerging Infectious Diseases; n.) “IHR”- 2005 International Health Regulations, and its amendments; 0.) “IRR” - The 2020 Revised Implementing Rules and Regulations of Republic Act No. 11332; p.) “KMITS”- Knowledge Managementand Information Technology Service of the DOH; q.) “LESU”- Local Epidemiology and Surveillance Unit; r.) “LGU”- Local Government Units; s.) “MERS”- Middle East Respiratory Syndrome; t.) “MESU”- Municipal Epidemiology and Surveillance Unit; u.) “NDEPH”- List ofNotifiable Diseases, Syndromes and Health Events of Public Health Concern; v.) “NGO” - Non-Government Organization; w.) “PESU”- Provincial Epidemiology and Surveillance Unit; x.) “PHEIC”- Public Health Emergency of International Concer; y.) “PIDSR”- Philippine Integrated Disease Surveillance and Response; z.) “RESU”- Regional Epidemiology and Surveillance Unit; aa.) “SARS”- Severe Acute Respiratory Syndrome; and bb.) “WHO”- World Health Organization. RULEII NOTIFIABLE DISEASES AND HEALTH EVENTS OF PUBLIC HEALTH CONCERN Section 1. Priority Diseases/Syndromes/Conditions Targeted for Surveillance. - The EB shall regularly update and issue a list of nationally notifiable diseases and health events of public health concern with their corresponding case definitions. For purposes of the Act and this IRR, the priority diseases/syndromes/conditions targeted for surveillance shall be selected based on the following categories: o =) Diseases spread eyoe CERTIFIED TRUE COPY i. Bacterial meningitis; Se — AUG 28 2020: # JNA oN Vag.

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e Haemophilus influenzae type b (Hib) e Streptococcus pneumoniae ii. Coronavirus disease 2019 (COVID-19); e Severe acute respiratory syndrome (SARS)-associated coronavirus 2 (SARS-CoV 2) iii. Diphtheria; e Corynebacterium diphtheriae iv. Hand Foot and Mouth Disease; v. Human Avian Influenza; vi. Influenza-like IIness (ILD; vii. Severe acute respiratory syndrome (SARS); e SARS-associated coronavirus viii.| Measles; e Measles morbillivirus ix. Meningococcal Disease; e Neisseria meningitidis x. Middle East Respiratory Syndrome (MERS); e Middle East respiratory syndrome coronavirus (MERS-CoV); and xi. Pertussis (Whooping cough) e Bordetella pertussis b.) Airborne diseases: i. Anthrax; e Bacillus anthracis ii. Human Avian Influenza; iii. Influenza-like Ilness (ILD); and iv. Measles e Measles morbillivirus c.) Diseases spread by direct contact: i. Acute Viral Hepatitis; e Hepatitis A virus (HAV) e Hepatitis B virus (HBV) e Hepatitis D virus (HDV) ii. Anthrax; e Bacillus anthracis iii. Bacterial meningitis; e Group B Streptococcus e Escherichia coli e Neisseria meningitidis iv. Diphtheria; e Corynebacterium diphtheriae vy. Hand-Foot-and-Mouth Disease. vi. Leptospirosis; e Leptospira vii. Meningococcal Disease; and CERTIFIED TRUE COPY ; NEL . SANG28 2020 " ve 7 of 31 ae ae CORAZON $. DE CRUZ. .... KMITS - RECORDS SECTION Department of Health

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e Neisseria meningitidis viii. Rabies e Rabies virus (RV) d.) Vehicle-borne diseases: i. Acute Bloody Diarrhea; Campylobacterbacteria Salmonella bacteria Shigella species (bacillary dysentery) Entamoeba histolytica (amoebic dysentery) Enterohaemorrhagic E. coli (EHEC) ii. Acute Viral Hepatitis; Hepatitis A virus (HAV) e Hepatitis B virus (HBV) Hepatitis C virus (HCV) Hepatitis D virus (HDV) Hepatitis E virus (HEV) iii. Anthrax; e Bacillus anthracis iv. Bacterial meningitis; e E.coli e Listeria monocytogenes v. Cholera; e Vibrio cholerae vi. Neonatal tetanus; © Clostridium tetani vii. Paralytic Shellfish Poisoning; viii.| Typhoid and Paratyphoid Fever; and e Salmonella enterica serotype Typhi e Salmonella enterica serotypes Paratyphi A, B (tartrate negative), and C (S. Paratyphi) _ ix. Poliomyelitis (Acute Flaccid Paralysis) CERTIFIED TRUE COPY e Poliovirus e.) Vector-bome diseases:

AUG 28ao oS “CORAZON SBELA’CRUZ i. Dengue; HOSReORO acaltn e Dengue viruses (DENV-1, -2, -3, and -4) won ii. Acute Encephalitis Syndrome/Japanese Encephalitis; and es e Japanese Encephalitis virus iii. Malaria e Plasmodium parasites (P. falciparum, P. malariae, P. ovale and P. vivax) Section 2. Basis for Inclusion and Exclusion. - The selection and the deletion of diseases and health events of public health concern, including the procedureto be followed, shall be governed by DOH Administrative Order No. 2018 - 0028 orthe “Guidelines for the Inclusion and Delisting of Diseases, Syndromes, and Health Events in the List of Notifiable Diseases,al \aer

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Syndromes and Health Events of Public Health Concern (NDEPH)”, or any subsequent amendments or revisions thereto. The DOH mayclassify notifiable diseases under those which should be immediately notifiable (Category I) or weekly notifiable (Category II). The listing and delisting of diseases of zoonotic origins, such as those being observed by the Department of Agriculture - Bureau of Animal Industry, shall be upon the recommendations of the Philippine Inter-Agency Committee on Zoonoses created pursuant to Administrative Order No.10, s. 2011; Provided, that the reference on notifiable diseases shall likewise include Volume 2, Section 10 of the latest Manual of Procedures of the Philippine Integrated Disease Surveillance and Response (PIDSR) and Event-based Surveillance and Response” Section 3. Criteria for Inclusion. - The criteria for inclusion, recommendation, and issuance of the List of Notifiable Diseases and Health Events ofPublic Health Concern for mandatory reporting are any one or more ofthe following: a.) Disease is of international or national concern; b.) Disease has epidemicor outbreak potential; c.) Disease is being eliminated; d.) Disease is included in the top ten (10) leading cause of morbidity and/or mortality in the Philippines; e.) Disease with large number of serious or long term disabilities in the affected population; f.) Disease with large numberofdeathsin the affected population; g.) Disease characteristics, prevalence, incidence and/or mortality is changing and would likely impact public health; , h.) Disease is a priority of the DOH;or i.) Disease or health eventthat fulfills either one of the following surveillance goals: i. To monitor and controlthe spread of disease; and ii. To monitor the trends of a disease overtime. Section 4. Criteriafor Exclusion. - The following are the criteria for exclusion (de-listing) in the List ofNotifiable Diseases and Health Events ofPublic Health Concern: a.) Disease is not considereda public health risk or threat; b.) Disease has no epidemic or outbreak potential; c.) Disease has been eliminated or controlled; d.) Disease is no longer included in the top 10 leading cause of morbidity and/or mortality; e.) Disease has low or no incidence of disability or residual complication; f.) Disease has low risk for mortality; or g.) Disease characteristics, prevalence, incidence and/or mortality is consistently low or has no impactto public health. CERTIFIED TRUE COPY “ CORAZON: DELA CRUZ ~ ye 9 of 31 .

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RULEII DECLARATION OF PUBLIC HEALTH EMERGENCY Section 1. Authority of the Secretary of Health. - Subject to Section 2 of this Rule, the Secretary of Health shall have the authority to declare epidemics of national and/or international concern, which shall include butare not limitedto: a.) Epidemic linked with nationally or internationally distributed pandemic; b.) Case/s of exotic disease acquired locally; c.) Diseases linked with pathogenicity; d.) Diseases with significantrisks of international spread; e.) Epidemics associated with health service failure; and f.) Epidemics in tourist facilities, among foreign travelers or at national/international events. No declaration by any LGU of an epidemic that constitutes national and international concern shall be valid and effective without the written affirmation/approvalof the Secretary of Health. Pursuant to Section 105 of the Local Government Code, in cases of epidemics, pestilence, and other widespread public health dangers, the Secretary of Health, upon the direction of the President of the Republic of the Philippines and in consultation with the LGU concerned, may temporarily assumedirect supervision and control over the health operations of the LGU for the duration of the emergency, but in no case exceeding a cumulative period of six (6) months; Provided, that the period for such direct national control and supervision maybe further extended upon the concurrence of the LGU concerned. The Secretary of Health may convene the Inter-Agency Task Force for the Management of Emerging or Re-emerging Infectious Diseases (IATF-MEID) created under Executive Order No. 168, s. 2014, the Inter-Agency Committee on Environmental Health created under Executive Order No. 489,s. 1991,or such inter-agency bodies ortask forces as may be created and assigned, for appropriate response (e.g. de-escalation or escalation of response). Regional counterparts of the IATF-MEID orother relevant inter-agency bodies, task forces, or committees may likewise be called upon to ensure the alignment of national directives with local actions. The Secretary of Health shall have the authority to declare if an epidemic or outbreak has ended. Section 2. Declaration by the President. - In the event of an epidemic of national and/or international concern that threatens national security, the President of the Republic of the Philippines shall declare a State of Public Health Emergency and mobilize governmental and non-governmental agencies to respondto the threat. Section 3. Declaration by Provincial, City, or Municipal Health Offices. - Provincial, city or municipal health offices shall only declare a disease outbreak within their respective localities; Provided, that the declaration is supported by sufficient scientific evidence based CERTIFIED TRUE COPY] er | aus 28 20707 a| Mr 10ers CORAZON: $. DELK CRUZ . “KMITS=RECORDS SECTION

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on disease surveillance data, epidemiologic investigation, environmental investigation, and laboratory investigation. Provided, further, that the Secretary of Health shall have the authority to affirm or reverse any declaration of a disease outbreak by any provincial, city, and municipal health office. RULE IV GRANT OF STATUTORY AND REGULATORY AUTHORITY Section 1. Powers and Functions. - To perform their disease surveillance and response functions, authorized personnel from the DOH andits local counterparts are granted the statutory and regulatory authority to enforce the following, subject to the guidelines as may be issued by the DOH: a.) Establishment of public health information systems and disease surveillance and response systems in private and public health facilities deemed necessary to protect the health of the population; b.) Mandatory reporting of notifiable diseases and health events ofpublic health concern; c.) Conduct of epidemic/outbreak and epidemiologic investigations; case investigations, patient interviews; review of medical records; contact tracing; collection, storage, transport and testing of samples and specimen; risk assessments; laboratory investigation; population surveys; and environmental investigation; d.) Rapid containment, quarantine andisolation, disease prevention and contro] measures, and product recall; and e.) Response activities for events ofpublic health concern. RULE V PUBLIC HEALTH INFORMATION AND AND DISEASE SURVEILLANCE AND RESPONSE SYSTEMS Section 1. Official List of Institutionalized Systems. - The official public health information and disease surveillance and response systemsshall be as follows: a.) Hospital Sentinel Surveillance System (HSSS); b.) Field Health Services Information System (FHSIS); c.) Philippine Integrated Disease Surveillance Response (PIDSR) System, with its Case-based Surveillance and Event-based Surveillance; d.) Community-Based Disease Surveillance System; e.) Laboratory Surveillance System; f.) Quarantine Health Services and Information System of the BOQ; and g.) Other duly institutionalized public health disease surveillance and response systemsas may be issued by the DOH (e.g. COVID KAYA for COVID-19, Health Facility Capacity Monitoring, amongothers). CERTIFIED TRUE COPY ~~ AUG28 2020- © an “_Department-of Health

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The DOH EBshall be responsible in giving the specifications of health information systems and disease surveillance and response systemsif there will be new systems created aside from the ones listed in the official institutionalized system to ensure that the data collected from various local units can be collated in a central database for future analysis and decision-making processes. Section 2. Operations. - The DOH andits local counterparts shall establish and maintain functional disease surveillance and response systems, which include coordination mechanisms, implementation protocols for reporting and response, measures for data security and confidentiality, and procedures and provision to ensure safety of personnel conducting disease surveillance and response activities. The DOH and its local counterparts shall ensure that all surveillance and response officers have adequate capacity for mandatory reporting of notifiable diseases, risk assessment, epidemiology, disease surveillance, and response to epidemics and health events of public health concern. They shall also ensure that the safety and protection of all personnel directly involved in surveillance and responseactivities are upheld. Section 3. Digitization. — The DOH,in close coordination with its local counterparts and other government agencies and stakeholders, shall endeavor to develop digitized public health information and disease surveillance and response systems to maximize the identification, detection, testing, quarantine and isolation, treatment, and other activities aimed at preventing, mitigating, containing, or addressing notifiable diseases and health events of public health concern. Section 4. Respect for Human Rights. - All personnel of the DOH andits local counterparts, and all other individuals or entities involved in conducting disease surveillance and response activities shall respect, to the fullest extent possible, the rights of people to liberty, bodily integrity, and privacy while maintaining and preserving public health and security. RULEVI MANDATORY REPORTING OF NOTIFIABLE DISEASES AND HEALTH EVENTS OF PUBLIC HEALTH CONCERN Section 1. Implementation. - The DOH,in close coordination with its local counterparts,is mandated to implement the mandatory reporting of notifiable diseases and health events of public health concern. Section 2. Persons and Entities Required to do Mandatory Reporting. - Subject to the procedure laid down under this Rule, all of the following, whether public or private, are required to accurately and immediately report notifiable diseases and health events of public health concern provided for under Rule II of this IRR or as may be issued by the DOH: a.) Licensed public and private medical andallied health professionals; b.) Health facilities and offices as defined under the DOH Administrative Order No. 2019-0060 or the Guidelines on the Implementation of the National Health Facility Registry (Annex “A”), or subsequent amendments or revisions thereto; CERTIFIED TRUE COPY AWA of 31 et AUGjhe2920 wn” CORAZON- cRuz KMITS= RECORDS SECTION

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c.) Workplaces including those in special economic and/or free port zones; d.) Public and private educational institutions providing basic education, higher education, or technical-vocational education and/or training; e.) Prisons, jails, or detention centers; f.) Major transportation passenger terminals, and seaports andairports; g.) Dining and hotel and other accommodation establishments, including other establishments as may be required by public health authorities; h.) Communities, including household members, the punong barangay, barangay health emergency response teams, homeowners’ associations, indigenous people communities, cooperatives, and community-based organizations; i.) Other government agencies providing health and emergency frontline services, border control, and othercritical services; and j.) Professional societies, civic organizations, and other NGOs. Section 3. Categories of Notifiable Diseases and Health Events ofPublic Health Concern.

• All persons or entities under Section 2 of this Rule shall report notifiable diseases and health events of public health concern in accordance with the PIDSR andtheir categorization or disease surveillance guidelines or manual of procedures that may be later developed. The diseases/syndromes enumerated under RuleII, or listed as a notifiable disease or health event of public health concern pursuant thereto, shall be categorized as immediately notifiable (Category I) or weekly notifiable (Category II): For the purposeofthis IRR, the following diseases/syndromes shall be categorizedas immediately notifiable (Category J): a.) Acute Flaccid Paralysis; b.) Adverse Event Following Immunization; c.) Anthrax; d.) COVID-19; e.) Hand-Foot-and-Mouth Disease; f.) Human Avian Influenza; g.) Measles; h.) Meningococcal Disease; i.) Middle East Respiratory Syndrome (MERS); j.) Neonatal Tetanus; k.) Paralytic Shellfish Poisoning; 1.) Rabies; and m.) Severe Acute Respiratory Syndrome (SARS). On the other hand, the following diseases/syndromes shall be categorized as weekly notifiable (Category II): a.) Acute Bloody Diarrhea; b.) Acute Encephalitis Syndrome; c.) Acute Hemorrhagic Fever Syndrome; d.) Acute Viral Hepatitis;

0. Otoees CERTIFIED TRUE COPY AUG 28 2020

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g.) Dengue; h.) Diphtheria; i.) Influenza-like Illness; j.) Leptospirosis; k.) Malaria; 1.) Non-neonatal Tetanus; m.) Pertussis; and n.) Typhoid and Paratyphoid Fever. Section 4. Submission of Report to the Local Epidemiology and Surveillance Units. - Mandatory reporting of notifiable diseases or health events of public health concern shall be done by submitting the Case Investigation Form (CIF) for diseases/syndromes under Category I diseases/syndromes), or the Case Report Form (CRF) for diseases/syndromes under Category II, to the local epidemiology and surveillance unit (LESU) mandated to be established or maintained under Rule VII of this IRR. The DOH may prescribe such other official forms as appropriate. In localities where no LESU is in place, the report shall be submitted to the local health office. Uponreceipt of reports, the LESU orthe local health office shall then timely submit reports in accordance with reporting procedures mandated under the PIDSR orin disease surveillance guidelines or manual of procedures that may be later developed” as may be directed by the DOH. In instances where the suspect case involves a foreign national, immediate coordination with the Department of Foreign Affairs and the Bureau of Immigration shall likewise be madefor their appropriate action. Section 5. Deadline for Reporting. - Diseases or syndromes included under Category I are considered immediately notifiable and should be reported to the LESU, RESU, and EB within twenty-four (24) hours from detection. Diseases or syndromes included under Category II shall be reported every Friday of the week. Section 6. Minimum Data Needed for Mandatory Reporting. - The necessary data for collection in the prescribed official forms under the DOH Manual of Procedures such as the CIF (Annex “B”) or the CRF (Annex “C”), shall be the following: a.) Name ofdisease reporting unit; b.) Nameof intervieweratfirst point of contact; c.) Nameof the person subject ofthe interview; d.) Age; e.) Sex; f.) Civil status; g.) Date ofbirth; h.) Permanent residential address (from the smallest identifiable geographical unit such as street, purok or barangay); 1 CERTIFIED TRUE COPY

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i.) Current residential address (from the smallest identifiable geographical unit such as street, purok or barangay); j.) Date of onset of illness or symptoms; and k.) Contact details such as mobile or landline phone number, or email address. In addition to the aforementioned details, the reporting entities must, as far as practicable, likewise obtain the following data as part of the CIF: a.) History of travel (places/countries visited, date of travel to places/countries visited, date of arrival to residence/the Philippines, as well as places recently visited in the Philippines) in the last thirty (30) days; and b.) Other health conditions such as comorbidities, medical history, last menstrual period if applicable, amongothers. The aforementioned details are crucial and indispensable for the formulation of appropriate policies and disease response activities. Hence, health professionals conducting the interview at point offirst contact shall obtain such details from a suspect case, properly informing the data subject that the information sought to be obtained is being processed in accordance with Republic Act No. 10173, or the “Data Privacy Act of 2012,” and that deliberately providing false or misleading personal information on the part of person, or the next of kin in case of person’s incapacity, may constitute as non-cooperation punishable under the Act or this IRR. Section 7. Furnishing of Information as Prerequisite to Availing of Health Services. - For notifiable diseases and health events of public health concern, patients are obliged to provide complete and accurate data required in Section 6 of this Rule to the interviewer at point of first contact prior to availing ofhealth care services. In emergency cases, the next of kin shall provide the necessary data while the patientis being treated. RULEVII EPIDEMIOLOGY AND SURVEILLANCEUNITS Section 1. Establishment ofESUs.- It is hereby directed thatall local health offices in every province, city and municipality nationwide, including all the persons and entities required to do mandatory reporting under Rule VI, Section 2, of this IRR shall establish or designate ESUs and submit such designation to the CHD/Regional Office of the DOH in their respective regionsnotlater than fifteen (15) days from the effectivity of this IRR. The ESU shall capture and verify all reported notifiable diseases and health events of public health concern; provide timely, accurate, and reliable epidemiologic information to appropriate agencies; conduct disease surveillance and epidemiologic response activities including contact tracing; recommend needed response; and facilitate capacity building in applied field epidemiology, disease surveillance and response as organized and provided by the EB. All ESUs shall be required to have a trained human resource complement and provision of adequate resources, including equipment, logistics, communication, CERTIFIED TRUE COPY AL sAU6 28 2020| 15 0f31 conazonfs DELA CRUZ KMITS - RECORDS SECTION Department of Health

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transportation, laboratory supplies and reagents, personal protective equipment and health insurance,to effectively perform their disease surveillance and response functions. Section 2. Organizational Structure at the Local Level. - The EB together with the RESU shall provide technical assistance to the Provincial/City/Municipal Epidemiology and Surveillance Unit (PESU/CESU/MESU)in determining appropriate organizational structure to ensure efficient and effective operation of an ESU. Once created, the budgetary requirement for the operation of the ESUs shall be drawn from the annual budgetary allocation of their respective motheroffices. The Office of the Provincial/City/Municipal Health Officer, as approved by the Provincial/City/Municipal Health Office Board, shall determine the establishment and composition of an ESU, in accordance with the organization of the respective Province/City/Municipality-Wide Health System of the said LGU. Each ESU shall have at least one (1) disease surveillance officer duly trained on applied/field epidemiology, surveillance, and response, and one (1) epidemiology assistant of an allied health profession. Pending the formalcreation or establishmentofplantilla positions of ESUs in LGUs, the Local Health Board may temporarily designate personnel capable of performing tasksas stated herein, and be provided with essential resources, to serve as members of the ESU. Section 3. Functional Relationship. - The RESUsshall be an office directly under the Office of the DOH Regional Director. Resources, such as appropriate numberofplantilla positions and budgetary requirements, shall be distinct and separate from the health emergencyunits. The functionality of the RESU shall be regularly monitored by the EB, while the PESU/CESU/MESJU shall be monitored by the RESU. Section 4. Functions. - The ESUsat the city and municipal level, as the case may be,shall havethe following functions: a.) Organize data collection and gather epidemiological data from their health facilities (Rural Health Units, Health Centers, Barangay Health Stations, satellite clinics, etc.); b.) Prepare and periodically update graphs, tables and charts to describe time, place and person for Notifiable / Reportable diseases and conditions; c.) Analyze data and provide feedback to health facilities and local leaders; d.) Identify and inform concemed personnel (Rural Health Physicians, Public Health Nurses, Rural Health Midwives, and Barangay Health Workers) immediately of any disease or condition in their expected areas that: exceeds an epidemic threshold, occurs in locations where it was previously absent, occurs more often in a population group than previously, and presents unusual trends or patterns; e.) Carry out outbreak investigations; f.) Coordinate with appropriate laboratory for collection and transport of specimens; g.) Liaise with other agencies such as Department of Agriculture or Department of Environment and Natural Resources whose assistance is needed to complete outbreak investigation; h.) Implement preliminary control measures immediately, if required; CERTIFIED TRUE COPY Mier Pa 16 of 31 —ceuco 28 2020.| pala CORAZON S.a CRUZLa KMITS - RECORDS SECTION Department of Health |

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i.) Forward epidemiological data to the next level on a regular basis and in accordance with the national surveillance protocol; and j.) Use epidemiological data to plan and implement communicable disease control activities at the municipal andcity level. ESUsat the provincial level shall perform the following: a.) Organize data collection and gather epidemiological data from their sentinel sites (Provincial Hospital, District Hospitals, etc.); b.) Prepare and periodically update graphs, tables, and charts to describe time, place and person for Notifiable / Reportable diseases and conditions; c.) Analyze data and provide feedbackto health facilities and provincial leaders; d.) Identify and inform city/municipal health offices immediately of any disease or condition in their expected areas that: exceeds an epidemic threshold, occurs in locations where it was previously absent, occurs more often in a population group than previously, and presents unusual trends or patterns; e.) Confirm the status ofreported events from the municipalities and cities and to support or implement additional control measuresif necessary; f.) Assess reported events immediately and, if found urgent, to report all essential information to the CHD/DOH Regional Office and DOH centraloffice. Urgent events are those with serious public health impact and/or unusual or unexpected nature with high potential for spread; g.) Provide on-site assistance (e.g., technical, logistics, laboratory analysis of samples) as required to supplementlocal investigations at the municipal andcity level; h.) Establish, operate, and maintain a public health epidemic preparedness and response plan, including the creation of multi-sectoral teams to respond to events that may constitute a public health emergencyof local and international concern; i.) Notify the DOH central office of all reported urgent events within twenty-four (24) hours as required in the IHR; j.) Forward epidemiological data to the next level as identified in the PIDSR Manualor disease surveillance guidelines or manual of procedures that may be later developed on a regular basis and in accordance with the national surveillance protocol; k.) Use epidemiological data to plan and implement communicable disease control activities at the provincial level; and 1.) Support municipal and city surveillance teams in strengthening surveillance and epidemic response through training and supervision. The functions of ESUs in entities required to do mandatory reporting ofnotifiable diseases and health events ofpublic health concern shall be governed under Rule X, Section 1 of this IRR. The aforementioned functions are subject to changes in accordance with subsequent amendments to the PIDSR Manual, if any, or as prescribed by EB, as necessary. CERTIFIED TRUE COPY st AUG a on fee CORAZON/S. DE CRUZ KMITS- RECORDS SECTION |) ye 17 of 31 Department of Health ~~. _

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RULEVIII DISEASE SURVEILLANCE Section 1. Processing of Information. — Data collection, analysis, dissemination of information, from official disease surveillance and response systems shall be done by authorized personnel from the DOH andits local counterparts, and shall be used for public health concern purposes only. Subject to the foregoing conditions and consistent with the provisions of the Data Privacy Act of 2012, the personnel authorized to process personal data and information, which shall include the checking of completeness of the data entries in the required forms, and consistency of data in the summary sheets and prescribed official forms such as the CIFs, and CRFs, shall be as follows: a.) The Municipal Health Officer of the Rural Health Unit/Municipal Health Office, the City Health Officer of the City Health Office; or the Provincial Health Officer of the Provincial Health Office, as applicable; b.) The Regional Epidemiology and Surveillance Unit Head of the CHDs/Regional Offices of the DOH; and c.) The Public Health Surveillance Division of the DOH EB. Section 2. Disease Surveillance Duty of DOH Offices. - The DOH shall ensure that epidemiology and surveillance capacity is treated as an essential service capability acrossall health systems and health facilities, and provide enabling policies, regulations, capacity building, capital outlay, operating expenses, and personnelto fulfill such. The DOH, through the following offices, shall perform the following disease surveillance functions: ° a.) The EB shall: i. Assess all reported epidemics within forty-eight (48) hours; and ii. Notify the WHO when the assessment indicates that the event is a public health emergency of international concern (PHEIC); and iii, Coordinate with other DOHoffices in establishing a laboratory network. b.) The BOQ shall: i. Develop and ensure compliance to protocols and field operation guidelines on entry or exit managementof persons, conveyances, and goods in coordination with airport and port authorities; ii. Be in charge of quarantine as deemed necessary; iii, Conduct surveillance in ports and airports of entry and sub-ports as well as the airports and ports oforigin of internationalflights and vessels; iv. Monitor public health threats in other countries; and v. Provide effective networking and collaboration among the BOQstakeholders. CERTIFIED TRUE COPY ad AUG 28aay Wee ? 18 of 31 RAZONA. DELA CRUZ CRTs - RECORDS SECTION wo Department of Health

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c.) The CHDs/Regional Offices of the DOH shall: i. Assess reported epidemics immediately and report all essential information to the DOHcentral office; ii. Provide direct liaison with other regional government agencies; iii. Provide a direct operational link with senior health and other officials at the regional level; and iv. Facilitate submission of weekly notifiable disease surveillance reports from public and private hospitals. d.) The RESUsshall: i. Provide on-site assistance (e.g., technical, logistics, and laboratory analysis of samples) as requested through any means of communication to supplement local epidemic investigations and control; ii, Coordinate with appropriate laboratory for collection and transport of specimens especially if specialized laboratory testing is necessary; iii, Establish, operate, and maintain a regional epidemic preparedness and responseplan, including the creation of multidisciplinary/multi-sectoral teams to respondto events that may constitute a public health emergency of local and international concern; iv. Assess reported epidemics immediately and report all essential information to the DOH central office; v. Providedirectliaison with other regional government agencies; vi. Provide a direct operational link with senior health and other officials at the regionallevel; vii. Facilitate submission of weekly notifiable disease surveillance reports from public and private hospitals; and viii. Advocate to the LGUs and the persons and entities required to do mandatory reporting under Rule VIofthis IRR, to ensure functionality oftheir ESUs and to actively participate in disease surveillance and response by having information drive and having systemsin place for mandatory reporting and responseto health events. RULE IX QUARANTINE AND ISOLATION Section 1. Quarantine and Isolation Measures. - In the performance of surveillance and responseactivities, authorized personnel of DOHandits local counterparts are empoweredto determine if a person exhibits symptomsof infection of, or is a close contact of a person found to have been infected with, a notifiable disease or a health event of public health concern, and accordingly issue a quarantine/isolation order or directive to compulsorily confine the person inside a facility or in his/her home residence for an indicated period. A person subject to such orderor directive is boundto stay therein until the expiration of said period. Failure to comply with the quarantine/isolation order, as well as violation of the terms or conditions of the quarantineor isolation,shall constitute non-cooperation. CERTIFIED TRUE COPY AUG 28 2020

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9 of 31 corazon? Dea cae KMITS - RECORDS’ SECTION Department of Health hd

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No home quarantine/isolation shall be permitted in instances where the nature of the notifiable disease or health event of public health concern requires a more stringent form of quarantineor isolation. Home and/or facility-based quarantine or isolation shall be in accordance with the protocols as maybe issued by the DOH taking into account humaneand dignified treatment and living conditions during the course of the quarantine. Compliance with the protocols on quarantine and isolation such as provision of necessary basic facilities shall be subject to regular ocular inspection or visit of quarantine/isolation facilities by the public health authorities, both homeand facility-based. The DOHorits local counterparts may mobilize other government offices, such as officials at the barangay level and personnel of law enforcement agencies to accompany them in enforcing quarantine or isolation measures; Provided, that the participation of local law enforcement agencies should only be limited to assisting the DOH andlocal counterparts in the enforcement of quarantine/isolation orders. RULE X DISEASE RESPONSE Section 1. Persons or Entities Required to Participate in Disease Response Activities, and Specific Responsibilities. - Pursuant to Rule I, Section 3(h) of this IRR, the following are required to participate in disease response activities as may be enforced by the DOH orits local counterparts. At the minimum, they are required to perform the following acts: a.) Licensed public and private medical and allied health professionals shall: i. For those employed in health facilities, notify the respective reporting or surveillance unit of their facilities of notifiable disease or health event of public health concern; and ii. For private practitioners, report the samedirectly to the local health office. b.) Health facilities and offices as defined under Annex “A”shall: i. Establish or designate their ESUswithin the period provided underthis IRR; ii. Comply with the appropriate surveillance system (verification, validation, quality check of CIF/CRF, encoding, and reporting to a higherlevel of ESU); iii, Report cases of notifiable diseases or health events ofpublic health concer to the appropriate public health authorities using the CIF or CRF, as the case may be; iv. Allocate hospital beds in such number or percentage as may be deemed necessary by the DOH,or corresponding to the peak day critical care capacity based on updated projections from a DOH-recognized epidemiological projection model for a particular epidemic, to accommodate and service patients affected by the notifiable disease or health event of public health concern. Provided, that compliance with this rule shall not constitute a violation of relevant warrantymade before the Philippine Health Corporation CERTIFIED TRUE COPY @ AUG 2820200 % wo conazoy S._DLA CRUZ)|

RECORD KMSertment of Health kad

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(PhilHealth) or the Health Facilities and Services Regulatory Bureau of the DOH; v. Coordinate the transfer of patients who are classified as mild cases to a different facility, in instances where there is a need to prioritize severe and critical cases and/or once the surge capacity has been reached; vi. Report health system data as required by the DOH,such as butnotlimited to, the number ofhospital beds available; vii. Participate in unified hospital command systems as may be organized by the DOH,its local counterparts, or other public health authorities; and viii.| Adhere to the Philippine Epidemic Preparedness and Response Plan issued by the DOH. c.) Private companies and institutions; workplaces including those in special economic and/or freeport zones; public and private educational institutions providing basic education, higher education, technical vocational education and/or training; major transportation passenger terminals, seaports and airports; dining, hotel and other accommodation establishments, including other establishments as may be required by the DOH; other government agencies providing health and emergency frontline services, border control, and other critical services; and prisons, jails, or detention centers shall: i. Establish or designate a unit that will perform the functions of an ESU within their respective premises; ii. Participate in disease response activities by reporting health events to their local health office using the event-based surveillance form (Annex “D”) within twenty-four (24) hours from identification; and ° iii. As appropriate, provide adequate support for their workforce in terms of transportation, lodging, food allowance, and other appropriate assistance. d.) Private companies in the transportation sector (aviation, maritime, road,rail) shall comply with the duty to transport samples, specimens, or hot boxes following the guidelines of the International Air Transport Association (IATA) on transporting infectious and hazardous materials, or such other similar guidelines, including mission-critical personal protective equipment, medicines, medical equipment, and other commodities. e.) Communities, including household members, the punong barangay, barangay health emergency response teams, homeowners’ associations, indigenous people communities, cooperatives, and community-based organizationsshall: i. Report any health event of public health concern to the local health office within twenty-four (24) hours from occurrence thereof; and ii. Perform such other functions to respond to the notifiable disease or health event of public health concern. + CERTIFIED TRUE COPY S| AUS 28 2020" We | CORAZON/S.DEZA CRUZ 21 of 31 KMITS>RECORDS SECTION7» \

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f.) Professional societies, civic and faith-based organizations, civil society organizations, and other non-government organizations shall: i. Designate a unit or person/s that shall perform the event-based surveillance of any notifiable disease or health event of public health concern in any activity that may be organized by them; and ii. Report any health event of public health concern that takes place to the local health office where such activity is held within twenty-four (24) hours from occurrence thereof. Forall of the foregoing, failure to comply with the disease response systems indicated herein shall constitute non-cooperation. Further, all of the foregoing surveillance and response activities shall be without prejudice to the guidelines/rules/regulations that may be issued by other national government agencies in close coordination with the DOH. Section 2. Disease Response Activities Required of Communities and the General Public. - Communities and the general public shall comply with minimum public health standards and/or non-pharmaceutical interventions as may be enforced by the DOHandits local counterparts may as part of their duty to participate in response activities to notifiable diseases and health events ofpublic health concer, which shall include the following: a.) For diseases spread by droplets enumerated in, or may beclassified as such, under Rule II: i. Regular and thorough washing of hands with soap and water, and if unavailable, regular disinfection of hands by using a sanitizer with at least 60% alcohol component; ii. Covering the nose and mouth with a tissue when coughing or sneezing. Properly disposing of used tissue, and washing of hands thereafter; iii. Cleaning with soap and wateror a bleach-and-water solution or disinfectant of surfaces and objects that are touched frequently; iv. Limited transport and movementofpatients (e.g. use of portable diagnostic equipment and tools to limit the movement of patients from one place to another within the health facility); and v. Wearing of masks, or other personal protective equipment (PPE) as may be prescribed by the DOHorits local counterparts. b.) For airborne diseases enumeratedin, or maybe classified as such, under Rule IT; i. Regular and thorough washing hands with soap and water, andif unavailable, regular disinfection of hands by using a sanitizer with at least 60% alcohol component; ii. Covering the nose and mouth with a tissue when coughing or sneezing. Properly disposing of used tissue, and washing of handsthereafter; iii, Cleaning with soap and wateror a bleach-and-water solution or disinfectant of surfaces and objects that are touched frequently; iv. Increasing ventilation in all settings to reduce airborne transmission, CERTIFIED. TRUE COPY _AUG.2 7020 Joan CORAZON J. DEL TONLf KMITS - RECORDS SECTION Department of Health |

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v. Limited transport and movementofpatients (e.g. use of portable diagnostic equipment and tools to limit the movement of patients from one place to another within the health facility); vi. To do home quarantine or homeisolation as advised by a medicalprofessional or by the DOH’s advisories; vii. Avoidance of close contact with people who have symptomsof the disease; and viii.| Wearing of masks, or other personal protective equipment (PPE) as may be prescribed by the DOHorits local counterparts. c.) For diseases spread by direct contact enumerated in, or may be classified as such, under RuleII: i. Regular and thorough washing hands with soap and water, and if unavailable, regular disinfection of hands by using a sanitizer with at least 60% alcohol component; ii. Cleaning with soap and water or a bleach-and-water solution or disinfectant of surfaces and objects that are touched frequently; iii, Avoiding close contact with sick persons; and iv. Isolating contagious persons. d.) For vehicle-borne diseases enumerated in, or maybe classified as such, under RuleII: i. Using barrier contraception when engaging in sexual intercourse if currently infectious due to sexually transmitted infection; ii. Non-sharing of needles when administering drugs; iii, Avoiding use of an infected person’s personal items; and iv. Taking precautions when undergoing tattooing or body-piercing procedures, e.) For vector-borne diseases enumeratedin, or may be classified as such, under Rule II: i. Removing stagnantwater in receptacles at least once a week; ii. Using screens on windowsand doors to keep mosquitoes outside homes; and iii. Using mosquito bed nets, if screened roomsare not available when sleeping outside of an enclosed space. The aforementioned shall be without prejudice to the authority of the DOHorits local counterparts to require additional minimum public health standards and non-pharmaceutical interventions should the same be warranted, and to disease-specific minimum public health standards and/or non-pharmaceutical interventions stated under Annex “E.” In addition, communities, as part of their response activities, shall extend the necessary assistance to ensure that no acts of discrimination shall be inflicted upon persons identified as having the notifiable disease or health events of public health concern whether confirmed, recovered, or undergoing treatment, as well as suspect and probable cases, including health care workers and personnel providing health and emergency frontline services. Discrimination refers to any distinction, exclusion or restriction which has the purpose oreffect of nullifying the recognition, enjoyment or exercise, on an equal basis with CERTIFIED TRUE COPY 45) ~AUG-28-2020 we CORAZON/S. DELA CRUZ,} MITS - RECORDS SECTION K Departmont_of Health 23 of 31 —_—

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others, of all human rights and fundamental freedoms.In includesall forms of discrimination, including denial of reasonable accommodation. Failure to comply with the foregoing shall constitute non-cooperation. Section 3. Disease Response Activities Required of the DOH. - The DOH, through the following offices shall perform the following response activities: a.) The Epidemiology Bureau shall: i. Rapidly determine the control measures required to prevent domestic and international spread of disease; ii. Provide support through specialized staff and logistical assistance during epidemic investigation and response; iii, Establish effective networking with other relevant government agencies at the national local level; iv. Provide direct operational link with senior health and other officials at the national and local levels to approve rapidly and implement containment and control measures; v. Provide timely and relevant data to the public; vi. Facilitate the dissemination of information and recommendations from DOH Central office and WHO regarding local and international public health events to the concerned agencies and institutions; and vii. Facilitate the budget allocation for surveillance and response at the CHDs/Regional Offices of the DOH; b.) The DOHrepresentatives to the LGUs shall ensure that the roles and functions ofthe CHDs/Regional Offices of the DOH are being implemented at their assigned LGUs,as follows: i. Plan and advocate the implementation of functional ESU to the Local Health Board; ii. Provide technical assistance in terms of hospital development, formation of functional unit of surveillance, outbreak, emergency and disaster response; iii, Provide regular feedback to the CHD/Regional Office of the DOH thestatus of ESU functionality, and regulatory issues; iv. Mobilize resources; v. Evaluation; and vi. Inter-agency and inter-sectoral collaborator; c.) The Disease Prevention and Control Bureau shall: i. Provide updates, technical advice, and recommendations on the recognition, prevention, and control of diseases; ii, Organize the DOH Management Committee for the Prevention and Control of Emerging and Re-emerging Infectious Diseases; iii. Prepare, and lead in the implementation of, the Philippine Preparedness and Response Plan for Emerging and Re-emerging Infectious Diseases; and CERTIFIED TRUE COPY 123 , a

AuG.28 20 & corazon¢-peLd cruz KMITS - RECORDS SECTION Department of Health 24 of 31

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iv. Timely update the Philippine Preparedness and Response Plan for emerging and re-emerging infectious diseases as the need arises. For this purpose, other agencies and offices of the government may be called uponto participate in the formulation of the response plan as well as for simulation exercises; d.) The CHDs/Regional Offices shall: i. ii. lil. iv. Vi. Provide on-site assistance (e.g., technical, logistics, and laboratory analysis of samples) as requested to supplementlocal epidemic investigations andcontrol; Establish, operate and maintain a regional epidemic preparedness and response plan, including the creation ofmultidisciplinary/multisectoral teams to respond to events that may constitute a public health emergency of local and international concern; Provide technical and logistical assistance in the establishment of ESUsat the provincial/city/municipal health offices; Ensure the functionality of the regional disease surveillance and response system; The Hospital Licensing Team at the CHDs/Regional Offices shall track and monitor the compliance of public and private hospitals in the implementation of PIDSR orother disease surveillance systems and their guidelines or manual of procedures that may be later developed as part of the requirements for renewal oflicense to operate. The team shall inform the CHDs/PHOs/LGUsof activities taken against non-complying hospital institutions. Likewise, provincial/city/municipal health offices shall report to the CHDs/ Regional Offices hospitals and related facilities that fail to comply with the reporting requirements of PIDSR or other disease surveillance systems and their guidelines or manual of procedures that may be later developed. The regional director shall issue a regional order to enforce compliance; and Create an Epidemic Management Committee at the regional level; e.) The RESUsshall: i. ii. iii. iv. Provide on-site assistance (e.g., technical, logistics, and laboratory analysis of samples) as requested to supplementlocal epidemic investigations and control; Establish, operate, and maintain a regional epidemic preparedness and responseplan, including the creation of multidisciplinary/multi-sectoral teams to respondto events that may constitute a public health emergencyoflocal and international concern; Provide technical and logistical assistance in the establishment of ESUsatthe provincial/city/municipal health offices; and Ensure the functionality of the regional disease surveillance and response system; f.) The Health Emergency Management Bureaushall act as the DOH coordinating unit and operations centerfor all health emergencies, disasters, and incidents with potential of becoming an emergency; CERTIFIED TRUE COPY | 1 AUG28 2020i pie, 4. 25 of 31 RAZON/S. DEVA CRUZ ye CORTE - RECORDS SECTION Department of Health |

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g.) The Health Promotion Bureau shall develop and implement strategic risk and response communications plan to empowerall stakeholders in observing recommended and evidence-based measures, upon the Secretary of Health’s declaration of an epidemic; h.) The Knowledge Management and Information Technology Service (KMITS), under the technical advice and in close collaboration with the EB, shall develop, establish, and maintain a harmonized electronic functional public health information system to support the disease surveillance and response systems, which shall include, but shall not be limited to, coordination mechanisms, data compatibility and interoperability, implementation protocols for reporting and response, and measures for data security and confidentiality; i.) The Health Facility Development Bureau shall lead, in close collaboration with the EB, the development offacility standards in the establishment and maintenance of functional ESUs, which include, but not limited to, infrastructure and equipment; j.) The Health Facilities Enhancement Program shall ensure that appropriate funding is provided for the development of government ESUs in terms of infrastructure, equipment, and surveillance and response vehicles; k.) The Health Human Resource Development Bureau and Personnel Administration Division shall lead in ensuring that appropriate staffing is provided in the national and regional ESUs; Provided, that the EB shall provide the appropriate staffing standards for ESUsat each level; and 1.) The Health Facilities and Services Regulatory Bureau shall include an ESU aspart of its minimum standards for the regulation of health facilities and services. Section 4. Disease Response Activities Required of Local Counterparts. - Local health offices shall perform the following response activities: a.) The Provincial Health Office (and CHOs of Highly Urbanized Cities and Chartered Cities) shall: i. Setup and maintain a functional provincial disease surveillance system equipped with the necessary resources and adequate local financial support. Financial support may come from the disaster, calamity, or other appropriate funding sources as determined bythe provincial government officials; ii. Collect, organize, analyze, and interpret surveillance data in their respective areas; iii, Report all available essential information (e.g., clinical description, laboratory results, numbers of human cases and deaths, sources and type of risk) immediately to the regional level; iv. Assess reported epidemics immediately and report all essential information to CHDs/Regional Offices of the DOH and DOH Central office; v. Provide on-site assistance (e.g., technical, logistical, and laboratory analysis of samples) as requested to supplement local epidemic investigations and control; CERTIFIED TRUE COPY MRL 384 AUG 28 2020 pe 26 of 31 CORAZON /S. DEYA CRUZ KMITS - RECORDS SECTION [4 Department of Health

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vi. Facilitate submission of weekly notifiable disease surveillance reports from public and private hospitals; and vii. Establish, operate, and maintain a provincial epidemic preparedness and response plan, including the creation of multidisciplinary/multi-sectoral teams to respondto events that may constitute a public health emergencyoflocal and international concern. b.) The Municipal/City Health Office shall: i. Setup and maintain a functional municipal/city/community disease surveillance system equipped with the necessary resources and adequate local financial support. Financial support may comefrom thedisaster, calamity, or other appropriate funding sources as determined by the municipal/city government officials; ii. Collect, organize, analyze, and interpret surveillance data in their respective areas; iii. Report all available essential information (e.g., clinical description, laboratory results, numbers of human cases and deaths, sources and type of risk) immediately to the provincial level; iv. Implement appropriate epidemic control measures immediately; v. Establish, operate, and maintain a municipal/city epidemic preparedness and response plan, including the creation of multidisciplinary/multi-sectoral teams to respondto events that may constitute a public health emergency; and vi. Facilitate submission of weekly notifiable disease surveillance reports from public and private hospitals. Section 5. Disease Response Activities Required of Philippine Health Insurance Corporation (PhilHealth).

• The PhilHealth shall support the implementation of disease surveillance and response in hospitals and private practitioners by using its accreditation authority and reimbursementof claimsas a leverage to encourage compliance. Section 6. Response Activities Based on Guidelines Issued by Authorized Entities. - Response activities set forth by the IATF-MEIDor such otherrelevant authorities as may be authorized by the DOHorits local counterparts shall be mandatory overpersonsorentities mentioned under RuleI, Section 3(h) of this IRR. Guidelines may include, but are not limited to: a.) Where appropriate, using governmental authorities to limit non-essential movement of people, goods, services into and out of areas where an outbreak occurs; b.) Providing guidance to all levels of government on the range of options for infection control and containment, including those circumstances where social distancing measures, limitations on gatherings or quarantine authority may be an appropriate public health intervention; c.) Emphasizing the roles and responsibilities of the individual in preventing the spread of an outbreak and the risk to others if infection-control practices are not followed; and d.) Providing guidance for LGUs, andindustries to prevent the spread of disease. CERTIFIED TRUE COPY ede [ 27 of 31 eeat48 AUG 28 2020 & are CORAZON S.-D CRUZ KMITS - RECORDS’ SECTION Department of Health

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Section 7. Other Disease Response Activities.

The aforementioned provisions notwithstanding, public health authorities may enforce other response activities as may be called for to address notifiable diseases or health events of public health concern, in accordance with the following criteria: a.) The response required shall be in the form of activities aimed to control the further spread of infection, outbreaks or epidemics and prevent reoccurrence. It includes verification, contact tracing, rapid risk assessment, case measures, treatment of patients, risk communication, conduct of prevention activities, and rehabilitation; b.) The response is mandated by a public health authority; and c.) The response is required of persons or entities mandated to participate in response activities pursuant to Rule I, Section 3(h) of this IRR. RULEXI PROHIBITED ACTS AND PENALTIES Section 1. Prohibited Acts. - The following shall be prohibited underthis IRR: a.) Unauthorized disclosure of private and confidential information pertaining to a patient’s medical condition or to any advice or treatment given to a patient considered privileged communication in accordance with existing laws, rules and regulations. Consistent with the Data Privacy Act of 2012, the reporting of information to public health authorities by the persons or entities mandatedto notify under Rule VI ofthis IRR shall not be considered a violation of this provision. Relévant issuances as may be promulgated by the DOH andother relevant agencies in coordination with the National Privacy Commission shall be applicable. Neither shall the disclosure of private and confidential information upon order issued by a court of competent jurisdiction be considered a violation thereof. b.) Tampering of records relating to notifiable diseases or health events of public health concern, which includes identification documents or passes and other similar documents for the movement of cargoes and passageof persons,official medicaltest results or medical certificates, or such other documents and records issued by public health authorities in connection therewith. c.) Intentionally providing misinformation by: i. Deliberately providing false or misleading information/details in the required official forms such as but not limited to the CIF, CRF, or Events-Based Surveillance Form; or ii. Creating, perpetrating, or spreading false information about the notifiable disease or health event of public health concern in any form of media, such as information having no valid or beneficial effect on the population, and are clearly geared to promote chaos, panic, anarchy, fear, or confusion. CERTIFIED TRUE COPY "i AUG 28 2020 fe” Tee ee

CORAZON/S. DEYA CRU we KMITS «RECORDS SECTION ak Department of Health Nee “ “ NL

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d.) Non-operation of the disease surveillance and response systems by responsible persons or entities mentioned under this IRR shall be considered a violation ofthis provision. e.) Non-cooperation of persons and entities that should report notifiable diseases or health events ofpublic concer, which can be any ofthe followingacts: i. Failure of persons and entities mentioned in Rule VI, Section 2 of this IRR to comply with mandatory reporting of notifiable diseases or health events of public concern; or ii. Failure of persons and entities mentioned in Rule VI, Section 2 of this IRR to grant public health authorities timely access to information of personsinfected with or suspected of having notifiable disease or health events of public health concem. f.) Non-cooperation of persons and entities that should respond to notifiable diseases or health events of public concern, which can be any ofthe following acts: i. Failure on thepart of entities required to establish ESUs under Rule VII ofthis IRR to comply with the duty to establish the same; ii. Failure on the part ofentities identified under Rule X of this IRR to perform specific disease responseactivities listed therein; iii. Failure to abide by minimum public health standards and/or non-pharmaceutical interventions as enforced by public health authorities pursuant to Rule X of this IRR; or iv. Failure to abide by other disease response activities as enforced by public” health authorities pursuant to Rule X of this IRR. g.) Non-cooperation of the person orentities identified as having the notifiable disease, which can be anyofthe followingacts: i. Refusal of the person identified by a public health authority as suspect or probable case to submit for physical examination and/orprovisionofclinical samplesas requiredfor the investigation; ii. Failure or refusal of the person or entity identified by a public health authority identified as suspect, probable or confirmed case to provide the required information necessary for disease surveillance or response, including for contact tracing activities; iii. Failure to comply with a quarantine/ isolation orderor directive duly issued by a public health authority; iv. Violation of any terms or conditions of the quarantine or isolation order or directive issued by a public health authority; or v. Knowingly or willfully infecting another with a contagious or communicable disease classified as notifiable or a health event of public health concern, or aids in the spreading of the same. CERTIFIED TRUE COPY a AUG 28 p020 Jae ( corazon’ DEVA CRUZ pe 29 of 31 KMITS - RECORDS SECTION Department of Healthi “ a ue

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h.) Non-cooperation of the person orentities affected by a notifiable disease or a health event ofpublic health concern, which can be any ofthe followingacts: i. Failure by close contacts to cooperate/submit to public health authorities doing contact tracing activities upon being notified of their status as such; ii. Violation of community quarantine or stay-at-home order or directive issued by public health authorities; or iii. Commission of the acts of discrimination against an individual on account of having a notifiable disease whether probable, suspect, or confirmed, whether undergoing treatment or recovered; on account of being a health worker(e.g. doctors, nurses, and other allied health workers) or being a personnel providing health and emergencyfrontline service. Section 2, Inter-Agency Arrangement, - The DOH maycoordinate with law enforcement agencies on the appropriate arrangement to implementthe filing of the criminal charges against the erring personsorentities for violation of the Act and this IRR. Section 3. Penalties. - Any person or entity found to have committed any of the prohibited acts referred to in Section 1 of this Rule shall be penalized with a fine ofnot less than Twenty Thousand Pesos (P20,000.00) but not more than Fifty Thousand Pesos (P50,000.00) or imprisonmentofnotless than one (1) month but not more than six (6) months, or both such fine and imprisonment, at the discretion of the proper court. If the offender is a foreign national, the case shall be referred to the Bureau of Immigration for the institution of summary deportation proceedings after service of sentence. If the offender is a professional with a license issued by the Professional Regulation Commission, the case shall be referred to the said commission for the institution of appropriate proceeding to suspend or revokethe license to practice for any violation of the Act and this IRR. If the offender is a civil servant, the case shall be referred to the Civil Service Commission for the institution of appropriate proceeding to suspend or revoke thecivil service eligibility for violation of the Act and this IRR. If the offense is committed by a public or private health facility, institution, agency, corporation, school, or other juridical entity duly organized in accordance withlaw,the chief executive officer, president, general manager, or such otherofficer in charge shall be held liable. In addition, the business permit and license to operate of the concemedfacility, institution, agency, corporation, school, or legal entity shall be cancelled. CERTIFIED TRUE COPY RAZO ihe ‘CRUZ ) Core WNSebelSECTION: LOE Department of Health 30 of 31

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RULEXII FINAL PROVISIONS Section 1. Appropriations. - The amount needed for the initial implementation of this IRR shall be charged against the current year’s appropriations of the DOH. Thereafter, such sums as may be necessary for the continued implementation of this IRR shall be included in the annual General Appropriations Act. Section 2. Construction and Interpretation.

These rules shall be given a liberal construction in favor of measures instituted by public health authorities in the exercise of the statutory and regulatory authority vested by the Act and this IRR to protect public health. Section 3. Separability Clause. - If any part, section or provision of this IRR is held invalid or unconstitutional, other provisions not affected thereby shall remain in full force and effect. Section 4. Repealing Clause. - The Implementing Rules and Regulations of Republic Act No. 11332, or the “Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern” issued by the DOH on 23 March 2020 is hereby repealed. All orders, issuances, and rules and regulations or parts thereof inconsistent with the provisions of this IRR are hereby repealed or modified accordingly. Section 5. Effectivity. - This IRR shall take effect immediately upon its publication in the Official Gazette or in a newspaperof general circulation. Let copies of this IRR be submitted to the Office of the National Administrative Register of the University of the Philippines Law Center. Approved: . DUQUEIII, MD, MSc Secretary of Health CERTIFIED TRUE COPY si AUG 282020 CORAZON/S. DEL CRuz~| KMITS - RECORDS SECTION Dopartment-of Health MA f Vv 31 of 31

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The 2020 Revised Implementing Rules and Regulations of Republic Act No. 11332, or the Mandatory Reporting of Notifiable Diseases and Health Annex “A” - Annex “B”- Annex “C”- Annex “D”~ Annex “E”- Events of Public Health Concern Act LIST OF ANNEXES . (online link: http://bit,ly/RA11332annexes) DOH Administrative Order No. 2019-0060 or the Guidelines on the Implementation of the National Health Facility Registry Case Investigation Forms Case Report Forms Event-based Surveillance Forms Minimum Public Health Standards or Non-Pharmaceutical Interventions Required of Communities and the General Public CERTIFED-TRUE COPY ome Lo AUG 28°2020 - hls eafll“ehhcou

MITS - RECORDS’ SE = i Department” of Health ~ VA sar ( mA

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Republic ofthe Philippines Department of Health OFFICE OF THE SECRETARY DEC 20 2013 ADMINISTRATIVE ORDER No. 2019 —_0060 SUBJECT: Guidelines on the Implementation of the National Health Facility Registry I. RATIONALE The Universal Health Care (UHC) Act (RA 11223) states that every Filipino shall be granted immediate eligibility and access to care through a registered network of health care providers known as Health Care Provider Network (HCPN). To achieve this end, quality data from all health facilities must be submitted and exchanged within the HCPN in a timely and efficient manner. This is further emphasized in the FOURmula One (F1) Plus for Health which states the importance of quality data and use of evidence for health policy development, program planning and implementation. The cornerstone to implement these is the Philippine eHealth Strategic Framework 2014-2020 which specifies the Philippine Health Information Exchange (PHIE) as the infrastructure for sharing of health information among participating health care providers in the treatment and care ofpatients. The creation of the National Health Facility Registry Annex "A" (NHFR) aims to provide a master facility list that sets attributes to uniquely identify both . private and public facilities and their corresponding service capability that will enable this exchange across information systemsin the health sector. Leveraging the NHFR to facilitate linking and exchange of data, such as PHIE,will produce comparable facility data sets useful for health facility operations such as supply chain, human resource management including disease reporting to unify multiple surveillance systemsand tracking of patients. A functional facility registry is one that is updated regularly through standard guidelines, is accessible to public and private stakeholders, meet the data needs of consumers,and is housed in a software solution that facilitates data curation, update, and archiving of no longervalid data. In view ofthis, guidelines on the NHFR implementation has been developed to address proliferation of health facility lists with different naming conventions and coding and address problemsin sharing, exchange, and consolidation of data in health facilities. Il. OBJECTIVES This Order aimsto institutionalize the NHFR as the official national reference of all health facilities in the Philippines and mandates the use of NHFRinall health facilities andall their corresponding information systems. Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila @ Trunk Line 651-7800, loc 1113, 1108, 1125 Direct Line: 711-9502; 711-9503 Fax: 743-1829 ® URL: http://www.doh.gov.ph; e-mail: offic hZdoh.gov ee

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The specific objectives ofthis Orderareto: 1. Provide clear operational guidelines for a sustainable, reliable, and credible registry system; 2. Ensure compliance of health stakeholders with the directives and guidelines of updating health facility data; and 3. Establish NHFRas an up-to-date, participatory, and easily accessible reference directory for the HCPN. IH. SCOPE AND COVERAGE These guidelines shall apply to all public and private health facilities in the Philippines licensed and registered by the Department of Health, including health facilities to be constructed/under construction. IV. DEFINITION OF TERMS For the purposesof this Order, the succeeding terms and acronyms shall be defined as follows: 1. Health facility — an institution that has health care as its core service, function or business. Health care pertains to the maintenance or improvementof the health of individuals or populations through the prevention, diagnosis, treatment, rehabilitation and chronic managementof disease, illness, injury and other physical and mental ailments or impairments of human beings. (See Annex A for list of facilities and their definition) 2. National Health Data Dictionary — reference on data definitions and information standards relevant to the health sector; provides a common languagefor the various agencies and governments involved in health services 3. National Health Facility Registry (NHEFR) — the official and complete list of all health facilities in the country that has a unique identification code, complete and up-to-date georeferenced registry 4. Spatial Data — also known as geospatial data; it is the data or information that identifies the geographic location of features and boundaries on Earth _ 5. Validate — To check all existing content of the NHFR and ensure entries are complete and correct V. GENERAL GUIDELINES 1. NHFRshall serve as the official and updated reference ofall health facilities in the country. a. All health facilities, especially those with License to Operate or Certificate of Accreditation, shall be reported and included in the NHFR. Health facilities include, but not limited to, Hospitals, Infirmaries, Rural Health Units, City Health Centers, Barangay Health Stations, Birthing Homes, Drug Abuse Treatment and Rehabilitation Centers, Diagnostic/Therapeutic Facilities, Medical Facilities for Overseas Workers and Seafarers, Water Testing Facilities, Social Hygiene Clinics, Psychiatric Care Facilities, School Clinics, Kidney Transplant Facilities, Blood Service Facilities, , tt

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Clinical Laboratories, Dental Clinics, Dialysis Clinics, and HIV Testing Centers b. The public can access and download the updated list of health facilities through the official NHFR website — nhfr.doh.gov.ph c. NHFRshall be available, accessible and downloadable twenty-four (24) hours a day and seven (7) days a week except during regular maintenance and technical downtimes. d. NHFR database shall be validated and updated every March by the DepartmentofHealth through the Knowledge Managementand Information Technology Service (KMITS) 2. NHEFRshall follow eHealth standards. a. NHFRshall use terminologies consistent with the National Health Data Dictionary. b. Spatial data collection procedure shall conform to the Geographic Data Collection Protocols of the Department of Health posted at DOH website with the link: www.doh.gov.ph/gps-protocols and attached as an annex in the NHFR Manual, c. NHFR data shall at all times be kept secured and protected. d. It shall follow a standard documentation for monitoring updates. 3. All health facilities shall display their NHFR code in a metal plate (Annex B). VI. SPECIFIC GUIDELINES 1. Inputting data into the NHFR a. Only the Department of Health through the Knowledge Management and Information Technology Service (KMITS), Centers for Health Development (CHD) Regulation, Licensing and Enforcement Division (RLED) and Provincial DOH Office PDOHO) Development Management Officers (DMO)shall input and edit data in the NHFR. b. NHFR user accounts shall be created: One (1) for the RLED unit of the CHD, one(1) for the Information and Communications Technology (ICT) unit of the CHD, and one (1) for each PDOHO DMO. Foruser account application and management, refer to the NHFR Manual of Operationsor at nhfr.doh.gov.ph/manual. c. The PDOHO DMOsshall use the NHFR Data Collection Form (Annex C) to collect updated information from Barangay Health Stations (BHS) and _ Rural Health Units (RHU). 2. Updating the NHFR a. The PDOHO DMOsshall update the data ofBHSs and RHUsandthe central and regional licensing officers shall update the data of all licensed health facilities of DOH. b. The CHD Health Facility Development Unit CHFDU) shal! coordinate with the PDOHO DMOs and CHD RLEDand inform them of the necessary updates that must be reflected in their regions’ list of health facilities in the NHER.In coordination with the Provincial Health Office, the HFDU shall liaise for data quality and oversight. oo

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c. The PDOHO DMOs, central and regional licensing officers together with KMITS shall check the validity ofthe information in the NHFR every first quarter of the year. 3. Monitoring and reporting a. KMITS shall create status reports of NHFR updates which shall be disseminated to the CHDs. b. NHERshall conform to a vetted monitoring and evaluation framework to guide impact and use. (Annex D) VII. ROLES AND RESPONSIBILITIES 1. Knowledge Management and Information Technology Service (KMITS)shall: a. Oversee and manage operational activities regarding NHFR forming a technical working group whowill update policies and plans on NHFR; b. Lead consultative and advisory activities with regard to the conceptual and regulatory aspects ofthe registry; Review and approve the updatedattribute data submitted by NHFR users Provide technical assistance/training to build capacity in using the system; e. Resolve issues, concerns and problems on the development, utilization, and implementation of the system; f. Implement NHFR monitoring and evaluation mechanisms to improve data quality and use including documenting and reporting of users’ feedback and recommended improvements in the system; p.9 2. Centers for Health Development (CHD) shall: a. Request from KMITS, unique NHFR codes for newly licensed, registered or aboutto be constructed health facilities. b. Update new attributesofall health facilities already captured in the NHFR; Note: Refer to the NHFR Manual of Operations for the personnel responsible and step-by-step guide for the updating process Provide technical assistance to NHFR users in their respective region; Assist KMITSin conducting capacity building activities; Report issues, concerns and problems encountered while using NHFR; and Recommend prospective improvements of the system Include NHFR facility codes when identifying health facilities in all their activities (i.e. data collection, reports list, etc.) wins Ae 3. All Health Facilities shall: Ensurethat their health facility is registered in NHFR; Report changesin health facility attributes to DMOs; c. Require electronic medical record system developer or service provider to use NHFR Facility Code, ifusing a non-DOH certified electronic medical record system; d. Display NHFR metal plates prominently in health facilities; and Con4otk oP

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4, Other Government Agencies (GA), Non-government Agencies (NGA), Government-owned and Controlled Corporations (GOCC), private sector, and Local Government Units (LGU) shall: a. Include NHFR facility codes when identifying health facilities in all their activities (i.e. data collection, reportslist, etc.) in coordination with DOH. VII. REPEALING CLAUSE All Orders, rules, regulations, and other related issuances inconsistent with or contrary to this Order are hereby repealed, amended, or modified accordingly. All other provisions of existing issuances whichare not affected by this Order shall remain valid andin effect. IX. EEFECTIVITY | This Order shall take effect immediately. FRANCISCO T. PUQUE III, MD, MSc Secretary of Health A | jaePa 5 of5

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ANNEX A - HEALTH FACILITIES DICTIONARY Health facilities primarily offer direct health service delivery while health offices provide other services to support and/ or facilitate the administration and managementof health care services. At times, these functions are integrated within a single institution and proper identification of function is necessary to avoid multiplicity of considering the total countofhealth facilities. 1. HEALTH FACILITY- an institution that has health care as its core service, function or business. Health care pertains to the maintenance or improvementofthe health of individuals or populations through the prevention, diagnosis, treatment, rehabilitation and chronic managementofdisease,illness, injury and other physical and mental ailments or impairments of human beings. 2. HEALTH OFFICE- a barangay, municipal, city, province, regional government and private offices that do not provide direct health services or with health services not defined as their core service, function or business. These include administrative and managementoffices of municipal, city, provincial and regional health units. Ex. Municipal Health Office, City Health Office, Provincial Health Office, Regional Health Office, research offices, ete. Ownership ofhealth facilities can be divided into: 1. Government — a health facility created by law. A government facility. may be under the National Government, DOH, Local Government Unit (LGU), Department of National Defense (DND), Philippine National Police (PNP), Department of Justice, State Universities and Colleges (SUCs), Government Owned and Controlled Corporations (GOCC) andothers. (A.O. No, 2012-0012) 2. Private — a health facility owned, established and operated with funds through donation, principal, investment or other means by an individual, corporation, organization. A private health facility may be a single proprietorship, partnership, corporation, cooperative, foundation, religious, non-government organization and others. (A.O. No. 2012-0012) HEALTH FACILITIES - DEFINITIONS AND FUNCTIONS: (in alphabetical order) 1. AMBULATORY SURGICAL CLINIC - a health facility which is primarily organized, constructed, renovated or otherwise established for the purpose of providing elective surgical treatment of outpatients whose recovery, under normal and routine circumstances, will not require inpatient care. (4.0. No. 183 s. 2004, A.O. No. 24s. 1994) 2. BARANGAY HEALTH STATION (BHS) - a government primary health facility that provides primary care services at the,barangay level; is focused on preventive and promotive population-based health services, assists in patient navigation as a satellite health facility of tbo |

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5, the Rural Health Unit (RHU) and Urban Health Unit (UHU);and followsthe standardsset by the DOH. The BHSis equivalent to the Barangay Health Center of the Local Government Code of 1991. The term health center is sometimes used by communities to refer to these facilities; see related Rural Health Unit/ Urban Health Unit BIRTHING HOME- a short-stay, non-hospital based health facility that provides maternity services including prenatal and postnatal care, normal spontaneous delivery and care of newborn babies to low-risk mothers and babies. BLOOD SERVICE FACILITY (BSF) — a unit, agency or institution providing blood products. The types of BSF are Blood Station (BS), Blood Collecting Unit (BCU), Hospital Blood Bank (BB), and are Blood Center (BC) (Regional, Sub-National and National). (4.0. No.2008-008) CLINICAL LABORATORY- a health facility where tests are done on specimens from the human body to obtain information about the health status of a patient for the prevention, diagnosis and treatment of diseases. The tests include, but are not limited to, the following disciplines: clinical chemistry, hematology, immunohematology, molecular biology and cytogenetics. The total testing process includes pre-analytical, analytical and post analytical procedures. (R.A. No. 4688, A.O. No. 2007-0027) a) General Clinical Laboratory — provides the following minimum service capabilities such as, but not limited to, routine hematology, qualitative platelet determination, routine urinalysis, routine fecalysis, blood typing, etc. b) Specialized Clinical Laboratory — offers highly specialized laboratory services that are not provided by a generalclinical laboratory. CUSTODIAL CARE FACILITY- a health facility that provides long term care, including basic human services like food, shelter to patients with chronic or mental illness, patients in need ofrehabilitation owing substance abuse, people requiring ongoing health and nursing care due to chronic impairments and a reduced degree ofindependencein activities of daily living. (A.O. No. 2012-0012) DENTAL CLINIC — a section or clinic in a hospital or non-hospital based facility with standard dental equipment, instruments and supplies plus all the anesthetic and sterilization apparatus that provides basic and/or expanded outpatient services for oral health education, oral examination, fluoride application, oral prophylaxis, tooth filling, tooth extraction, root canal, minor surgeries. May also offer specialized dentistry service such as orthodontic treatment, cosmetic dentistry, prosthodontic dentistry and diagnostic dental services. DIAGNOSTIC FACILITY-— a type of health facility that examines the human body or specimens from human body(except laboratory for drinking water analysis) for the diagnosis, sometimes treatment of diseases. The test covers the pre-analytical, analytical and post

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analytical phases of examination. (A.O. No. 2012-0012) Examples: Clinical Laboratory, Drug Testing Facility, Radiologic Facility, HIV Testing Center, Water Testing Facility 9. DIALYSIS CLINIC - a health facility where a cleansing process using dialyzing equipment (artificial kidney) and appropriately recognized procedures is performed. (4.0. No. 2012- 0001) 10. DRUG ABUSE TREATMENT AND REHABILITATION CENTERS — a health facility that provides comprehensive patient drug treatment and rehabilitation services which ranges within a spectrum of medical and psychological management. This is further classified into: a. Non-residential Treatment and Rehabilitation Center / Outpatient Center — a health facility that provides diagnosis, treatment and managementof drug dependents on an outpatient basis. It may be a drop-in/walk-in center, recovery clinic, or any other facility with consultation and counseling as the main services provided, or may be an aftercare service facility. Patients diagnosed with moderate substance use disorder are oftentimes referred to this center. b. Residential Treatment and Rehabilitation Center/ Inpatient Center ~ a health facility that provides comprehensive and rehabilitation services utilizing any of the accepted modalities as described in the Manual of Operations towards the rehabilitation of a person with substance use disorderin an inpatient basis. Patients diagnosed with severe substance use disorder are often times admitted to this center. c. Residential Treatment and Rehabilitation Center with Outpatient Service Capability — a health facility that provides both outpatient and inpatient service. _ 11. DRUG TESTING FACILITY- a health facility that is capable of testing a specimen to determine the presence of dangerous drugstherein. a. SCREENING LABORATORY —a laboratory capable of drug screening test to eliminate negative specimen from further consideration and to identify the presumptively positive specimen. b. CONFIRMATORY LABORATORY ~— a laboratory that performs qualitative and quantitative examination of a specimen independent from that of a drug screening test. 12. GENERAL HOSPITAL- a type of hospital that provides services for all kinds of illnesses, disease, injuries or deformities. A general hospital shall provide medical and surgical care to the sick and injured, maternity, newborn and child-care. It shall be equipped with the service capabilities needed to support board certified/eligible medical specialist and other licensed physicians rendering services in, but not limited to Clinical Services (Family Medicine; Pediatrics; Internal Medicine; Obstetric and Gynecology; Surgery), Emergency Services, Out Patient Services, Ancillary and Support Services such as clinical laboratory, imaging facility and Pharmacy.(4.0. No. 2012-0012); see related Hospital and Specialty Hospitalotde yo ee

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a. Service capability of general hospitals are the following: 1, Level 1 Hospital - Non-departmentalized hospital that provides clinical care and managementon the prevalent diseases in the locality with clinical services that include general medicine, pediatrics, obstetrics and gynecology, surgery and anesthesia. Provides appropriate administrative and ancillary services (clinical laboratory, radiology, pharmacy) and provides nursing care for patients who require intermediate, moderate and partial category of supervised care for 24 hours or longer. (4.0. No. 2012-0012) 2. Level 2 Hospital - Departmentalized hospital that provides clinical care and managementon the prevalent diseases in the locality, as well as particular forms of treatment, surgical procedures and intensive care. Same clinical services provided in Level 1 Hospital, as well as specialty clinical care. Provides appropriate administrative and ancillary services (clinical laboratory, radiology, pharmacy), gives total nursing and intensive skilled care. (4.0. No. 2012-0012) 3. Level 3 Hospital - Teaching andtraining hospital that provides clinical care and managementon the prevalent diseases in the locality, as well as specialized and sub specialized forms of treatment, surgical procedure and intensive care. Same clinical services provided in Level 2 Hospital, as well as sub-specialty clinical care. Provides appropriate administrative and ancillary services (clinical laboratory, radiology, pharmacy), nursing care and continuous and highly specialized critical care. (A.O. No. 2012-0012) * 13. HALFWAY HOUSE -— a community-based, short term, housing facility for those in recovery from physical, mental, and emotional disabilities, including those suffering from mild to moderate drug & alcohol dependence, with a structured environment and crucial support in reintegrating into society. 14. HIV TESTING CENTER— a health facility credited by the Health Facilities and Services Regulatory Bureau (HFSRB), capable of performing HIV Testing by medical technologists that have undergone thetraining on HIV Testing Proficiency. (4.0. No. 2014 — 0005) 15. HOSPICE — a health facility that provides hospice care defined as a componentof palliative care of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, otherwise known as end-of-life care that consists of medical, psychological, spiritual and practical support or patients unable to perform self-care and with declining conditions despite definitive treatment and other disease modifying interventions. (IRR ofR.A. No. 11215) 16. HOSPITAL- a place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment andcare ofindividuals suffering from illness, disease, injury or deformity, or in need of obstetrical or other medical and nursing care. The term ‘hospital shall also be construed as any institution, building or place where there are installed beds, or cribs, or ONpheraG | we

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bassinets for twenty-four-houruse or longer by patients in the treatment of diseases, diseased- conditions, injuries, deformities, or abnormal physical and mental states, maternity cases, and all institutions such as those for convalescence, sanitaria or sanitaria care, infirmities, nurseries, dispensaries and such other names by which they may designated. (R.A. No. 4226),see related General Hospital and Specialty Hospital 17. HUMAN STEM CELL (CELLULAR THERAPY FACILITY)-~a facility that mayact as an entity providing the service of cellular therapy product collection and a location where cellular therapy product processing activities are performed in support of its clinical program. Thefacility may also serve as the storage area for cellular therapy productfor future processing, distribution or administration. (4.0. No. 2013-0012) 18. INFIRMARY — a health facility that provides emergency treatment and care to the sick and injured, as well as clinical care and management to mothers and newborn babies.It provides basic, non-complex inpatient, diagnostic, and treatment services usually by general practitioners. The need for infirmaries is decided according to the local context. (R.A. 4226, A.O, No. 2012-0012) 19. IN-VITRO FERTILIZATION CENTER -— a health facility that performs in-vitro fertilization and other health related services that has passed accreditation of the DOH. 20. MEDICAL FACILITIES FOR OVERSEAS WORKERS AND SEAFARERS- a health facility that conducts Pre-Employment Medical Examination (PEME). It refers to a complete medical examination during screening to determine physical and mental fitness to work for overseas workers and seafarers for inter-island/overseas employment. (4.0. No. 101 - 2004) 21. MEDICAL OUTPATIENT CLINIC- a health facility that provides ambulatory general or specialized outpatient care to patients with injuries or infirmity requiring the range of non- urgent to immediate care, commonly addressing minor and non-life threatening illnesses and injuries. Examples: Family Planning Clinic, HIV Clinic, Social Hygiene Clinic, School Clinic, Office Clinic 22. MENTAL HEALTH FACILITY- refers to any establishment, or any unit of an establishment, which has,as its primary function the provision of mental health services. (R.A. No. 11036) 23. MOBILE HEALTH SERVICE — a mobile motorized resource with ability to transport, transfer, carry and provide health services. These mobile resources are housed and offered as a service of a “mother”health facility or health office. Ex. Ambulance, Mobile clinic, Mobile dental van, Mobile x-ray 24. NATIONAL REFERENCE LABORATORY- the highest level of laboratory in the country, mandated to provide laboratory confirmatory services, provide training, perform surveillance, do outbreak response, provide External Quality Assurance, perform kit evaluation, and do research. NRL may have designated Sub-National Laboratories (SNL). Page 5 of10 ree

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25. NEWBORN HEARING SCREENING REFERENCE CENTER- shall refer to the central facility at the National Institutes of Health (NIH) that defines testing and follow-up protocols, maintains an external laboratory proficiency testing program, oversees the national testing database and caseregistries, assists in training activities in all aspects of the program, and oversees content of educational materials. (R.A. No. 9709)
26. NEWBORN SCREENING REFERENCE CENTER- central facility at the National Institutes of Health, Philippines (NIHP)that defines testing and follow up protocols, maintains an external laboratory proficiency testing program, oversee the national testing database and case registries, assist in training activities in all aspects of the New Born Screening (NBS) program, oversee content of educational materials, recommends establishment of New Born Screening Centers (NSCs) andact as the Secretariat of the Advisory Committee on Newborn Screening. (IRR ofR.A. No. 9288) 27, NUCLEAR MEDICINE FACILITY- a health facility, presently regulated by Philippine Nuclear Research Institute (PNRI), embracing all applications of radioactive, materials in diagnosis, treatment or in medical research, with the exception of the uses of sealed radiation sources in radiotherapy. (A.O. No. 2012-0012)
27. NURSING HOME- a residential facility providing a high level of long-term custodial, personal or nursing care for persons such as the aged or the chronically ill. The facility may also provide palliative and/or hospice care at endoflife.
28. OFFICE CLINIC — a medical outpatient clinic inside a professional work or employment environment that provides primary care services including treatment of minor ailments, immediate management of emergency cases, health education, health promotion andreferral to an appropriate facility; see related Medical Outpatient Clinic
29. OUTPATIENT DRUG TREATMENT FACILITY- a community-based drug recovery facility which adheres to a specific integrated model of treatment for people affected by drug use. It provides a continuum ofcare from outreach and low threshold services and involves the coordination of a numberofhealth, social and other non-specialist services needed to meet the patient’s needs. An Outpatient Drug Treatment Facility within a Drug Abuse Treatment and Rehabilitation Center (DATRC) or Hospital is recognized as its service or unit and not as a separate facility.
30. PHARMACEUTICAL OUTLET-— refer to entities licensed by appropriate government agencies, and which are involved in compounding and/or dispensing and selling of pharmaceutical products directly to patient or end-users. (R.A. No. 10918)
31. PHYSICAL THERAPY AND REHABILITATION FACILITY -a health facility concerned with the maximal restoration or development of physical, psychological, social, occupational and vocational functions in persons whose abilities have been limited by disease, trauma, congenital disorders, or pain to enable people to achieve their maximum functional age 6 of 10 yent

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abilities. It involves the diagnosis, evaluation and managementof people ofall ages with physical and/or cognitive impairment and disability. (4.0. No. 2012-0012) 33. POLYCLINIC

• a health facility which is a combination of three (3) or more medical outpatient clinics that provides general and/or specialist examination and treatmentto patients and offers diagnostic laboratory and imaging services.

34. PRIMARY CARE FACILITY - a type of health facility that provides population and individual based-health services that accessible, continuous, comprehensive and coordinated care that is accessible at the time of need, including a range of services for all presenting conditions. It also servesas theinitial point of contact for individual based services, through its ability to navigate and coordinate referrals to other health care providers in the health care delivery system, when necessary. Examples of Primary Care Facilities are Urban Health Centers in cities, Rural Health Unit, and health stations. 35, QUARANTINE CLINIC- a designated health facility for referral of suspect/s or probable case/s of public health emergency of international concern where people who have been exposedto an illness, usually an infection, but are notill or have not yet shown any sign of the illness are restricted to. (IRR ofR.A. No. 9271)
35. RADIOLOGIC FACILITY — a health facility concerned with the use ofimaging techniques in the study, diagnosis and x-ray guided treatment of disease. This includes the use of x-rays in general radiography and fluoroscopy, interventional radiology, lithotripsy, computed tomography, mammography, bone densitometry, and tumorlocalization and simulation.
36. RECOVERY CLINIC — a non-residential treatment facility where specialized consultations, evaluations and treatment may be provided for those recovering from drug use.
37. RURAL HEALTH UNIT/ URBAN HEALTH UNIT (RHU/UHV) - a government primary health facility that serves as first contact of primary care services in the municipality or city delivering health promotion, disease prevention, health maintenance, counselling, patient education, diagnosis and management & treatment of acute and chronic illnesses and referrals. It ensures a follow-through course of treatment of a person as whole and provides both population-and individual-based health services. It provides leadership in patient navigation and coordination in a network and follows the standards set by the DOH. The RHU/ UHUis equivalent to the Municipal or City Health Center ofthe Local Government Code of 1991. The term health center is sometimes used by communities to refer to these facilities; see related Barangay Health Station
38. SANITARIUM- is an institution established to make available hospital services specifically for Hansenites (Hansen Disease). The sanitaria serves as the referral center for the management of complications, patient and family counseling and community education for leprosy and also for the integration of its Multi Drug Therapy (MDT)treatment. (4.0. No. 2005-2013)
39. SCHOOL CLINIC- a medical outpatient clinic inside school, college or university premises that provides primary care services including but not limited to oral care, health WD wilbim | ee ya

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health promotion, treatment of minor ailments, immediate management of emergency cases and referral to an appropriate facility, following the standards set by the DOH; see related Medical Outpatient Clinic 41. SPECIALTY HOSPITAL - a hospital that specializes in a particular disease or condition or in one typeof patient. A specialized hospital may be devotedto treatment ofany the following: (4.0. No. 2012-0012); see related Hospital and General Hospital a. Treatment of a particular type of illness or for a particular condition requiring a range of treatment. Example ofthese hospitals are Philippine Orthopedic Center, National Centerfor Mental Health, San Lazaro Hospital b. Treatment of patients suffering from diseases of a particular organ or groups of organs, Example of these hospitals are Lung Center of the Philippines, Philippine Heart Center, National Kidney and Transplant Institute c. Treatment of patients belonging to a particular group such as children, women, elderly and others. Examples of these hospitals are Philippine Children’s Medical Center, National Children’s Hospital, Dr. Jose Fabella Memorial Hospital 42. SPECIALIZED HEALTH FACILITY - a type of health facility that provides highly specialized care addressing particular conditions and/ or providing specific procedures and management of cases requiring specialized training and/ or equipment. Specialized health facilities within hospitals are recognized as a service/ unit and not as a separate stand-alone facility. Examples: Dialysis Centers, Mental Health Facilities, Ambulatory Surgical Clinics,

Drug Abuse Treatment and Rehabilitation Centers 43. TRADITIONAL AND COMPLEMENTARY MEDICINECLINIC— a health facility that provides a broad set of health care practices that are not integrated into the dominant health care system. Examplesare, but not limited to the following services: acupuncture, chiropractic, naturopathy, etc. (PITAHC ORDER 2018 — 109) 44. TRANSITIONAL CARE FACILITY —a type ofhealth facility that oversees the continuity of care during the course of chronic or acute illness. The transitional care facilities also encompass both the sending and receiving aspects of transfers including, but not limited to, logistical arrangements, patient and family health education and coordination among health professionals involved in the transition. Examples: Nursing Home, Hospice, Infirmary, Halfway House 45. WATER TESTING FACILITY -—a facility that performs either bacteriological, biological, physical, chemical and radiological analysis, or a combination of any of these methods to determine the potability and safety of water. (4.0. No. 2006 — 0024) were

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Prepared By: Health System Development and Management Support Division (HSDMSD) Health Facility Development Bureau (HFDB) Department of Health References for the Health Facilities Dictionary: Republic Act 9228 entitled “Rules and Regulations Implementing Republic Act 9228 otherwise knownasthe “Newborn Screening Act of2004” Republic Act No. 9271 entitled ““An Act Strengthening The Regulatory Capacity OfThe Department Of Health In Quarantine And International Health Surveillance, Repealing For The Purpose Republic Act No. 123 Of 1947, As Amended” Republic Act 9709 entitled “An act establishing a Universal Newborn Hearing Screening Program for the Prevention, Early Diagnosis and Intervention of Hearing Loss” Republic Act 10918 (IRR)entitled “An Act Regulating and Modernizing the Practice of Pharmacyin the Philippines, Repealing For the Purpose Republic Act Numbered Five Thousand Nine Hundred Twenty-One (R.A. 5921), Otherwise Known As the Pharmacy Law” Republic Act No. 10354 entitled “An Act Providing For A National Policy On Responsible Parenthood And Reproductive Health” Republic Act No, 10918 entitled “An Act Regulating and Modernizing the Practice of Pharmacy in the Philippines, Repealing for the Purpose Republic Act Numbered Five Thousand Nine Hundred Twenty-One (R.A. No. 5921), Otherwise Knownas the Pharmacy Law” Rules and Regulations (IRR) of Republic Act No. 11215 otherwise knownas the National Integrated Cancer Control Act (NICCA). Administrative Order No, 2004 - 083 entitled “Rules and Regulations Governing the Licensure and Regulation of Ambulatory Surgical Clinics” Administrative Order No. 2004 -147 entitled “Amending Administrative Order No. 70-A, series 2002 re: Revised Rules and Regulations Governing the Registration, Licensure, and Operations of Hospitals And Other Health Facilities in the Philippines” Administrative Order No. 2004 - 181 entitled “Rules and Regulations Governing Accreditation of Medical Facilities for Overseas Workers and Seafarers” Administrative Order No. 2005 — 0013 entitled “Revised Roles and Responsibilities of the Eight (8) Sanitaria Hospitals Administrative Order 2006 — 0024 entitled “Rules and Regulations Governing the Accreditation of Laboratories for Drinking Water Analysis” Page 9 of 10 pnfinre

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Administrative Order No. 2008 ~ 0027 entitled “Revised Rules and Regulations Governing the Licensure and Regulation of Clinical Laboratories in the Philippines” dministrative Order No. 2008 - 008 entitled “Rules and Regulations Governing the Regulation of Blood Service Facilities” Administrative Order No. 2008 — 0010 entitled “Revised Rules and Regulations Governing the Registration and Licensure of Dental Laboratories in the Philippines” Administrative Order No. 2012-0001 entitled “New Rules and Regulations Governing the Licensure and Regulation of Dialysis Facilities in the Philippines Administrative Order No. 2012 - 0012 entitled “Rules and Regulations Governing the New Classifications of Hospitals and Other Health Facilities in the Philippines” Administrative Order No. 2013 — 0012 entitled “Rules and Regulations Governing the Accreditation of Health Facilities Engaging in Human Stem Cell and Cell-Based or Cellular Therapies in the Philippines” Administrative Order No. 2014 — 0005 entitled “Revised Policies and Guidelines in the Collaborative Approach of TB and HIV Prevention and Control” Administrative Order No. 2014 - 0012 entitled “New Guidelines On The Management Of Rabies Exposures: To Provide New Policy Guidelines And Procedure To Ensure An Effective And Efficient ManagementFor Eventual Reduction IfNot Elimination OfHuman Rabies” Administrative Order No. 2014 — 0034 entitled “Rules and Regulations on the Licensing of Establishments Engaged in the Manufacture, Conduct of Clinical Trial, Distribution, Importation, Exportation and Retailing of Drug Products and Issues of Other Related Authorizations” Administrative Order 2018 -0014 entitled “Revised Guideline in the Implementation ofthe One-Stop Shop Licensing System” Dangerous Drug Boards Regulation No. 4 s. 2003 entitled “Implementing Rules and Regulations Governing Accreditation of Drug Abuse Treatment and Rehabilitation Centers and Accreditation of Center Personnel” PITAHC Order No. 2018 ~ 109 entitled “Guidelines on the Management of Research Programs/Projects on Traditional Medicine and Complementary Medicine (TM/CM)” M Sanford, Angela & Orrell, Martin & Tolson, Debbie & Abbatecola, Angela & Arai, Hidenori & Bauer, Juergen & J Cruz-Jentoft, Alfonso & Dong, Birong & Ga, Hyuk & Goel, Ashish & Hajjar, Ramzi & Holmerova, Iva & R Katz, Paul & Koopmans, Raymond & Rolland, Yves & Visvanathan, Renuka & Woo, Jean & Morley, John & Vellas, Bruno. (2015). An International Definition for “Nursing Home”. Journal of the American Medical Directors Association. 16. 181-4. 10.1016/j.jamda.2014.12.013. rofeas|

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Annex B. Nationa} Health Facility Registry Template Specifications for NHFR Metal Plate: ” soe 12.00" -:- eee ” . weeee ee

Y NATIONAL HEALTH FACILITY REGISTRY--: -}--- ~~ encraveo Lerters (GREEN) . ' 1.5mm STAINLESS STEEL : . "ENGRAVED NUMBERING (BLUE) DOH LOGO DIRECT PRINTED --—+- ——- 5. TO STAINLESS STEEL oS . 3 j—a-—=-=———" ENGRAVED BOARDER LINE (@LUE) WESLEYAN UNIVERSITY GENERAL HOSPITAL AND —}—@_— encrsveo cervens ccreen) . CARDIOVASCULAR CENTER 7 |: a 144°a HOLE FOR SCREW OR BOLT STAINLESS STEEL PLATE Figure 1. NHFR Metal Plate specifications ox os Figure 2. Sample NHFR MetalPlate Guidelines for Display of NHFR in Health Facility

1. Ensure that the metal plate is prominently displayed at the lobby, entrance, or reception counter ofthe health facility at all times.

Do not add any word, figure, mark, picture, design, drawings, advertisement or imprint. of any nature on the metalplates. 3. Do not alter the content of the plate without prior notice to DOH. Any changes in the health facility information (Health Facility Name, Address, Contact Number, and Head of the Facility, etc.) shall be reported to the CHD. wtf He Page 1 ofl?

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Annex C, NHFR Collection Form OFFICIAL HEALTH FACILITY NAME NHER Code(if available) Old health facility name(if available) {_ [RHU | | BHS | Forlicensed facilities: Health facility type Hospital Infirmary . 1 heck b ided Level Bed capacity; (please check box provided) Bedcapacity; Birthing Home DATRC Note: For licensed health facilities, please Bedcapacity Bed capacity: ATTACH photocopyof permit and License validity: license to operate Licensing status: License number: Ownership (please check boxprovided) || Government || Private ADDRESS: Street name and number Building name and number Region Province Municipality Barangay Zip Code CONTACT DETAILS: Landline number Fax Number Mobile number Email Address FACILITY HEAD: First name Middle name

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Last name Position title GEOGRAPHIC COORDINATES (in decimal degrees): Latitude (up to 6 decimaldigits) Longitude (up to 6 decimaldigits) Methodof geographic data collection (i.e. GPS device, Google Maps, Mobile phone, etc.) RESPONDENT: Full name Position title Signature Mobile number E-mail address Date NOTED BY (DMO/MHO): Full-name Positiontitle Signature E-mail address Date For more information, email the NHFR administrator: nh loh.gov.ph v3.0

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Annex D. NHFR Monitoring and Evaluation Framework INPUTS OUTPUTS OUTCOMES IMPACT TWGmeeting occur regularly TWGformed with updated eye : terms ofreference and [—— aang Ox is Functional NHERis member composition NHER costed workplan, em as. H used to link data within submitted, and published core function information systemsat annually health facilities Stakeholders comply through facility and regularly feedback registry service on policies tags NHER program guidelines and NHER program guidelines policies validated by stakeholders andpolicies drafted and published at website ‘ Complete NHFR data NHER focal points at iabtnaaahcra produced used by various Robust, central and regional of the codes stakeholders for their comprehensive, and offices identified operations efficient NHER for decision making used NHFRdata is used for by public and private °, “ane t sates System users trained Data quality within NHFR assured decision making health facilities System administrators are capable eHealth standards (such to extend and manage NHFR as dictionaries, System administrators stakeholder requirements terminologies are Interoperable NHFR are trained to develop [|-———> implemented) with health sector NHFR information systemsis System administrators are able to made available connect NHFRto health facility Other NHER interfaces profiling systems and other developed for other health visualization platforms (i.e. GIS, information systems dashboards) to appreciate data wr oe Page lof 1

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. Annex "B" Page 1 of 2 Case Investigation Form Philippine Integrated Disease Rabies (ICD 10 Code:A82) Surveillance and Response Nameof DRU: Type: ORHU OCHO OGov't Hospital OPrivate Hospital OClinic OGov't Laboratory OPrivate Laboratory ODAirport/ Address: Seaport I. PATIENT Patient Number. Patient's LastName First Name Middle Name INFORMATION: Current Address: (Specify House/Let #, Street/Purok/Subdivision, Barangay, Munici- AMM] DD| YY| Age: pality/City, Province, Region) Sex: O Male OG Days Permanent Address: (Specify House/Lot #, Street/Purok/Subdivision, Barangay, €X: lo Female |Date of Oo Municipality/City, Province, Region) Birth: Months O Years District: HCPN Patient Admitted? GlYes CINo OUnknown AM 20 Ww RM vy Date Admitted/ Seen/ Date Onsetof Consult Illness Date of Report: Ar| oo | Name of reporter: Contact Nos.: Date of AM| POT YW : : . : Investigation: Nameof investigator/s: Contact Nos.: Il. EXPOSURE HISTORY: Type of exposure: Obite Oscratch Affected site Osaliva Oconsumedmeat OUnknownOC Other, specify Date of exposure: Place of exposure: Category of Exposure: GG Feeding/touching an animal 0 Licking of intact skin(with reliable history and thorough physica! examination) C Exposure to patient with signs and symptoms of rabies by sharing of eating or drinking untensils O Casual contact(talking to, visiting and feeding suspected rabies cases) and routine delivery of health care to patient withsigns and symptoms of rabies Nibbling of uncovered skin with or without bruising/nematoma Minor scratches/abrasions without bleeding Minor scratches/abrasions which are induced to bleed All Category I! exposures on the head and neck area are considered Category Ill and should be managed as such Transdermal! bites(puncture wounds, lacerations avulsions) or scratches/abrasions with spontaneous bleeding Licks on broken skin or mucous membrane Exposureto a rabies patient through bites,contamination of mucous membranes(eyes,oral/nasal mucosa,genital/anal mucous membanes) or Openskin lesions with body fluids through splattering and mouth-to-mouth resuscitation. O Unprotected handling of infected carcass or ingestion of raw infected meat oo0o0no00g0nv0nod a C Atl Category I! exposures on head and neck area Type of animal: Odog Ocat 0 bat 0 Other, specify Lab. diagnosis done? O Yes ONo OUnknown If Yes, result: Animal status: D domestic O stray Owld © Other, specify Il. VACCINATION HISTORY: Animal vaccination history: Patient History: Date vaccine started i Brand N. if Vaccine: O Vaccinated Wound cleaned?: Yes No Unknown rang Name of waceine © Unvaccinated . . Route of Administration: Patient given RIG?: OYes ONo OUnknown oO mM O intradermal O Unknown (RIG is Rabies Immunoglobulin) Post exposure completed Patient given rabies vaccine?: OYes CINo OG Yes © No Unknown er con't at the back 7 we i) Deliberately providing false or misleading, personal information onthe part of the patient, or the next of kin In case of patient’s incapacity, may Smmattbicte wow em mmesceslan asret Wm cemdew bee Mamssblia Rat bln 4449%

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yN { @ Philippine Integrated Disease
Survelllance and Response PIDSA Case Investigation Form Rabies (ICD 10 Code:A82) Page 2 of 2 IV. CLASSIFICATION AND OUTCOME: FINAL CLASSIFICATION Alive Died Date died: / / 0 Suspect Case O Probable Case D Confirmed Case Case Definition/Classification: Suspect Case A person presenting with an acute neurological syndrome (encephalitis) dominated by forms of hyperactivity (furious rabies) or paralytic syndrome (dumbrabies) that pro- gresses towards coma and death, usually by respiratory failure, within 7-10 days after thefirst symptom if no inten- sive care is instituted or as diagnosed by attending physi- cian. Probable Case Suspect case plus history of contact with suspected or laboratory-confirmed rabid animal. Confirmed Case A suspected casethatis laboratory confirmed. Laboratory Confirmation: -Detection of rabies viral antigens by direct fluorescent antibody test (FAT) or by ELISAin clinical specimens, preferably brain tissue (collected post mortem). -Detection by FAT on skin biopsy (ante mortem). -FAT positive after inoculation of brain tissue, saliva or CSFin cell culture, or after intracerebral inoculation in mice or in suckling mice. -Detectable rabies-neutralizing antibody titer in the serum or the CSFof an unvaccinated person. -Detection of viral nucleic acids by PCR ontissue collect- ed post mortem or intra vitam in a clinical specimen (brain tissue or skin, cornea, urine or saliva). -lsolation of rabies virus from clinical specimens and con- firmation of rabies viral antigens by direct fluorescent antibody testing. . constitute non-cooperation punishable under the Republic Act No. 11332. Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient'swas

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Case Investigation Form Version 2019 Eupanetnegmted eens oD10CodeBOS, BOD Name of DRU: DRU Complete Address: -hasi- —syesI Bok Type: ORHU OCHO OGov't Hospital OPrivate Hospital OClinic Saaney aaateiy POURS Regn OGov't Laboratory OPrivate Laboratory OlAirport/Seaport I. PATIENT INFORMATION Patient Number EPI ID Patient's First Name Middie Name Last Name Sex: 0 Male O Female Date of Birth: |Age: Current Address: (Specify House/Lot #, Street/Purok/Subdivision, Barangay, DO Days Municipality/City, Province, Region) Pregnant? OYONOU ist C] Months if Yes, weeksof pregnancy MM DOD YY IQ Years Patient admitted? OY ON Date Admitted/| Mi| 22| Y |Permanent Address: (Specify House/Lot#, Street/Purok/Subdivision, Barangay, Seen/Consult Municipality/City, Province, Region) Is the case a memberof Indigenous Group? OY ON If YES, specify: Nameof parent/caregiver: |Contact Nos.: Date of Report: HM| 22| Y Inameof reporter: Contact Nos.: Irawetigation: Mt) Be Nameofinvestigator/s: Contact Nos.: Il. CLINICAL DATA Fever: OY ON Arthralgia/arthritis: OY ON Are there any complications? Date onset: / / Swollen lymphatic nodules: OY ON OY ON Rash: OY ON If YES, specify: Date onset: / / lf Y, specify location: Other symptoms: O cervical O sub-occipital Cough: OY ON C post-auricular Working/Final Diagnosis: Koplik sign: OY ON C others, specify Runny nose/coryza: OY ON Red eyes/conjunctivitis: OY ON I. VACCINATION HISTORY AND VITAMIN A SUPPLEMENTATION Patient received measles-containing vaccine (MCV)? oY ON If Yes, indicate the number of doses whicheveris applicable: MV___ MR__ MMR__ Date last dose received MCV: _/ / Measles vaccine received validated through: 1 Vaccination Card Cl Logsheet CI Byrecall O (others, specify) Was vaccination received during special campaigns? OY ON If patient did not receive any MCV,state the reason/s: DO Mother was busy C1 Child wassick 0 Forgot schedule D Againstbelief 0 No vaccine available O Other reasons, specify 0 Medical contraindication O Vaccinator not available O Fearof side effects C1 Not eligible for vaccination Wasthe patient given Vitamin A during this illness? OY ON IV. EXPOSURE HISTORY With history of travel within 23 days prior to onset of rash?: ON OY If YES, specify place and timing: Place of travel: Date of travel:// O <7 days fromrashonset O 7-23 days from rash onset *Was there contact with a confirmed Measles case 7-23 days prior to rash onset? ON OU OY *Was there contact with a confirmed Rubella case 7-23 days priortorashonset? ON OU OY If YES, nameof contact: Place of residence: Date ofcontact // Tick the type of place where exposure probably occur: ODay care OBarangay OHome OSchool CHealth Care Facility ODormitory Others, specify *Are there other known cases with fever and rash (regardless of presence of 3 C’s) inthe community? OY ON ou e Note: If the answerto any of the two questions was YES, coordinate with the ESUfor validation andfield investigation contaf the back Deliberately providing false or misleading, personalinformation onthe part of the patient, or the next of kin in case of patient's incaye | constitute non-cooperation punishable under the Republic Act No. 11332.

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Measles/Rubella Case Investigation Form Version 2019 V. LABORATORY TESTS Specimen collected Date received (Put v in the box in RITM Measles IgM Rubella IgM Virus PCR Provided) If YES, Date sentto| (tobe filledup| Result Result Isolation Result| Result Date Collected RITM by RITM) OSerum ft} ODried Blood Spot ft Pd ClOropharyngeal/ Nasopharyngealswab?| _ /f/f |od VI. FINAL CLASSIFICATION Vil. SOURCE OF INFECTION O Laboratory Confirmed Measles O Epi-linked Confirmed Measles O Measles Compatible O Laboratory Confirmed Rubella O Endemic O Epi-linked Confirmed Rubella O Imported O Discarded Non Measles/Rubella O Import-related O Unknown Vill. OUTCOME: O Died FINAL DIAGNOSIS: O Alive Date died:__/ / CASE DEFINITION AND CLASSIFICATION CASE DEFINITION Suspected case: Any individual, regardless of age, with the following signs and symptoms: e= fever (38°C or more) or hot to touch; and @= Maculo-papular rash (non-vesicular) AND e at least one of the following: cough, coryza (runny nose), or conjunctivitis (red eyes) CASE CLASSIFICATION Laboratory-confirmed Measles: a suspected measies case that has been confirmed by a proficient laboratory as positive for Measles IgM antibodies and/or positive for measles virus isolation or Polymerase Chain Reaction (PCR) Epidemiologically Linked Confirmed Measles: a suspected measles case that has not been confirmed by a laboratory but was geographically and temporally related with dates of rash onset occurring between 7 and 23 days apart from a laboratory-confirmed case or another epidemiologically confirmed measles case Clinically Compatible Measles: a suspected measles case, for which no adequate clinical specimen was taken and the case has not been linked epidemiologically to a laboratory-confirmed case of measles or other communicable disease OR laboratory confirmationis still pending Laboratory-confirmed Rubella: a suspected measles case with a positive laboratory test results for rubella-specific |gM antibodies or otherlaboratory test method Epidemiologically Linked Confirmed Rubella: a suspected case whohas direct contact with another laboratory confirmed rubella case with rash onset occurred 12-23 days before the present case Non-Measles/Rubella Discarded Case: a suspected case that has been investigated and discarded as a non-measties (and non-rubella) when anyof the following are true:

• negative laboratory testing in a proficient laboratory on an adequate specimen collected during the proper time period after rash onset
• epidemiological linkage to a laboratory confirmed outbreak of another communicable diseasethat is not measles/rubella
• confirmation of another etiology SOURCE OF INFECTION: Endemic: a confirmed measles case acquired the infection within the country wherein the chain of measles virus transmission is continuous for 212 months imported. a returning traveler or visitor exposed to measies out- side the country during the 7-23 days prior to rash onset and supported by epidemiological or virological evidence. import-related: a \ocally acquired infection that occurs as part of a chainoftransmission originating from an imported case as supported by epidemiological or virological evidence. Unknown: a confirmed case for which no epidemiological or viro- logical link to importation or endemic transmission can be established after a thorough investigation. LABORATORY CONFIRMATION: Positive serologic test result for anti-meastes 1gM antibodies Fourfold rise in anti-measles IgG antibodies in acute and convales- cent serum e Isolation of measles virus Dot immunobinding assay Polymerase chain reaction (PCR)testing for measles nucleic acid Therapeutic Dosage of Vitamin A for Measles cases: e 50,000 IU for children <6 monthsold e 100,000 IU for children 6 to 11 months old e 200,000 IU for children 12 to 71 months old Note: The therapeutic dosage of Vitamin A for measles cases should be given upon diagnosis regardless of when the last dose of vitamin A capsule was given. Detiberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act No. 11332. ye

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Version 2019 y NS Philippine tntegrated Disease Case Investigation Form Surveillance and Response a Acute Flaccid Paralysis Lae Name of DRU: Type: ORHU OCHO CGov'tHospital OPrivate Hospital DClinic Address: OGov'tLaboratory Private Laboratory DAirport/Seaport |. PATIENT Patient Number: Patient's First Name Middle Name Last Name INFORMATION: Sex: OMale OFemale Date ofBirth: / / Age: ODays Months OYears MM DD YY Nameof Parent/ Caregiver: Current Address: Contact No: Permanent Address: YY DB Ww Patient Admitted? ClYes [No Date Admitted/ Seer/Consult MM Date of Report: ee a Date of Investigation: uu pe a NameofInvestigator: Contact No: Is the case a memberof an Indigenous Group? OY ON If YES, Specify: ll. CLINICAL DATA (Put a check[ V ] In the appropriate box) Deep Previous SITE OF FLACCID Sensory Motor Consultation PRODROME PARALYSIS PARALYSIS Status| ponon| Status Name and address |Fever: OY ON| Date onset: / / Rightam: OY ON of health facility 1: |Cough: OY GN| Present at birth?: O Y ON Letarm: OYON —___ Diarrhea/Vomiting:| Asymmetric?: OY ON . . DateofVisit: OYoanN Rightleg) OY ON had . PROGRESSION Lefties: OY ON —/ Muscle pain: Paralysis fully developed within 3 ———— ————— Name and address OYaN ti day t y deve ns of iin 9 Breathing muscles: O Y C1N| NOTE:Instructions on the ofhealth facility 2:| Meningeal signs:| ° . rom onsen Orne| Neck muscles:+ OY ON| grading/scoring ofthe sensory ———. oYda : . status, deep tendon reflexes — OY ON Facial muscles; OY ON DateofVisit: anti ie , and motor status are presented Direction of paralysis: Working Diagnosis: t the back of thi —//_! Ol Ascending © Descending gbiag ‘ at ihe back of this page. (ll. EPIDEMIOLOGIC DATA History of neurologic disorder?: OY ON lf YES, specify disorder. Did the patient trave! (>10 km from house) one monthpriorto iliness?’ OY ON If YES, specify place: Date traveled: From, / / To / / Other AFP casesin patient's community within 60 days of patient's paralysis? 0 Y ON Does the patient had any history of injection, trauma and/ or anima! bie? OY ON If YES, specify type ls there an Environmental Sample tested positive for WPV/ VDPV/ Sabin-like 2in the area? OY O1N IF YES, Specify the date: ofsf IV. IMMUNIZATION HISTORY Polio Vaccine given: OY ON Is this a “Hot case"? OY ON tA- OPV Tota! Routine OPV doses received: —s- Date last OPVdose:// Total SIA OPV doses received: Date last OPVdose: _// IPV Total IPV doses received: Date last [PV dose:/ / V. LABORATORY DATA Stool If YES, date} Date sent Datere Amount of Speci Conditl : Stool pecimen Condition sample| Collected?| "taken to RITM| celved RITM Result opened out| (To be filed out by RITM) y Owev If WPV, Sabin-like No.of Ice packs: 1 OY ON —/_f —/ft —/f/f CO Sabinsike or VDPV: Specify: Qty of Ice packs: O Frozen OVvDPV OType 1 D Thawed but cold CNEG OType2 Warm CNPEV OType3 Type of Container: owpv If WPV, Sabin-tike Name of Courier, 2 ayY oN atl S/ CSabindike| 0° VDPV: Specify: O Vopyv OType t

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RECEIVED BY: ONEG OType2 CNPEV O Type 3 Vi. 60-DAY FOLLOW-UP Expected date of follow-up: / / Follow-up done: 0 Y ON| If NO,reason for no P.E: lf Yes, actual date of follow-up conducted: / / P.E. done? OY ON O Patient Died Date:/ J Residual paralysis at 60 days?: OY ON 0 Lost to Follow-up If Yes, Specify: Flaccid/FloppyO Spastic O O OTHERS, Specify: Presence of Atrophy?: OY ON Sie: RA: OY ON tA: OY ON Note other observations: RL: OYON tu: 0YaN “DB 1g false or mis! onthe part of the patient, ar the next of kin In case of patient's may under the~~

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Case Investigation Form Acute Flaccid Paralysis Version 2019 Vil. CLASSIFICATION (TO BE FILLED UP BY THE EXPERT PANEL ONLY) FINAL CLASSIFICATION CLASSIFICATION CRITERIA FINAL DIAGNOSIS O Confirmed wild polio D Vaccine-derived paralytic polio VDPV) O Vaccine-associated paralytic polio (VAPP) C1 Death O Recipient VAPP Oi Contact VAPP O Polio compatible UO Discarded as Non-Polio Date classified: / / D Laboratory D Lostto follow-up C With residual paralysis 0 Without residual paralysis Was this case considered as NOTAFP? OY ON "D AEP Case Definition: e AnAFP caseis defined as a child less than 15 years of age presenting with recent or sudden onsetof floppy paralysis or muscle weaknessdue to any cause, OR e Any personof any agewith paralytic illnessif poliomyelitis is suspected bya clinician. ‘Hot’ or ‘high risk’ Case Description: e Acasethat is considered highly suspected for being polio based onclinical data and with the following presenting characteristics: — Less than 5 years of age — Less than 3 OPV doses — Feverat onsetof paralysis — Asymmetric paralysis — Rapid progression of paralysis (within 3 days) And/or

_— — Has been in contact with or living in area with possible or recent Polio virus circulation. Adequate Stool Definition: © Two stool specimen (at least adult thumb size) © Collected within 14 days from onsetof paralysis e With a collection interval of at least 24 hours Grading/Scoring of Sensory Status, Deep Tendon Reflexes and Motor Status: A. Sensory status is presented in percentage and categorized as follows: $25% = Absent 225% but <100% = Reduced 100% = Normal B. Deep tendon reflexes are presented in (+) symbol and categorized as follows none or 0 = absent + =reduced ++ = normal +++ with/without clonus = increased or exaggerated C. Motor Status is presented in fraction and categorized as follows: 0/5 = absent or no movement e 1/5 to 3/5 = reduced movement(with movementbut not against resistance or gravity) e 4/5 to 5/5 = normal (movement with full resistance and against gravity) 9 false or Pp on the part of the patient, or the next of kin In case of patient's may under the Act No. 11332°mf

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Page 1 of 3 Philippine Integrated Disease {AB urvelliance and Response Case Investigation Form PIDSS

» a Severe Acute Respiratory Infection (SARI) (ICD 10 Code: J22) Name of DRU: O u u u U Type: RHU CHO — Gov't Hospital Private Hospital Clinic Oo. Ol . a) 0 Address: Gov't Lab. Private Lab. Alrport/Seaport Others Source: oO Surveillance —_“ outbreak |. PATIENT Patient Number: Patient's First Name Middle Name Last Name INFORMATION: Current Address: House/Lot No. Street Barangay Municipality/City Pravince MM| 0D yy Age: Days UMale Date of Permanent Address: House/Lot No. Street Barangay Murnicipality/City Province] Sex: |“Femate Birth: _jMonths Years Civil Status: Name of Workplace: Occupation: Address of Workplace: il. HISTORY OF ILLNESS, PHYSICAL EXAMINATION AND PRE-EXISTING CONDITIONS Ramtec? 4 Date Admitted| ““~| ©

Date Onsetorp| “~| @ [> Yes No— Unknown Seen/Consult IlIness Did you take anyof the following medication(s) Are there any influenza-like-iliness during prior to consultation? the weekin your: ca: : Did you received Anti-influenza u Ranitidine (e.g. Flumadine) Household Vaccination in the past year Amantidine uy u u u . es— No Unknown u Zanamivir “ves No “Unknown pyosettamivir (e.g. Tamiflu) School/Daycare|__ Others: (Please specify) OlYed Ol No 1 Linknown History of exposure to anyoftheff: History of travel: Chest X-ray u Bats u Poultry/Migratory Birds oO
Done u Not Done U camels U pigs Yes (specify country) Result: Horses Others: No SARI Suspect Casefor Patients < 5 years 2. IMCI criteria for severe pneumo- ‘Temperature at consultation: °C old and EITHER ONEofthe two IMCIcriteria nia for pneumonia Any child 2 months to 5 years Feverish Fever! Feveris of age with cough or difficult Duration: days/weeks

1. IMCI Criteria for pneumonia: breathing Headache LJ . OQ Cough Any 2 monthsto 5 years of age with With anyof the following danger Signs and QD gorethroat coughor difficult breathing signs: Symptoms: |9 Difficulty of breathing Breathing faster than 60 breaths/min Others: (Please specify) (infants < 2 months) u Unable to drink or breastfeed Breathing faster than 50 breaths/min (2- U Vomits everything 12 months) Convulsions Breathing faster than 40 breaths/min (1- | ethargic or unconscious 5 years old) Chest Indrawing orstridor in a Requires hospital admission. calm child Requires hospital admission. LJ ui . ee . Asthma Chronic renal disease Clinical Impression: u : —— ue. Chronic cardiac disease Diabetes . , 4 Chronic liver disease u Haematologic disorders Influenza-like-illness (ILI) Pre-existing 4 Chronic neurological or neuro-| frmunodeficiency diseases pr itions . Condit muscular disease Pregnancy Others, specify: lll. LABORATORY TESTS: Specify [If YES, date tak-| Type of laboratory Results Date result Specimen en test done N=Negative; |=Indeterminate; U-Unknown —~— MM| pO| Ww mM) oOo] & o,o,0 Positive for: Nt UU D um| oD| w mye; 2 Positive for: ON O| au Deliberately providing false or misleading, personal information on thepart of the patient, or the next of kin in case of patient's Incapacity, may constitute non-cooperation punishable under the Republic Act No. 11332 DOH-EB-PIDSR-SARICIF-REVO

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Case Investigation Form Severe Acute Respiratory Infection (SARI) Page 2 of 3 IV. CLINICAL MANAGEMENT AND OUTCOME Oo Oo Oo Yes No Unknown O Yes QONo © Unknown Antibiotics f Yes, please specify Bacterial Testing If Yes, please specify 7 Yes a No 0 Unknown Other Therapeutic ae Yes " No n Unknown Antiviral i i ntivirals f Yes, please specify Procedures If Yes, please specify _ Yes _ No 4 Unknown Fluid Therapy f Yes, please specify Final Diagnosis ™Yes = No | ™Unknown Ol Atve OHAMA O Died Oxygen f Yes, please specify Outcome at Discharge | Others (specify) ad Yes 4 No ot Unknown Intubation f Yes, please specify Date of discharge Othersa CASE DEFINITION/CLASSIFICATION: INFLUENZA- LIKE-ILLNESS(ILI Suspected case: A person with acute respiratory infection, with measured fever of 238°C and cough with onsetwithin the last 10 days. Probable case: Not applicable Confirmed case: A suspected casethat is laboratory-confirmed (used mainly in epidemiological investigation rather than surveillance). SEVERE ACUTE RESPIRATORY INFECTION (SARI SARI Suspect Case for Persons > 5 years old: An acute respiratory infection with: -history of fever or measured fever of 2 38 C°; -and cough; -with onsetwithin the last 10 days; -and requires hospitalization -WITH difficulty of breathing; OR -A suspect case of severe undiagnosed pneumonia, Acute Respiratory Distress Syndrome, Severe Respiratory Disease due to Novel Respiratory Pathogens Deliberately providing false or misleading, personal information on the part ofthe patient, or the next of kin in case ofal Incapacity, may constitute non-cooperation punishable under the Republic Act No. 11332 DOH-EB-PIDSR-SARICIF-REVO

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Page 3 of 3 Case Investigation Form Severe Acute Respiratory Infection (SARI) CASE DEFINITION/CLASSIFICATION: (Continued) SARI Suspect Casefor Patients <5 years old: EITHER: IMCI criteria for pneumonia Any child 2 months to 5 years of age with cough or difficult breathing, AND: Breathing faster than 60 breaths/min (infants < 2 months) Breathing faster than 50 breaths/min (2-12 months) Breathing faster than 40 breaths/min (1-5 years old) OR: IMCI criteria for severe pneumonia Any child 2 months to 5 years of age with coughor difficult breathing and any of the following danger signs: Unable to drink or breastfeed Vomits everything Convulsions Lethargic or unconscious Chest indrawing orstridor in a calm child AND Requires hospital admission. Notes: e The requirement of “hospital admission” is meant to imply that in the judgment of a treating clinician the patient hasanill- ness that is severe enough to require inpatient medical care. e “Shortness of breath or difficulty breathing” is intended to capture dyspnea or air hunger. This does not refer to nasal con- gestion or other upper airway obstruction. e “History of fever’ does not require a history of documented fever and may include a patient’s subjective report of having a feveror feeling “feverish”. e SARI may reflect a newillness superimposed on an underlying condition or older illness e SARI is not equivalent to classic pneumonia and would not always present as pneumonia. It is expected that much of the severe respiratory disease associated with influenza would be due to exacerbations of chronic lung disease or heart disease, for example, and would not include an admitting diagnosis of pneumonia. PROBABLE CASE A person fitting the definition above of a “Suspect Case” with clinical, radiological, or histopathological evidence of pulmonary parenchyma disease (e.g. pneumonia or ARDS) but no possibility of laboratory confirmation either because the patient or samples are not available or there is no testing available for other respiratory infections, AND Close contact with a laboratory confirmed case, AND Condition not already explained by any other infection or etiology, including all clinically indicated tests for community-acquired pneumonia according to local management guidelines. CONFIRMED CASE: A suspected casethatis laboratory-confirmed. Deliberately providing false or misleading, personal Information on the part of the patient, or the next of kin In case of patient's vo incapacity, may constitute non-cooperation punishable under the Republic Act No. 11332 DOH-EB-PIDSR-SARICIF-REVO

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Page 1 of 2 Philippine Intoarated DI Case Investigation Form ilippine Integrated Disease . Mi Surveillance and Response Malaria (ICD 10 Code: B50 - B54) Region: Province: Municipality/City: Type: ORHU OCHO OGov't Hospital OPrivate Hospital OClinic NameofDRU: OGov't Laboratory OPrivate Laboratory DAirport/Seaport Nameof Interviewer: lL. PATIENT Patient Number: Patient's Last Name First Name Middle Name INFORMATION: Current Address: (specify House #, Street/Purok/Subdivision, Barangay, Municipatoty/City, OD Male MM BD YY Age: Province, Region) O Female Pi

(Spe jouse rr jon, Bar junicipatot Pregnant? O Days Permanent Address (Specify House #, Street/Purok/Subdivision, Barangay, Municipaloty/ sex |o von Dateof q Months 1 No . . O Years Civil Status: If Yes, # of weeksof District: HCPN: pregnancy ___ Patient Admitted? Yes ONo OUnknown [Date Admitted/ MM Be YY [Date Onset of MM} BP a Seen/Consult Itness Occupation: Name of Company/ Employer: O OFW Ci Farmer QO Student C Forest Worker 1 Phil National Police/PNP O Fisherman 1 AFP/ Military/ Ma- rines OOthers ll. LABORATORY TESTS DONE AND RESULTS: I. Other Signs and SymptomsDuring Hospitalization: Date Smear was taken: i Date RDT taken: , ot O Jaundi MM DD YY ate wastaken: 7 = wy aundice Result (check all parasite seen) Result QO Severe weakness esu OP. falciparum i . P OP. falciparum 0 Convutsion OP. vivax Oo PV Cl Respiratory dist CP. malariae 5 noe espiratory distress O P. ovale an QO Poor urine output . O Non-PfPan OP. knowlesi (has to be confirmed by PCR) Cl Nesative Q Coffee-colored urine legativ O NMPS {no maaria parasite seen) 9 ; . O Impaired consciousness Q Abdominal bleeding IV. EXPOSURE HISTORY: History of blood transfusion in the past 2 weeks? 0) Yes [No If yes, indicate the following: Date of Transfusion: / I Nameof facility of blood transfusion: MM DD YY History of malaria infection in the past 36 months? O Yes O No NameofFacility of Diagnosis: If yes, indicate the following: Date diagnosed: / / MM DD YY Species: History of Trave! A. History of travel in the past 2 months before onset of signs and symptoms? OYes ONoIf yes, indicate places visited below: Travel Period Placesvisited with overnight stay: (Sitio/Barangay, Municipality, Province) ; Date of Arrival Date of Departure Deliberately providing false or misleading, personal Information on the part of the patient, or the next of kin In case of patient's Incapacity, may corfstitute non-cooperation punishable under the Republic Acct No. 11332 44 LLC

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Page 2 of 2 Philippine Intearated Di Case Investigation Form ilippine Integrated Disease . Surveillance and Response WMialaria (ICD 10 Code: B50 - B54) B. History of travel 2 months after onset of signs and symptoms? OYes ONoIfyes, indicate places visited below (***Applicable for Diagnosis and/or investigation was donelate) _, . . Travel Period Placesvisited with overnight stay: (Sitio/Barangay, Municipality, Province) Date of Arrival Date of Departure V. Contact Tracing—Possible onward transmission: Did any of the family members, visitor in the house or neighbors and other contacts have similar symtomsor illness during the last 6 weeks after the date of onset of signs and symtpms? OYes ONo If yes, provide details below: Describe Date when illness illness/symptoms was observed Contact Number Name Age Address VI. Outcome OAlive O Died Date Died: Case Definition/Classification: CaseDefinition/Classification: (FOR VERIFICATION: THIS IS THE CURRENT CASE DEFINITION OF MALARIA) ® Uncomplicated malaria: Signs and symptoms vary; most patients experience fever. Splenomegaly and anemia are common associated signs, Common but non-specific symptoms include otherwise unexplained headache, back pain, chills, sweating, myalgia, nausea, vomiting. e Severe malaria: Coma, generalized convulsions, hyperparasetemia, normocytic anemia, disturbances in fluld, electrolyte, and acid-base balance, renal failure, hypoglycemia, hyperpyrex- ta, hemoglobinuria, circulatory collapse/shock, spontaneaus bleeding (disseminated Intravascular coagulation) and pulmonary edema. e Laboratory confirmation. Demonstration of malaria parasites in blood films (mainly asexual forms) In areas WITHOUT access to laboratory-based diagnosis: e Probable uncomplicated malaria case: A person with signs (fever, splenomegaly, anemia) and/or symptoms (unexplained headache, back pain, chilis, sweating, myalgia, nausea, vomiting) of malaria who receives anti-malarial treatment. e Probable severe malaria case: A person who requires hospitalization for symptoms and signs of severe malaria (coma, generalized convulsions, renal failure, hyperpyrexia, circulatory collapse/shock, spontaneous bleeding, and pulmonary edema) and receives anti-malarial treatment. e Probable malaria death: death of a patient diagnosed with probable severe malaria. (In areas WITH access to laboratory-based diagnosis) (FOR VERIFICATION: THIS [S THE CURRENT CASE DEFINITION OF MALARIA) e Asymptomatic malaria: A person with no recent history of symptoms and/or signs of malaria who shows laboratory confirmation of parasitemia. e Confirmed uncomplicated malaria case: A person with signs (fever, splenomegaly, anemia) and/or symptoms (unexplained headache, back pain, chills, sweating, myalgia, nausea, vomiting) of malaria who receives anti-malarial treatment AND with laboratory confirmationof diagnosis. e Confirmed sever malaria case: A person who requires hospitalization for symptoms and signs of sever malaria (coma, generalized convulsions, hyperparasitemi a, normocytic anemia, disturbances tn fluid, electrolyte and acid-base balance, renal failure, hypoglycemia, hyperpyrexia, hemoglobinuria, circulatory collapse/shock, Spontaneous bleeding, disseminated intravascular coagulation, and pulmonary edema) and receives anti-matarial treatment AND with laboratory confirmation of diagnosis (microscopy or RDT). e Confirmed malaria death: death of a patient classified as confirmed severe malaria. ° Malaria treatment failure: A patient with uncomplicated malaria without any clear symptoms suggesting another concomitant disease who has taken a correct dosage of anti- malarial treatment, and who represents with clinical deterioration or recurrence of symptoms within 14 days ofthe start of treatment, in combination with parasitemia (asexual forms). Deliberately providing false or misleading, personal Information on the part of the patient, or the next of kin In case of patient's incapacity, may constitute non-cooperation punishable under the Republic Acct No. 11332 Lfye

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_ Case Investigation Form Philippine Integrated Disease Diphtheria Surveillance and Response (ICD 10 Code: A36) Nameof DRU: Type: OQRHU/CHO OGov't Hospital OlPrivate Hospital OClinic DRU Complete Address: OGov't Laboratory OPrivate Laboratory OAirport/Seaport A. PATIENT INFORMATION Patient Number EPHD Patient's First Name Middle Name Last Name . Sex: O Male O Female ; . Current Address: Pregnant? OY ONQU Date of Birth: Age: Daye Permanent Address: If Yes, weeks of pregnancy] MM DD yyYY O Months / ef O Years Civil Status: oe Occupation Patient admitted? OY ON Date Admitted/ Ma| po| Yvy Phone Seen/Consult Nameof parent/caregiver: Contact Nos.: Wu| DD/ yyy Date of Report: Nameofreporter: Contact Nos.: Mm| oD| yrvy Investig ation: Nameof investigator/s: Contact Nos.: Il. BACKGROUND INFORMATION Diphtheria-containing vaccine doses: OYes ONo If Yes, Numberof totaldoses: Ol Zero O11 o2 O 3 © Unknown Date of last vaccination (MM/DD/YYYY) / / Source of information O Card O recall O TCL Known Exposure to © Confirmed case O Probable case D Carrier C1 International traveler Other meansof exposure: School name, if applicable: Any travel within 14 days before onset ofillness O Yes (ONo if yes where(in detail) Hl. CLINICAL DETAILS Date onsetof fever and / or sore throat: (MM/DD/YYYY) i / Check Signs/Symptoms which apply: CO Fever © Sore throat D Difficulty of swallowing O Difficulty of breathing O) Cough O Pseudomembrane O Others, specify Outcomeat discharge Ciclinically well CO Death (Date died) (mm/dd/yyyy) Cl Referred to 0 Other, specify IV. TREATMENT INFORMATION Administered antibiotic therapy? O Yes OO No O Unknown if yes, Date Administered Diphtheria Anti toxin (DAT) therapy: 0 Yes O No O Unknown _ if yes, Date V. SPECIMEN COLLECTION for Corynebacterium diphtheriae Date of collection: (dd/mm/yyyy): / / / Date of sample send: / / / Date of results: / / / Check what applies: O Positive 0 Negative 0 Undetermined 0 Not processed If Positive O Toxigenic O Non—toxigenic VI. FINAL CLASSIFICATION: O Suspect O Lab confirmed O Epitinked C1 Clinically compatible 0 Discarded To include linelist for close contacts 7 Deliberately providing false or misleading, personal information on thepart of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act No. 11332. ye y

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Page 2 of 2 Case Investigation Form Diphtheria CASE DEFINITION/CLASSIFICATION: Suspected Case:Any person with illness of upper respiratory tract characterized by pharyngitis, nasopharyngitis, tonsillitis or laryngitis and adherent pseudomembraneofthetonsils, pharynx, larynx and/or nose. Laboratory-Confirmed Case: A caseis a person (regardless of a symptoms) with Corynebacterium spp. Isolated by culture and positive for toxin production.

• Special consideration. Sometimes during outbreak investigation when household contacts are investigated, people will be identified with positive Corynebacterium cultures and evidence of toxigenicity, who do not meet the suspected case definition. These people should still be reported as laboratory-confirmed cases, as their treatment and public health responseis the sameasthe other laboratory-confirmed cases. Epidemiologically linked Case: A case that meets the definition of a suspected case andis linked epidemiolog- ical linkage is having intimate respiratory or physical contact with a laboratory-confirmed case within the 14 days prior to onsetof sore throat in the laboratory-confirmed case. Clinically Compatible Case: A case that meets the definition of a suspected case and lacks both a con- firmatory laboratory test result and epidemiologic linkage to a Jaboratory-confirmed case. Discarded Case: A suspect case with:

C. diphtheriae but negative ELEK test (nontoxigenic Corynebacterium); or 2. Negative PCRfor the toxin gene Deliberately providing false or misleading, personalinformation onthe part of the patient, or the next of kin in caseof patient'shas constitute non-cooperation punishable under the Republic Act No. 11332. ye

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Page 1 of 2 Philippine Integrated Disease Case Investigation Form Surveillance and Response Neonatal Tetanus (ICD 10 Code: A33) Nameof DRU: Address: Type: ORHU/CHO OGov't Hospital OPrivate Hospital OClinic ‘ OGov't Laboratory OPrivate Laboratory DAirport/Seaport L. PATIENT Patient Number. Patient's Last Name First Name Middle Name INFORMATION: Complete Address: Permanent Address: MM| DD| YYyY Agein days: Sex: O Male Date of * 10 Female Birth: District: [LAZ: Patient Admitted? O Yes O'No O Unknown Date Admitted/ ply ple] YY’ |pate Onset of MM DD YY Seen/Consult lliness MM Bo Mother's Full Name: Date of Report: Date of investigation: Contact Number: IL. CLINICAL DATA: {n the first 2 days oflife, check which applies: From 3 to 28 days oflife does the baby have convulsions or mus- did the baby suck and cry normally? O Yes C1No O Unknown| cles stiffness orfits, trismus? From 3 to 28 daysoflife was the baby unable to suck and cry nor- | Yes C1No O Unknown mally? O Yes O1No O Unknown Was the umbilical stump infected? (bad smell, pus) OYes ONo O Unknown Ill. MOTHER'S INFORMATION: Prenatal Care Immunization Status If she has a card, copy the datesofall No. of total pregnancies:____ Tetanus containing immunizations Livebirths: Living children: How many doses of Tetanus containing vaccine| recorded on the card: has the mother received? doses TD1: I ! How many prenatal care visits did the mother} unknown D2_ maketo a health facility during her pregnancy? ; Seee Date last dose given:Jf TDs When was the first prenatal visit?ff , . | TDS: / / If she received 2 doses, were they given during ———$—— Is the prenatal care history reported by: this pregnancy? OY ON OU Is the child protected atbirth*? O Card Recall O Both O Unknown OyYes ONo O Unknown Is the immunization status reported by: State reason for no or fate prenatal OCard ORecail G Both O Unknown care: IV. DELIVERY PRACTICES: Place of Delivery. OJ Home 0 Hospital/lying-in/elinic C Other, specify: If bom in a hospital/lying-in/clinic, give name and address of the hospital/lying-in/clinic: Cord was cutusing: O Scissors 0 Blade O Bamboo DO UnknownOD Other, specify: Who attended the delivery? O Physician O Nurse C Midwife O Hilot O Unknown 1 Other, specify: Stump treated (dressed) with: T Alcohol O Povidone iodine O Unknown~~ CO Other, specify: V. CLASSIFICATION AND OUTCOME: CASE CLASSIFICATION OUTCOME O Suspected Case O Alive O Confirmed Case O Died Date died: MM/DDIYYYY O Unknown Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's Incapacity, may, constitute non-cooperation punishable underthe Republic Act No, 11332.

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Page 2 of 2 Case Investigation Form Neonatal Tetanus CASE DEFINITION/CLASSIFICATION: Suspected Case: Any neonate who would suck and cry normally during the first two daysoflife and develop tetanus-like illness or death between 3 and 28 days of age and not investigated Clinically-Confirmed Case: Any suspected case found to have ail three of the following: normal ability to suck and cry during thefirst 2 daysoflife AND could not suck normally between 3 and 28 days of age AND developed muscle stiffness and/or spasms which mayincludejerking, trismus, clenched fists or feet, continuously pursed lips, and/or curved back (opisthotonus) OR Aneonate from 3 to 28 days of age diagnosed as a caseof tetanus by a physician. NOTE: Neonatal tetanus case classification is based solely on clinical criteria. Any neonatal death occurring in babies 3-28 days old with no apparent cause should be suspected as NT and evaluated according to the abovecriteria. In calculating age, the day ofbirth is considered thefirst dayoflife (i.e., the baby is 1 day old on the day he/she wasborn). Protection at Birth (PAB) is defined as any ofthe following: Regardlessof interval: 2 TDV doses during the pregnancywith the youngestchild, or 1 TDV dose during the pregnancy with the youngestchild plus 2 doses prior to the pregnancy, or 3 TDV doses prior to the pregnancywith the youngestchild Deliberately providing false or misleading, personal information onthepart ofthe patient, or the next of kin in case of patient's incapacity, m constitute non-cooperation punishable under the Republic Act No. 11332. i yw

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Case Investigation Form Version 2019 Philippine Integrated Disease Pertussis Surveillance and Response (ICD 10 Code: A37) Name of DRU: DRUC lete Add Type: ORHU/CHO OGov't Hospital OPrivate Hospital GClinic ress: ompiele ess OGov't Laboratory Private Laboratory WOAirport/Seaport A. PATIENT INFORMATION Patient Number EPIiD Patient's First Name Middle Name Last Name Current Address: Sex: 0 Male O Female Date of Birth: Age:_ O Pregnant? OYONOU D YY O Days Permanent Address: If Yes, weeks of pregnancy wy BY QO Months 4 / O Years pecupation Patient admitted? OY ON Date Admitted/ bp| yer Civil Status: Seen/Consult Nameof parent/caregiver: Contact Nos.: MM| DD| YY Date of Report: Nameof reporter: Contact Nos.: MM] pO| Yvvy Investig ation: Nameof investigator/s: Contact Nos.: ll. BACKGROUND INFORMATION Pertussis-containing vaccine doses: OC Yes ONo If Yes, Numberof total doses: O Zero 01 O2 O 3 O Unknown Date of last vaccination (MM/DD/YYYY) / / Source of information O Card O recall O TCL Known Exposure to O Confirmed case O) Probable case O)Carrier $C International traveler Other meansof exposure: School name,if applicable: Any travel within 14 days before onset of illness OYes (No if yes where (in detail) Ill. CLINICAL DETAILS Date onset of fever and / or sore throat: (MM/DD/YYYY) / / Check Signs/Symptoms which apply: 0 Post-tussive vomiting CO Apnea (for infants) O Paroxysms of coughing 0 Inspiratory whooping O Coughing lasting at Jeast 2 weeks QO Others, specify Outcomeat discharge Oclinically well O Death (Date died) (mm/dd/yyyy) Cl Referred to O Other, specify IV. TREATMENT INFORMATION Administered antibiotic therapy? O Yes No O Unknown if yes, Date V. SPECIMEN COLLECTION for Bordetella Pertussis Sample collected 0 Yes O1No__ if yes type sample: 0 throatswab O nasal swab Date of collection: (dd/mm/yyyy): / / / Date of sample send: / / / Date of results: / / / Check what applies: O Positive O Negative O Undetermined O Not processed Vi. FINAL CLASSIFICATION: 01 Suspect 0 Confirmed To include linelist for close contacts AAL UV Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in caseof patient's ingghaciy, may constitute non-cooperation punishable under the Republic Act No. 11332. ne (

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Page 2 of 2 Case Investigation Form Pertussis CASE DEFINITION/CLASSIFICATION: Suspected Case: Any person with cough lasting at least 2 weekswith at least one of the following:

• Paroxysms (i.e. fits) of coughing
• Inspiratory “whooping”
• Post-tussive vomiting (i.e. vomiting immediately after coughing) without other apparent cause
• Apnea, with or without cyanosis (For infants < 1 year old) : Confirmed Case: i e Asuspect casethat is laboratory confirmed or epidemiologically linked to a laboratory-confirmed case ; e Laboratory criteria for diagnosis: Isolation of Bordetella pertussis from clinical specimen Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's ingdpdcity, may constitute non-cooperation punishable under the Republic Act No. 11332. rie

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Surveillance and Response Philippine Integrated Disease Case Investigation Form Meningococcal Disease (ICD 10 Code: A39) Page 1 of 2 Nameof DRU: Type: ORHU CICHO [iGov't Hospital OPrivate Hospital OClinic Address: OGov't Laboratory OPrivate Laboratory (QAirport/Seaport |. PATIENT INFORMATION Patient Number EPID: Patient's First Name Middle Name Last Name Indigenous peopie?: OY ONOU If Yes, specify: Current Address: specity Houseor Building number, Street, Barangay, Municlpality/City, Prov- MM BD YY Age: Ince, Region . Civays _|Mate [Date of Permanent Address: specity Heearnangcamber, Street, Barangay, Municipality/City, Sex: OFemate Birth: O Months Clvears Civil Status: Occupation: Name Workplace: Address of Workplace: Nameof School: Addressof School: If student: INFORMATION: |Clyes CINo Mlunknown |Seen/Consult of Illness CFever Ciseizure Lmalaise CHeadache Ostiff neck Cicough Signs and [JMaculopapular rash Civomiting (Sorethroat Symptoms: CPetechia CChangeof sensorium ORunny nose Cpurpura Cidrowsiness CiDyspnea Cother lesions: [lothersigns / symptoms: Clinical Presentation: Case Classification: Outcome: Cimeningitis Cisuspected Case DAlive Oisepticemia Clprobable Case CiDied, Date Died / / Doth Ciconfirmed Case (mm/dd/yy) Ill. CASE Were blood/CSF extracted before the first dose of antibiotics was given to the patient? MANAGEMENT: OYes OONo Ounknown Administered antibiotic therapy? ClYes CINoif yes, Date (mmidd/yy) IV. LABORATORY TESTS: . If YES, date| Type of laboratory Results Specimen taken test done N=Negative; l=Indeterminate; U-Unknown; ND= Not Done Dateresult MM| DO|] Y WM] bp| yy Culture Positive for: ON Ol QU OND Mu| bo TY MM| bbT yy CSF Latex agglutination| Positive for: ON Ol OU OND Mv| Be| Ww Mw{| be| Ww Gram stain Positive for: DON Dl OU OND Mu| po| YW Mu| bb| YY Culture Positive for: ON Of OU OND Blood MM| 2D vw WMT 2b} YY PCR Positive for: ON Ot OU OND Deliberately providing false or misleading, personal Information onthe part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 {

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Page 2 of 2 Case Investigation Form Meningococcal Disease V. PAST HISTORY:|Did the PATIENT or CLOSE CONTACT/S interact with a suspected or confirmed meningococcal case within 2 weeks before onset ofillness? Dyes, the patient DYes, close contact/s (name/s) If yes, what was the nameof the suspected or confirmed meningococcal case? Whatis the address of the suspected or confirmed meningococcal case? Wheredid the patient or close contact/s interact with the meningococcal case? When? MM/OD/YY Numberof Days? Did the PATIENTtravel within 2 weekspriorto illness? If yes, where? DyYes OONo Dunknown Did a CLOSE CONTACTIS ofthe patient travel within 2 weeks priorto illness? {If yes, who and where? CYes CNo Ounknown Did the PATIENT attend any social gathering within 2 weeksprior toillness? If yes, where? OlYes CINo CuUnknown Did the PATIENT have upper respiratory tractinfection within 2 weekspriorto illness? LYes LINo ClUnknown Did a CLOSE CONTACT/S have upper respiratory tract infection within 2 weeksprior to the patient's illness? OYes CINo unknown, If Yes, who? CASE DEFINITION/CLASSIFICATION: : Suspected case: Clinical purpura fulminans in the absence of a positive blood culture; or : Gram-negative diplococci, not yet identified, isolated from a normally sterile body site (e.g., blood or CSF) Note: /n patients <1 year, suspect meningitis when fever is accompanied by bulging fontanels i Probable case: Detection of N. meningitidis antigenin formulin-fixed tissue by immunohistochemistry (IHC); orin : i CSFby latex agglutination : i e Confirmed case: A suspected or probable case plus: *Isolation of N. meningitidis from a sterile site (CSF, blood) or

• Positive test for N. meningitides DNA froma sterile site (CSF, blood) LABORATORY CONFIRMATION: ie Positive cerebrospinal fluid (CSF) antigen detection or culture. ie Positive blood culture. ie Positive PCRtest Deliberately providing false or misleading, personal information on thepart of the patient, or the next of kin in case ofhy may constitute non-cooperation punishable under the Republic Act. No. 11332 4

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Annex "C" Case Report Form Page Number: 1 of 2 1 Dengue (ICD 10 Code: A90-A91) Revision Number: 2020 DOH-EB-PHSD-01 Effectivity: Region . _ Province: __ Municipalityity: Name of DRU: Type: FIRHU [JCHO/MMHOPHO [1Gov'tHospital []Private Hospital [Clinic Address: Name of interviewer: COMPLETE CURRENT ADDRESS (place of residence within 30 COMPLETE PERMANET vantwio,| LaPATENTS FULLNAME| | sex| pate or Birth days) House/eciding a Street, cit| '4'9¢n©| Consutt| Date of First Place of —| Admit| Date admitted!| 116 onset of itiness Patient No,| Last name,First name, ° ge (FM) ate ol HouselBullding #, Street, B Mu 4 tityici Status| p ed? consultation Consultation| ted? seen: (FIRST symptors)) name Barangay, Municipality/City, arangay, Municipality/City, eople consulted Province ' Province It. ff ff St. it. wh tf ff atFL —//__ ft tf ft —f/f fs PL Age: ' S-Single cate i M-Married Specify House of Building number, Specify H Builds miber Response| indicate LastName, followed by |D-davs| Sex Street, Barangay, Municipalay'Cay, pecify House or Building number, Sep- Y-Yes Y-Yes rite!| “Heatnamaandnicdentme’| cmon }FFemale| MMDDIYY Provirze, Region Stron, Barangay,MunicipeltyCy Separated WN MMDDIYY Name ofFaciity |W| MMDD/YY UMDDIYY Widowed linigal Cla tio Case Classification A. DENGUE WITHOUT SUSPECT WARNING SIGNS " ae _ : B. DENGUE WITH WARNING SIGNS C. SEVERE DENGUE A previously well person with acute febrile illness of 2-7 days duration foun acute febmile iiness of 2-7 days duration plus twa of the Person with acute febrile illness of 2-7 days duration with any of the Dengue with at feast one ofthe following criteria: with dinical signs and symptoms of dengue following: i nt >2 oSevere plasma leakage leading to shock and/or fluid accumulation » Abdominal painortendemess © Liver enlargeme! on wth respiratory distress OBABLE: A suspeded case wi i + Headache : ®vin + Persistent vornting « Laboratory increase in HOT

• Severe bleeding as evaluated by clinidan PROBABLE: Asuspecied case with positive dengue [gM antibody test « Body malaise ° Darhes © Clinical fluid accurnutation Concurrent with rapid decease Severe organ involvement such as AST or ALT >1000, impaired CONFIRMED: A suspected case with positive results for: . Myalgia ° Flu shed skin (ascites, pleural effusion) in platelet count conscousness and failure of heart and ather organs. Misi autture isolation mC Per) . ratgia ° . . i i Polymerase Chain Reaction oF . Retro-orbital pain » Skin rash (petecheal, Herman's = ipoeans eDengue NS antigen test « Anorexia sign) » Restlessness requires strict ob ‘on and medical : Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 yer

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Case Report Form Page Number:1 of 2 1 Dengue(ICD 10 Code: A90-A91) Revision Number: 2020 DOH-EB-PHSD-01 Effectivity: Region: Province: Municipality/City: Nameof DRU: Type: JRHU [ICHO/MHO/PHO []Gov'tHospital (Private Hospital [Clinic Address: Name ofinterviewer. COMPLETE CURRENT AODRESS LETE PATIENTS FULL NAME (place of residence within 30 con’ ADDRESS. aNeT Indigeno Date admitted/ No.| ta Firstname, Middie| A Sex| pate of Birth days) House/Bullding #, Street, Civil us| Consult| Date of First Place of| Admit| “seen| Date onsetofIliness Patient No.| Last name, First name, Middle ge (FM) House/Bullding #, Street, : Status ed? consultation| Consultation| -ted? ((FIRST symptom/s)) name Barangay, Municipality/City, People consutted Barangay, Municipality/City, Province Province —i_/ —_I. tr Jkt —/f aa —fft {skst It so ara te if —fft JL tt aa ar Age: $-Singte icate Specify House or Building number, , : M-Married Response| indicate Last Name, followed by |D-day3| Sex: Street, Barangay, Municipality/City, Specify House or Building number, Sep- Y-Yes airy| Y-Yes ines First name, and Middle name yemomns F;Female mMODIYY Province, Region Street, Barangay, Municipaliyicity, Separated N-No MMIDDIYY Name of Facility| y.No MMOOIYY MM/DD/YY Widowed Silnical Classification Case Classification A. DENGUE WITHOUT SUSPECT WARNING SIGNS . ar _ ‘ B. DENGUE WITH WARNING SIGNS C. SEVERE DENGUE A previously well person with acute febrile iliness of 2-7 days duration flea acute febrile iness of 2-7 days duration plus two of the Person with acute febrile illness of 2-7 days duration with anyof the Dengue with at least one of the following criteria: with clinical signs and symptome of dengue * following: Liver ent t>2em «Severe plasma leakage leading to shock and/or fluid accumulation Abdominal pain ortendemess ° F enlargement

2 with respiratory distress PROBABLE: A suspected case with positive d IgM antibody test « Headache ‘ Nausea

Persistent vemting * Laboratory: increase in HCT « Severe bleeding as evaluated by clinician ected case with positive dengue IgM antibody « Body malaise + Vomiting * Clinical fluid accumulation concurrent with rapid decrease «Severe organ Involvement such as AST or ALT >1000, impaired CONFIRMED: A suspected case with positive results for: « Myatgia + Diarhea ‘ascites, pleural effusion in platetet count consciousness andfailure of heart and other organs. Viral cutture Isolation, or . hed sk ( 1p ) : « Asthralgia * Flushed skin . « Mucosal bleeding »Polymerase Chain Reaction (PCR), or . Retro orbital pain ° samen (petecheal, Herman's | etnargy Dengue NSt antigen test ° x: e Restlessness “requires strict observation and medical Intervention Deliberately providingfalse or misleading, personal information onthepart of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 yer

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Case Report Form Page Number:1 of 2 2 Dengue(ICD 10 Code: A90-A91) Revision Number: 2020 DOH-EB-PHSD-01 Effectivity: Region: Province: Municipality/City: Nameof DRU: Type: CIRHU [ICHO/MHO/PHO [JGov'tHospital [Private Hospital [Clinic Address: Name ofinterviewer. NSt IgG ELISA IgM ELISA PCR PATIENT'S FULL NAME Vaccinated| Date First Vaccinated Oate Last Vaccinated Clinical Case Patient No.| Last name, First name, Middle| with Dengue| with Dengue Vaccine (i} with Dengue Vaccine (if} ci. sitication Classification Outcome name Vaccine vaccinated Resutt Date done Resutt Date done Resutt Date done Resutt Date done —te ht lif ht ft —ttft ts tt ht tt ts th —tte ats tt ft —fft —fft ft ts —ff tt ft tt tft att aaa —tt tf —fot P: P: Positive N: No waming| Positive N: signs N: Negative r Positive r Positive Response Indicate Last Name, followed by First Y-¥ W: With Negative E: |: Negative : Negative S: Suspect A: Alive Codes!| 'ndicate Last Name,fo y Fi es MMIDDIYY MMIDDIYY wamnin: E: MM/DDYY MMIDDIYY—| E: Equivocal MMIDDIYY=| E:Equivocal| MMIDD/YY| P: Probable D: Died ify dat Instructions name, and Middle name N-No signs 3 Equivecal Equivocal PR: Pending PR: Pending C: Confirmed of taney . S: Severe PR:

Pending Result Result Dengue Pending Result Clinical ClassificationCase Classification A, DENGUE WITHOUT WARNING SIGNS E . Person with acute febrile illness of 2-7 days duration plus two of the B, DENGUE WITH WARNING SIGNS . . c. SEVERE DENGUE . aos A previously well person with acute febrile illness of 2-7 days following: Person with acute febrile illness of 2-7 days duration with anyof the Dengue with at least one of the following criteria: duration with clinical signs and symptoms of dengue ” following: . «Severe plasma leakage leading to shock and/or fluid accumulation PROBABLE: A suspected case with positive dengue IgM Nausea Abdominal pain ortendemess ° Liver enlargement >2cm with respiratory distress antibodytest « Headache | ay Mu itin Persistent vomiting + Laboratory: increase in HCT «Severe bleeding as evaluated by clinician ; A suspected case with positive results for: « Body malaise ° banhes Clinical fluid accumulation concurrent with rapid decrease Severe organ Involvement such as AST or ALT >1000, impaired «Viral culture isolation, or . Myatgia 5 Flashed skin (ascites, pleural effusion) in platelet count consciousness and failure of heart and otherorgans. «Polymerase Chain Reaction (PCR), or a i i : Reeotital pain + Skin rash (petecheal, Herman's tetany «Dengue NS1 antigen test « Anorexia sign) Restiessness “requires strict observation and medical intervention Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case ofpatient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 ae

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= Case Report Form Page Number: 1 fos Chikungunya Viral Disease (ICD 10 Code: A92.0) Revision Number: 2 1 DOH-EB-PHSD-01 Effectivity: Region: Province: Municipatity/City. Nameof DRU: Type: TIRHU (ICHO/MHO/PHO [Govt Hospitat [Private Hospital [Clinic Address: Name ofinterviewer: COMPLETE CURRENT ADDRESS( Date Date onset of Patient No PATIENT'S FULL NAME A Sex| sate of Birth place of residence within 30 days) HeeeulkdinatSteet, Herren Civil| Consu| Date of First Place of Admit-| admitted! illness *| Last name, First name, Middle name ge {F/M) House/Bullding #, Street, Barangay, Munt clpalttyiCity, Province Ys Status| Ited?| consultation Consuttation ted? see {FIRST Municlpatity/Clty, Province , consulted symptoms) —_ —/f} aitfs —i_t —/__ft tfst —L_t —/—t ts —i_t tf at ff ft fF $-Single M- frltcate ina 7 . . S cas Sep- indicate Last Name, followed by First D-d Sex: Specify House or Building number, Street, Bara 1 Ss House or Building number, Stree’ Y¥-¥

Y-¥ eaname, and Middle name’ M4 months F-Femate mavpory| SPecity MunicipaiityiCity, Provines, Region Baenge, Municipantyfcity Province, Region Separat N-No| MMIDDIYY Name of Facitity| yNo| MM/DDIYY MMIDDIYY ft. - years

Mai we Widowe d Case Classification Suspect Acute onset of fever (with a temperature of >38.5°C or hot to touch), and severe/incapacitating arthralgia not explained by other medical conditions. Probable Acute onset of fever (with a temperature of >38.5°C ar hot ta touch), and severe/incapacitating arthralgia not explained by other medical conditions and residing or having visited epidemic areas, having reported transmission within 15 days prior to the onset of symptoms. Confirmed A case meeting laboratory criteria, irrespective of the clinical presentation: At least oneof the following tests in the acute phase: ~ Virus isolation

• Presenceofviral RNA by RT-PCR ~ Presenceof virus specific IgM antibodiesin single serum sample collected in acute or convalescent stage.
• Four-fold rising of IgGtiters in samples collected at least three weeks apart Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 yen

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Case Report Form Page Number: 2 Chikungunya Viral Disease(ICD 10 Code: A92.0) Revision Number: 2 DOH-EB-PHSD-01 Effectivity: Region: Province: Munlcipality/City: Nameof DRU: Type: IRHU [ICHO/MHO/PHO [Gov't Hospital [Private Hospital [Clinic Address: Nameof Interviewer: Serology IgM Serology IgG EUSA RT-PCR Viral tsolation Is there history of PATIENT'S FULL NAME ig| Date of Onset of travel within 15 days Case Patient No, Fever Arthralgia A to known ongoing Outcome Last name, First name, Middle name Anthralgia Result Date done Result Date done Result Date done Result Date done epidemic ChiKV Classification fs hp ft aa aa ty aa aa aa fp ft at ft ft ff —ff ft —fof —fft tot tt ft ft fs fp re Positive P: Positive P: Positive R i Neganve Negative Ewan pyNegative S: Suspect A: Ali ‘esponse Indicate Last Name, followed by First Y-¥ Y-¥ E:

Se YY 1 : Sus: Alive Codesim Indic etast Ne ume, fotlo wedby irs r Yes N had MMIDDIVY biebomaa MMIDDIYY Equivoc al MMIDDIYY paveeet MMIDDIYY Equivocal MMIDDIYY es tspectty place) Pi Probable 4 o Died {specify date of Result Pending Pending Pending Resutt Result Result Case Classification Roweon et of fever (witha t ture of

38.5°Cor hot to touch), and severefincapacitating arthralgia not explained b Confirmed 38.5° a i i Xplai . can eim t a sae . h € ved
ona( a temperalure or © touch), and severe/incap 9a 9 ¥ A case meeting laboratory criteria, irrespective of the clinical presentation: other medical conditions. Atleast oneof the following tests in the acute phase:

• Virus isolation Probable : a | |

• Presence of viral RNA by RT-PCR Acute onset of fever (with a temperature of >38.5°C or hot to touch), and severe/incapacitating arthralgia not explained by

• Presenceof virus specific IgM antibodies in single serum sample collected in acute or other medical conditions and residing or having visited epidemic areas, having reported transmission within 15 days prior to convalescent stage. the onset of symptoms.

• Four-fold rising of IgG titers in samples collected at least three weeks apart Deliberately providing false or misleading, persona! information on the part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332ee

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Case Report Form Philippine Integrated Disease Acute Meningitis-Encephalitis Surveillance Surveillance and Response |. INFORMATION ABOUT THE DISEASE REPORTING UNIT (DRU) *Name: Contact Number: Type: 1 Government UO Private Address: Il. PATIENT EPI 1D No: Patient Case Patient's Last Name: First Name: MiddleName| Sex: DMale Date of Birth: Age: INFORMATION Number: : OFemale aa MM_DD__YY ODays [J Months 0 Years Complete Address: (Specify House No/Street/Subdivision/Purok/Brgy/Municipality/City/Pravince) District: ILHZ: Region: ; nePy.iadv the Indigenous| [Sentinel site eople(IP): : : : In Present Address: (Specify House No./Street/Subdivision/Purok/Brgy/Municipality/City/Province) If Yes, Specify Chon sentinel site Ill. CLINICAL DATA(Put a check [ V] in the appropriate box) IV. DETAILS OF INVESTIGATOR /REPORTING Waspatient admitted? Signs and Symptoms: Admission Diagnosis Nameof Investigator: 0 Yes C1 No Fever OY ON 01 CNS Infection Desianation: O Suspected Bacterial Meningitis esignation: If yes, date admitted: *Change in mental status: 0 YON P uy 9 7 / New-onset seizures: O Y CN O Suspected Encephalitis Contact No.: TN oD . O Others MM DD YY ‘ : ta Date of t of il . Neck stiffness: C] Y ON *If the clinical presentation ofthe CNS infection is more of either suspected Date of Investigation- MM DD. YY ate of onset of illness: Meningeal signs: OYoN Bacterial Meningitis or suspected Encephalitis, check the specific box Date of report to CHD: / fof *Change in mental status includes altered consciousness, confusion, or inability to talk.

the patient fulfills the case definition of Acute Flaccid Paralysis, referto the

Portto . YM DD. yy MM OD YY AFP surveillance point person. V. ILLNESS/VACCINATION HISTORY Tick appropriate box (2)for the corresponding vaccination *Exposure History: Did the patient travel outside of the province in 2 weeksprior Date last dose No. of doses Date lastdose No. of doses Tick the type of place where exposure to illness? OJE fof TO Meningococcal aa probably occur: 0 Day care D Barangay D Yes O No ClPentaHib // C] Pneumococcal CO Home DO School 0) Dormitory IF YES, specify place: CO Meastes tf pcv OPcvio O Health Care Facility D Workplace TT Orecvi3 a OT O Others, specify Date traveled: From:// To:// —— ———__— “Exposure means any other member have similar MMDD YY MM DD YY O MMR/MR aa symptoms. Wl. CASE Were blood/CSF extracted beforethe first dose of antibiotics was given to the patient?(Fill up if case is a suspected Bacterial Meningitis case) MANAGEMENT: OYes ONo Unknown VI. LABORATORY DATA Sample Collected| Date/Time Date/Time Received at| CSF Appearance Microbiology Result CSF Cytology and Date sent to Date Received and| Date of testing and collected the hospital laboratory| (To be filled up by Sentinel {To be filled up by Sentinel Hospital)| Chemistry Result RITM Volume of Sample| RITM Result (To be filled up by Sentinel hospital) (To be filled up by Sentinel Hospital) (To be filled up by RITM) (To be filled up by RITM) hospital laboratory CSF)| OYON fft aa O Clear Gram stain: O Y ON Test Result Units aa Ay aS- mM DO YY MM OD YY C] Turbid-purulent Result: MM 0D YY wm pp DJE " C Blood stained Culture: O YOON WBC Dengue CJ Others Result: Protein — ml OH.influenzae AM/PM AM/PM Others: (specify): Glucose OS. pneumoniae Result: DN. meningitidis DNegative Serum 1 OYON Date sent to RITM: Date Received and Volume of Sample: Date oftesting:/J (Acute) _fotf _foft _ff a MM DD YY MM DD YY MM DD YY MM DD YY MM DO YY Result OJE ODengue O Negative mi 2 OYON aee ff aa _ff Date oftesting:of/ (Convale- MM OD YY MM 0D YY MM DO YY MM DOD YY MM DD YY scent) ml Result OJE ODengue O Negative

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Case Report Form Version 2019 Philippine Integrated Disease Acute Meningitis-Encephalitis Surveillance Surveillance and Response Vil. CASE CLASSIFICATION (*Case Classification will be filled out by Epidemiology and Surveillance Units) A. For Acute Encephalitis Syndrome B. For Bacterial Meningitis Case Classification: Case Classification: D Suspected 0 Suspected Meningitis O Laboratory confirmed JE§ © AESother agent OD Probable Bacterial Meningitis DO Probable JE 0 AES unknown 0 Confirmed Meningitis; if confirmed case, please state confirmatory test Final Diagnosis: Vill. OUTCOME O Alive Date of Discharge: / / ODied Date of death: / / If JE, ff-up after 3 mos: MM OD YY MM DD YY . Dateofff-up: Recovered wi sequelae 0 Yes 0 No Status at ff-up: If yes, specify: O Home Against Medical Advice (HAMA) Date if HAMA: / / MM DD YY OTransferred/ Referred To: CASE DEFINITION of Acute Meningitis-Encephalitis Surveillance A combined case definition for AES and BM surveillance shall be used. Suspected cases will be captured through the standard case definition of Acute Meningitis-Encephalitis Surveillance System (includes meningitis, encephalitis, and overlapping cases) Suspected: A case of suspected Acute Meningitis-Encephalitis A person of any age,at any time of year, with the acute onset of fever and a change in mental status (including symptoms suchas confusion, disorientation, coma,or inability to talk) AND/OR new onsetof seizures (excluding simple febrile seizures).a Other early clinical findings can include an increase inirritability, somnolence or abnormal behavior greater than that seen with usual febrile illness. Laboratory-confirmed Japanese Encephalitis -An Acute Encephalitis Syndrome case that has been laboratory-confirmed as Japanese Encephalitis Confirmed BM: A casethat is laboratory-confirmed by growing (i.e. culturing) or identifying (i.e. by Gram stain or antigen detection methods) a bacterial pathogen (Hib, pneumococcus or meningococcus) in the CSF or from the blood in a case with a clinical syndrome consistent with bacterial meningitis Probable Japanese Encephalitis An Acute Encephalitis Syndrome case that occurs in close geographical and temporal relationship to a laboratory-confirmed case of Japanese Encephalitis, in the context of an outbreak. Probable BM: A suspected case with CSF examination showingat least oneofthe following:

• turbid appearance;
• leukocytosis (> 100 cells/mm3);
• leukocytosis (10-100 cells/ mm3) AND either an elevated protein (> 100 mg/dl) or decreased glucose (< 40mg/dl Acute Encephalitis Syndrome- other agent: An Acute Encephalitis Syndromecase in which diagnostic testing is performed and an etiologic agent other than Japanese Encephalitis virusis identified, Acute Encephalitis Syndrome -unknown:-An AEScasein which diagnostic testing is not performed or testing was performed but no etiologic agent wasidentified or in which the test results were indeterminate Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the— Act No. 11332

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Philippine integrated Disease Surveillance and Response Case Report Form Acute Bloody Diarrhea Region: Province: Municipality/City: Nameof DRU: Type: TIRHU/CHO (Gov't Hospital [Private Hospital [Clinic Address: OPrivate Laboratory [Public Laboratory OSeaport/Airport Indige-| Con- Place of . Date Admitted/| Date onset of Patient No. Patients Full Name Age| Sex| Date of Birth CompleteCurrent Complete Permanent nous| sulted Pateost Consultation| Admitted? Seen/ illness (FIRST People ? Consulted symptoms) f/f aa —/fe fF tt ‘ a to _ff _f/f affT ff aa —/ft| _f/f _f/f f/f _/ft _f/f _/fo fof aa _ff ff _/ft _f/f _f/f tL Age: Indicate D- days Specify House # Street’| Specify House # Street’| Please Response M - months P P . . dodes/”| Indes tastname,Fitname,| Ye Tear”| mmidchyyy| yrurowsubdsion,| Furkisubdhston Be| spec1 Y- Yee| mmicainyy |NametFact-| ¥o¥es| mmigayny| maidetnyy Instructions rE Female City, Province, Region| City, Province, Region| tribe M - Male CaseDefinition: e Suspected case: A person with acute diarrhea with visible bloodin the stool. e Confirmed Case: Suspect case with stool positive for bacterial or parasitic pathogens (i.e Shigella dysenteriae type 1, Entamoeba histolytica or Escherichia coli) through bacterial culture or any molecular diagnostic test Deliberately providing false or misleading, personal information on thepart of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No? 332 wk

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Philippine Integrated Disease Surveillance and Response Case Report Form Acute Bloody Diarrhea . . . Date of Specimen Laboratory Test . . Patient No. Patient's Full Name Age Sex Date of Birth Collected Done Laboratory Results| Case Classification Outcome aa aa aa _/tf aa _f/f aa aae _f/f _ f/f/ aa aa _f/f _f/f aoe aa Age: Indicate . B : days Peary pecitylabora P- vostve (specify organ- Response Codes /

• months ism ‘i S—Suspect A-Alive iP. structions Indicate Last name, First name, Middle name san - years mmiddiyyyy mmiddiyyyy (Bacterial culture or mR Negative Result C-Confirmed D- Died (specify date) F Female any molecular diag- |" ending Resu M - Male nostic test) Deliberately providing false or misleading, personal Information on thepart ofthe patient, or the next of kin in case of patient’s Incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 ye

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Philippine Integrated Disease Surveillance and Response Acute Viral Hepatitis (ICD 10 Code: B15-B17) Case Report Form Region: Province: Municipality/City: Nameof DRU: Type: QIRHU/CHO []Govt Hospital [1Private Hospital [Clinic Address: OPrivate Laboratory []Public Laboratory OSeaport/Airport Indige-| Con- Place of . Date Admitted/| Date onset of Patient No. Patient's Full Name Age| Sex| Date of Birth CompleteCurrent CompletsFermanent nous| sulted DateofFIRST Consultation| Admitted? Seen/ iliness (FIRST People ? Consulted symptoms) a aa _/fo Js _it / aaae _/tf JL ! _ff _ff _ft fo aa aa _/fo fs _/fe _f/f aft tL _/fi aa _/ft jt _f/f _/ft f/f td /ft ' aa —/sf Age: Indicate Response paysS Specify House # Street!| Specify House # Street/| Please Cocca?| Indewtetastnane;rirstname,| Ye Tyear| mmidchyyy| PurowSubdvsionBe| PurekSubalision, | specity)¥Yes| mmaaryny |NemeetFect-| Yves| mmigayny| mmddyy Instructions al Female City, Province, Region| City, Province, Region| tribe M - Male Case Definition/Classification: ness. ® Suspected case: A person with acute illness characterized by acute jaundice, dark urine, loss of appetite, body weakness, extreme fatigue, and right upper quadrant tender- e Confirmed Case: A suspected casethat is laboratory confirmed Laboratory Confirmation: Hepatitis A: Positive for IgM anti-HAV Hepatitis B: Positive for Hepatitis B surface antigen (HBsAg) or Positive for IgM anti-HBc and antiHBe Non-A, non-B: Negative for IgM anti-HAV and IgM anti-HBs (or HBsAg) Hepatitis C: Positive for anti-HCV Hepatitis 0: HBsAg positive or IgM anti-HBcpositive PLUS anti-HOV positive (only as co-infection or super-infection of hepatitis B) Hepatitis E: IgM anti-HEV positive Deliberately providing false or misteading, personal Information onthe part of the patient, or the next of kin In case ofpatient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 ae

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Philippine Integrated Disease Case Report Form Surveillance and Response Acute Viral Hepatitis (ICD 10 Code: B15-B17) Patient No. Patient's Full Name Age Sex Date of Birth Dateof Specimen Laboratory Results Case Classification Outcome _f/f _/tf _ff _// _ff _/ff _/ft f/f aa f/f _f/f _f/f _f/f _ff _/tf _f/f Age: indicate M:aysas P - Positive (specify organism) Response Codes / Indicate Last name, First name, Middle name sit

• years mmiddiyyyy mmiddlyyyy Pen pending Resulter euspectad D-Died(epectty date) F - Female M - Male Deliberately providing false or misleading, personal Information on the part of the patient, or the next of kin In case of patient's Incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 yi

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Philippine Integrated Disease Surveillance and Response Cholera (ICD 10 Code: A0O) Case Report Form Region: Province: Municipality/City: Nameof DRU: Type: FIRHU/CHO (Gov't Hospital [Private Hospital [Clinic Address: OPrivate Laboratory [Public Laboratory OSeaport/Airport Indige-| Con- Place of . Date Admitted/| Date onset of Patient No. Patient's Full Name Age| Sex| Date of Birth Compre qurrent Complete Permanent nous| sulted pateRST Consultation| Admitted? Seen! illness (FIRST People ? Consulted symptoms) f/f _/f/f —/teJ _ff aa —/tf fs /ff aa —/t fe aoo _ff —/fo Jt _f/f aa —/tf |e _If aa _ft Jt aa aa f/f fle ftft _f/f eeeees eeA Age: indicate Response a days s Specify House # Street!| Specify House # Street!| Please Indicate Last name, First name, . Purok/Subdivision, Ba- Purok/Subdivision, specify| Y - Yes Name of Facil- Y-Yes Codes / Middle name sue ~ years mmiddtyyyy rangay, Municlpatity/| Barangay, Municipality!| what| N-No mmiddlyyyy ity N-No mmiddlyyyy mmiddlyyyy Instructions al Female City, Province, Region| City, Province, Region| tribe M - Male Case Definition: © Probable: A suspected casethat is Cholera RDT positive. ® Suspected case: A suspected case is any patient aged 2 2 years who has acute watery diarrhoea and © Confirmedcase: A suspected case that is laboratory-confirmed. severe dehydration or died from acute watery diarrhoea. (Acute watery diarrhoeais characterized by Laboratory Confirmation of Cholera: oe three or moreloose or watery, non-bloody stools within a 24-hour period.) e Isolationof Vibrio cholerae 01 or 0139 from stools in any patient with diarrhea by culture or any molecular diag- Deliberately providing false or misleading, personal information onthe part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 yy

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Philippine Integrated Disease Surveillance and Response Case Report Form Cholera (ICD 10 Code: AQO) . . Main sourceof Date of Specimen . . Patient No. Patient’s Full Name Age Sex Date of Birth drinking water Collected Stool Culture Result| Case Classification Outcome aa eea / _fft _/fo aa f/f aaa /ft aa /fe ff —// aa If aa Age:we P - Positive (specify organ- Response Codes / Indicate Last name, First name, Middle name vnor mmidd/ Spring mmiddiyyyy Neate poPopsble A- Alive Instructions a ' , Sex yyyy Local Water System PR— Pending Resutt C Confirmed D - Died (specify date) F - Female Commercial Water ND Not done M Male Deliberately providing false or misleading, personal information on thepart of the patient, or the next of kin In case ofpatient's Incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332 We

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Philippine Integrated Disease Case Report Form Surveillance and Response Typhoid and Paratyphoid Fever (ICD 10 Code: A01) Region: Province: Municipality/City: Nameof DRU: Type: TJRHU/CHO [Govt Hospital [Private Hospital (JClinic Address: OPrivate Laboratory (PublicLaboratory§ OSeaport/Airport Indige-| Con- Place of ; Date Admitted/} Date onset of Patient No. Patient's Full Name Age| Sex| Date of Birth CompleteCurrent CompletePerm anent! ‘nous| sulted Dateofnnst Consultation| Admitted? Seen! illness (FIRST People ? Consulted symptoms) _f/f fy ff a aa| aan —/ft |_t _fot f/f —/fe fs /tf aa —/fe JL _/ft _ft _f/f| a /ft Jd —/te fe Age: Indicate Response pays 5 SpecifyHouse# Street/ Specitymouse ‘ Street/ cpecity yey, Indicate Last name, First name, Purok/Subdivision, Ba- urok/Subdivision, speci -Yes Nameof Facil- Y-Yes Codes / Middte name son “years mmiddiyyyy rangay, Municipality’| Barangay, Municipality’| what| N-No| ™ddlyyyy Ity N- No mmiddlyyyy mmiddlyyyy Instructions rl Female City, Province, Region| City, Province, Region| tribe M - Male Case Definition: e 2 i ®@ Suspected case: A person with anillness characterized by insidious onset of sustained fever, headache, Confirmed case: A suspectedor probable casethat is laboratory confirmed. malaise, anorexia, relative bradycardia, constipation or diarrhea, and non-productive cough for 5 days or . more. Laboratory Confirmation: ° Probable case: © Laboratory confirmati itu lecular methods of Sal

• Asuspected case thatis positive in Typhoid Rapid Diagnostic Test, or CaocoyphlBNA froma normallysterile site, Is of Salmonella typhi or detection of Salmonella typhi or Sal-
• A suspected case thatis epidemiologically linked to a confirmed case in an outbreak. Deliberately providing false or misleading, personalInformation on the part of the patient, or the nextof kin in case of patlent’s incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332

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Philippine Integrated Disease Case Report Form Surveillance and Response Typhoid and Paratyphold Fever (ICD 10 Code: A01) Laboratory Result Patient No. Patient's Full Name Age Sex| Date of Birth Datoof Specimen Case Giassitica- Outcome Stool / Widals Test Typhidot Tubex Blood 2777 Culture aa _/ft _f/f _ff _/tf _/tf _fs _/tf _/tf ff ft _f/f Age: Indicate Meme Positi P- Positi P-Posit! { pe ityone SS Response M - months P- Positive Positive — Positive specify organ- uspect . Codes’ Instruc- Indicate Last name, First name, Middle Yr. - years mmiddfyyyy mmiddlyyyy N-Negative N-Negative N-Negative ism) P—Probable A-Alve tions name Sex. ND-Not Done| ND-NotDone| ND-Not Done N-Negative C- Confirmed D - Died (specify date) F - Female ND-— Not Done M - Male Deliberately providing false or mlsteading, personal Information on thepart of the patient, or the next of kin In case of patient's Incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332

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Philippine Integrated Disease Surveillance and Response Case Report Form Version 2019 Rotavirus Surveillance 1, INFORMATION ABOUT THE DISEASE REPORTING UNIT (DRU) *Name: Contact Numberof DRU: Type: CiGovernment U)Private Address: I.PATIENT EPIID No: Patient Case *Patient’s Last *First Name: Middle Name:| *Sex:D/Male *Date of Birth: Age: INFORMATION Number: Name: OFemale , 7 ODays D Months "MM 0D YYYY OYears *Current Address: (Specify House No/StreevPurok/Subdivision/Brgy/Municipality/City/Province, Region) District: Health Care ILHZ: Region:| 's the patient| Is patient enrolled in 4 P’s provider is member of| (National Household network/SDN: Indigenous Targeting System)? People(IP): Y ON Permanent Address: (Specify House No/Street/Purok/Subdivision/Brgy/Municipality/City/Province, Region) OY ON IfYes,Specify JII.CLINICAL DATA (Put a check [ V] in the appropriate box) IV.EPIDEMIOLOGIC V. IMMUNIZATION HISTORY VI. DETAILS OF INVESTIGATOR/ REPORTING *Date of Onset of Diarrhea: / {(MM/DOIYY) Are there two or more Received Rotavirus Vaccine? NameofInvestigator: Was Patient admitted at the wards for diarrhea? O Y ON diarrhea cases? OY ON If yes, date of admission:// (MM/DD/YY) . — — Did patient receive IV rehydration therapy while at the ER? 0 Y ON TY Yes here: If Yes, total doses received:___ —| Position/Designation: Did patient have previous hospitalization due to diarrhea? OY ON es, wnere. Datefirst dose received: If yes, date of hospitalization__// (MMIDDIYY) Q Community a f = / ~ Contact Numbers: Vomiting: OY ON 0 School If yes, date of onset of vomiting:// (MM/DD/YY) CO Household Date last dose received: ; : : : / / Date of Investigation:s/s/ Degree of Dehydration: No dehydration 0 Some dehydration DSevere dehydration | No Sar Bo WM DD VY Fever: OY ON © Unknown Date of Report: // ADMITTING MM DD YY DIAGNOSIS: FINAL DIAGNOSIS: Vil. LABORATORY DATA Vill. CLASSIFICATION AND OUTCOME STOOL SPECIMEN SPECIMEN CONDITION AND ADEQUACY ELISA RESULT PCR RESULT *Classification: Suspected OY ON (To be filled out by RITM) (Tobe filled out by RITM) (To be filled out by RITM) Confirmed oO Y oO N *Stool Collected? 0 Y O1N| Date received by RITM: /_/ ONEG OPOS Genotype: . if YES, date taken: MM DD YY Outcome: Condition: O FrozenQ Thawed but cold OWarm DEquivocal Alive ff No. of i ks: Date of result . . uM DD ~y¥ o. of ice packs: Date of result: i Date of discharge: __/ Date sent to RITM: Quantity of stool: yoy MMOD YY MM DD YY ro OSufficient OSufficient for ELISA but ne remaining sample MM DD YY Died “wa “DD vv Llnsufficient DateofDeath; / / MM DO YY. CASE DEFINITION AND CLASSIFICATION: Suspected Case: Acute (< 14 days) watery diarrhea, defined as three or more loose or watery stools in a 24-hour period in a child < 5 years of age whois admitted for treatment of diarrheato a hospital ward or emergency unit at a participating surveillancefacility. Children with bloody diarrhea and nosocomial infections are excluded. Confirmed Case: A suspected casein whose stool thepresence of rotavirus is demonstrated by means of an antigen-based enzyme immunoassay (EIA)or any molecular diagnostic test. Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act. No. 11332/ a () we

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Philippine Integrated Disease Surveillance and Response Case Report Form influenza-like Illness (ICD 10 Code: J11) Region: Province: Municipatity/City. Nameof DRU: Type: ORHU [ICHO [Gov't Hospital (Private Hospital [Clinic Address: OPrivate Laboratory [Public Laboratory DSeaport/Airport Re- Hxof trav- Date celved . t abroad Date Anti Date Date of ‘ Patient Patient's Date of Civil Current Permanent el tyes onset Laborato Classifica- Out- Age| Sex for the IP Admitted?| admitted/ influ- of last specimen y Result ; No, Full Name Birth Status Address Address last specify seen! es enza| vaccination| collection Done tion come 2idays? consulted s vac- cine —fst —/tf —_/_ft. Jit ft —tt —_tfs tt Ht —/ft ft fis Age: Dsdeys Herey Keroe Y-¥ lsolati Indicate M- ouse #, ouse #, Y-Yes N- es ion A- Alive Response Street(Purok/ Street/Purok/ N-No Y-Yes r PCR S- Suspect Codes / wurstname, Pots ars| Mvddlyy Subdivision, Subdivision, No Placecf| (membe} NAo |r YY iddtyy| YYeS vy vy| Serology Specity oF |. confirmed| «Sted Instructions Lastname’ sye Barangay, Barangay, rofthe Viral cutture ganiem (specify Sex: Municipality/City, Municipality/City, (1P? date) F. Female Province Province M-Male Case Definition and Classification: Laboratory Confirmation: © Suspected case: A person with sudden onsetof fever of 238°C AND cough or sore throat in the absence of other diagnoses with short- ® Virus isolation or Polymerase Chain Reaction (PCR)of swab or aspirate from the suspected Individual or direct detection of influen- nessof breath or difficulty of breathing and require hospital admission. za viral antigen or 4-fold rise in antibody titer : seppe ji 5 : . . between early and late serum. e Confirmed case: a suspect IL! case who has laboratory confirmation of influenza virus infection, using one ofthe following crite- nearly and nia: .

• virus isolation
• molecular diagnostic test *Deliberately providing false or misteading, personal information on the part of the patient, or the next of kin in case of patient’s incapacity, may constitute ip punish under the Republic Act No. 11332

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Philippine Integrated Disease Surveillance and Response Case Report Form Leptospirosis (ICD 10 Code: A27) Region: Province: Municipality/City: Nameof DRU: Type: ORHU/CHO Gov't Hospital CPrivate Hospital [Clinic Address: OPrivate Laboratory [Public Laboratory OSeaport/Airport Nameof Interviewer: { Patient Name Age Sex Date of Birth| Exposure| Place ofexposure| Occupation Specimen Laboratory Test| Laboratory Case Out No. collected Done Results Classification utcome —/ —/_I —/__ft / Please specify exposure: Exposure to Please specify labora- Age: indicate infected animats Field of work tory test done: A-Alve Response *. days Sex: oracm encase epee, ication : {including nome r P- Positive S-Suspect O-Died Codes/| Indicate Last Name,First name, Mid- . ment contami- treet/Purok/Subdivision,| maker: housewife! RD N- Negati PI Instruc- die name Yreveare Female mamiddiyyyy nated with anl- Barangay, Municipality/ husband, mmiddlyyyy MAT PR—Pending P-Probable (Please dear” sate tions . mal urine (e.g. City, Province, Region student PCR Resutt mmiddfyyyy) wadingIn flood None) waters, rice fields, drainage, ete.) Case Definition/Clas sification: Suspect Case History of fever within the past two weeks andat leasttwo of the following clinical findings: myalgia, headache, jaundice, conjunctival suffusion without purulent discharge, or rash (i.e. maculopapular or petechial); OR atleastone ct Confirmed Case the following clinical findings: Aseptic meningitis, G! symptoms (e.9., abdominal pain, nausea, vomiting, diarrhea), Pulmonary complications (¢.g., cough, breathlessness, hemoptysis), Cardiac arrhythmias, ECG abnormalities, Renal insufficiency (e.g., anuria, oliguria), Hemorrhage (é.g., intestinal, pulmonary, hematuria, hematemesis), Jaundice with acute renal failure, possibly AFTER exposure to infected animals or an environment contaminated with animal urine (e.g. wading in flood waters, rice fields, drainage). Note: Other common symptoms include nausea, vomiting, abdominal pain, diarrhea, arthralgia. The clinical diagnosis is difficult where diseases with symptoms similar to those of leptospirosis occur frequently Probable Case A Clinically compatible case with af Jeast oneof the following: Involvement in an exposure event (@.9., adventure race, triathlon, flooding) with known associated cases, OR presumptive laboratory findings, but without confirma- tory laboratory evidence of Leptospira infection. A suspected case in an ongoing epidemic or epidemiotogical linked to a confirmed case ORa clinically tested positive by Rapid Test Kits. Deliberately providing false or misleading, personal Information on the part of the patient, or the next of kin in caseof patient’s Incapacity, may constitute n ( under the Republic Acct No. 11332 Case Definition/Classification: A suspect casethat is laboratory confirmed. Laboratory Confirmation: Asolation (and typing) from blood or other clinica! materials through culture of pathogenic Leptospira. -Positive serology, preferably Microscopic Aggtutination Test (MAT) or Polymerase Chain Reaction (PCR), using a range of Leptospira strains for antigens that should be a representative of local strains.

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Case Report Form Philippine Integrated Disease a . Surveillance and Response Non-neonatal Tetanus(ICD 10 Code: A35) Region: Province: Municipality/City: Name of DRU: Type: LJIRHU/CHO [Gov't Hospital [Private Hospital [Clinic Current Address: OPrivate Laboratory [Public Laboratory OSeaport/Airport Permanent Address: Civil Status: . . Date . Post-Partum? If Yes . Patient No. Patient's Full Name Age Sex of Birth Occupation Dateoflast delivery Complete Address Indigenous People —!ts —//__ b Is —/t —//__ —/I —/ —//__ Age: indicate Response Paysas Indicate Specify House #, Street/Purok Subdivision, Codes / indicate Last Name,First name, Middle name Yr. - years mmiddlyyyy occupation Mmiddlyyyy Barangay, Municipality/City, Province, Please specify what tribe Instructions Sex- yermate P Region M - Male Case Definition: Suspect case: Any person >28 daysof age with acute onsetof at least oneof the following: trismus (lockjaw), risus sardonicus (sustained spasm ofthe facial muscles) or generalized muscle spasms (contractions) Clinically-Confirmed: A case meeting the suspectdefinition and clinically-confirmed as tetanus by a physicianftrained clinician NOTE: Basis for case classification is clinical and does not depend on laboratory confirmation. Deliberately providing false or misleading, personal information on the part of the patient, or the next of kin in case of patient's incapacity, may constitute non-cooperation punishable under the Republic Act No. 11332. Vee

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Philippine integrated Disease Surveillance and Response Case Report Form Non-neonatal Tetanus(ICD 10 Code: A35) Date of| Place . , Received Received : Date Admit- Date . . ,| Case . Consult- first| of con-| Admit- With recent . Skin le- tetanus| tetanus anti- . Out- Patient's Full Name ed? consul-| sultatio| ted? fedseen of onset of wound? Wound site Wound type sions toxoid vac-| toxin or Classifi- come tation n cination? TIG? / —/ffaa | —//if —/—/_| _/f —/f| a | —/I| __ _ /| —/! |__. | —Jt/ —/__f |} e Abrasion Y-Yes e Animal bite speci Y=Yes e Avulsion & pay N=No * Bum U - Unknown U= Unknown Head &Neck |* Open fracture / Trunk e Crash NOTE:Skin Y-Yes S-Sus-| A-Alive Y-Yes | NOTE: Upper extremity | Dental (caries/ lesionsfor| %~ Yes (specify) pect D-Died Response Codes / Instructions N-No mmiddfyy mmiddiyy| Recent Lower extremity extraction) the past 3 N-No N-No C-Clini-| (specify woundrefers Unknown e Fireworks months U -Unknown| U-Unknown| callycon-| date) to past 3 « Insect bite 7 firmed months « Laceration which may whether e Puncture Include : heated or not e Surgery abscess, * Tissue necrosis| ulcer, bilster, e Others, specify gangrene, cellulitis, et Deliberately providing false or misleading, personal information onthe part of the patient, or the next of kin in case of patient's incapacity, may constitute non. peration punishable under the Republic Act No. 11332. we

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Classified Document: This documentis distributed only to limited number of DOH and selected NGOstaff in orderto improve common awareness on reports and rumours of events which may havenational’ intemational implications. Please send newor additional information onthis or other public health events. Document Status Type of Internal Document Annex "D" Epidemiology Bureau Verification Event-based Surveillance and Response (ESR) Report Tel: (02) 654-7800 loc 2929 E-mail: esr.central@gmail.com March 6, 2018 Code: INTERNAL VERIFIED 1 Report date and time Date this health event was first reported to Surveillance Team 2 ‘Verification date and time Date this health event was confirmed/verified by health authority 3s Type of Health Event Check whatis applicable: [- Suspect [7 Clustering [~ Outbreak [% N/A if an outbreak, who validated? I— EB-DOH [~ DOH-RESU I~ LGU [~ Others, specify. | Was areportmade? [> Yes [No 4 Health event What happened? (type:of health event reported) 5 “Location Complete address (number, ‘Streel/Baranga Y, municipality province) where the reported event was observed. For multiple location (specify on description of cases) 6 Start date Date of start of event or date of onset of fi rst case 7 Number ofccases Initial number of reported casels from the event 8 "Description of cases Pertains to who were affected (age and sex or nature of work), Whatare € the ¢ common signs and symptoms of cases, when, where 9 Number of deaths Initial number of reporteddeathis from the event 10 Description of deaths Whowere affected (age and sex), from Where? (address of fatalities) When? (Dates of fatalities) and What are the causes of deaths or description of symptoms prior to death of cases? 11 Laboratory Examination Is there a procedure done? j- yes I None Specimen collected: | Blood/serum [~ StoolRectal Swab [- CSF Others: N/A Type of Examination done: Indicate what type of examination was done Result: Laboratory findings as to specimen collected from the event 12 IHR Notifi cation decision questions Is the public health impact serious? T Yes T No Is the event unusual or unexpected? T Yes I~ No Is there a significant risk of intemational spread? IT Yes T No Is there a significant risk of international travel or I~ Yes I No trade restriction? Assessment done by: Name and signature of the ESR Officer/Coordinatar wha prepared the report, designation and his/her contactdetails 13 Assessment PHELC/ PHERC/ PHENC/ PHEIC 14 Status of health event {f the health event is Ongoing, Controlled or Closed 15 Actions taken What was done? By whom? When? 16 Assistance needed Specific assistance needed,if there is any 17 ESRU Action To just continue monitoring or will assistance be provided, etc. . . \qe DOH-EB-AEHMD-QMOP-03-Form2 Rev.5

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18 Remarks Other important information not elsewhere mentioned before 19| Who has been informed? To whom the information have been shared (DOH offices, LHO, WHO and other stake holders) 20 ~~ Source(s) of information Name, Office and contact numbers (landline/cellphone) 21 ~~ Prepared by Name and signature of the ESR Officer/Coordinator who prepared the report, designation and his/her contact details 22 Reviewedby: Click here to enter text. 23 ~—Noted by: 24~~ Approved by: *Public Health Event of Local (L), Regional (R), National (N) Concern ** Public Health Emergency of International Concern (PHEIC); according to WHO-Intemational Health Regulation Definition ***Captured by National ESRStaff Entries should be signed priorto releaseof verification form DISCLAIMER: Every effort has been made to provide accurate, up-to-date information. However, the knowledge base is dynamic and errors can occur. By using the information containedin this list, the reader assumesall risks in connection with such use. The EB shall not be held responsible for errors, omissions nor liable for any special, consequential or exemplary damages resulting, in whole or in part, from any reader's useor reliance upon this material. ee DOH-EB-AEHMD-QMOP-03-Form2 Rev.5

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Classified Document: This document is distributed only to limited number of DOH and selected NGOstaff in orderto improve common awareness on reports and rumours of events which may have national/ international implications. Please send new or additional information on this or other public health events. Document Status Typeof Internal Document Epidemiology Bureau Follow-up ma’) Event-based Surveillance and Response (ESR JE} Tel: (02) 651-7800 loc 2929 p ( Report E-mail: esr.central@gmail.com . March 4, 2018 Code: INTERNAL VERIFIED 1 Report date andtime Date this health event was reported to Surveillance Team 2 Update No. This reflects the number of follow-up reports received since Verification Report 7 3 Verification report date Date of verification report 4 Date of previous report Date indicatedin the last verification/follow-up form 5 Type of Health Event Check whatis applicable: T Suspect [7 Clustering J~ Outbreak N/A fan outbreak, who validated? J” EB-DOH [~ DOH-RESU f~ LGU I~ Others, specify. | Was a report made? Yes No 6—_ Health event Update on the status of the health event (areas of involvement comparedto the first reported case, changesin the pattern of the health event) 7~~ Location Complete address (number, Street/Barangay, municipality province) where the reported event was observed 8 Start date Date ofstart of event or date of onset offirst case 9 Number of cases _

Previously Reported

Number of previously reported cases

of case/s

Number of case/s added or subtracted I~ Added I Subtracted Total Cases asof date Number of case/s (Previously reported case/s + new case/s) 10| Updated description ofall cases Pertains to new information about the cases reported. (Who? When? Where? Why?) 11. Number of deaths

Previously Reported

Number of previously reported deaths

of death/s

Number of death/s added or subtracted T— Added [7 Subtracted Total Deathsas of date Numberof case/s (Previously reported case/s + new case/s) 12 Updated description ofall deaths Pertains to new information about the death/s reported. (Who? When? Where? Why? 13 Laboratory Examination Is there a procedure done? [Yes [None Specimen collected: —~ Biood/serum I Stool/Rectal Swab [~ CSF Others: Pls specify other specimens collected Type of Examination done: indicate what type of examination was done Result: Laboratory findings as to specimen collected from the event 14 IHR Notification decision questions _Is the public health impact serious? I Yes I~ No Is the event unusual or unexpected? Is there a significant risk of international spread? ‘| Yes F No Is there a significant risk of international travel or TT” Yes rT No trade restriction? T Yes Tl No Assessment done by: Name ofstaff who made the assessment je Cre DOH-EB-AEHMD-QMOP-03-Form3 Rev.5

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15 Assessment PHELC/ PHERC/ PHENC/ PHEIC 16 Status of health event If the health event is Ongoing, Controlled or Closed 17 Actions taken What was done? By whom? When? 7 18 Planned Activities Describe planned activities, if any 19 Assistance needed Specify or put Noneif not needed 20 ESRU Action To just continue monitoring or will assistance be provided, etc... 21 ~~ Remarks Other important information not elsewhere mentioned 22 Who hasbeeninformed? 23 Source(s) of information Name, Office, Designation and the contact numbers of the person who gave the information 24~~ Prepared by: Name and signature of the ESR Officer/Coordinator who prepared the report, designation and his/her contactdetails 25 Reviewedby: Click here to enter text. 26~— Noted by: 27~~“ Approved by: *Public Health Event of Local (L), Regional (R), National (N) Concern ** Public Health Emergency of Intemational Concern (PHEIC); according to WHO-Intemational Health Regulation Definition ***Captured by National ESR Staff Entries should be signed priorto releaseof verification form DISCLAIMER: Every effort has been madeto provide accurate, up-to-date information. However, the knowledge baseis dynamic and errors can occur. By using the information contained in this list, the reader assumesall risks in connection with such use. The EB shall not be held responsible for errors, omissions nor liable for any special, consequential or exemplary damages resulting, in whole orin part, from any reader's use or reliance upon this material. rv DOH-EB-AEHMD-QMOP-03-Form3 Rev.5

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Annex “E” Minimum Public Health Standards or Non-Pharmaceutical Interventions Required of Communities and the General Public Modeof Transmission List of Notifiable Diseases and Health Events of Public Health Concern Minimum Public Health Standards or Non-Pharmaceutical Interventions (NPIs) Required of Communities and the General Public Direct Contact e Skin-to-skin contact e Kissing e@ Sexual intercourse e Contact with soil, water, or vegetation harboring infectious organisms . Acute Viral Hepatitis a. Hepatitis A virus (HAV) - sexual intercourse b. Hepatitis B virus (HBV)- sexual intercourse c. Hepatitis D virus (HDV) - sexual intercourse . Anthrax a. Bacillus anthracis . Bacterial meningitis a. Group B Streptococcus b. Escherichia coli c. Neisseria meningitidis . Diphtheria - touching open soresor ulcers a. Corynebacterium diphtheriae . Hand-Foot-and-Mouth Disease - skin-to-skin, kissing . Leptospirosis* a. Leptospira . Meningococcal Disease- kissing a. Neisseria meningitidis . Rabies* a, Rabies virus (RV) For Diseases Transmitted Through Direct Contact: e Regular and thorough washing hands with soap and water, and if unavailable, regular disinfection of hands by using a sanitizer with at least 60% alcohol component; e Cleaning with soap and water or a bleach-and-water solution or disinfectant of surfaces and objects that are touched frequently; e Avoiding close contact with sick persons; and e Isolating contagious persons. For Viral Hepatitis: e Practicing protected sex (e.g. using of condom during sex) For Leptospirosis: e Identifying and controlling the source of infection (e.g. open sewers, contaminated wells). e Controlling of feral reservoirs is often not feasible but control measures can be highly effective in small, defined animal populations (dogs, certified cattle herds). Selective rodent control may be important. e Interrupting transmission, thereby preventing infection or disease in the humanhost: O wearing protective clothes and equipment; © disinfecting contaminated surfaces such as stable and abattoir floors; oO marking areas with increased risk exposure (warning signs). For Rabies: e Education on dog behaviour and bite prevention for both children and adults. | iuec

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Annex “E” Increasing awareness of rabies prevention and control in communities includes education and information on responsible pet ownership. Droplet Spread e Spray with relatively large, short-range aerosols produced by sneezing, coughing, or talking 1. Bacterial meningitis a. Haemophilus influenzae type b (Hib) b. Streptococcus pneumoniae 2. Coronavirus Disease 2019 (COVID-2019) a. Severe acute respiratory syndrome (SARS)-associated coronavirus 2 (SARS-CoV2) 3. Diphtheria a. Corynebacterium diphtheriae 4. Hand Foot and Mouth Disease 3.Human Avian Influenza 6. Influenza-like IIness (ILI 7. Severe acute respiratory syndrome (SARS a. SARS-associated coronavirus 8. Measles a. Measles morbillivirus 9. Meningococcal Disease a. Neisseria meningitidis Regular and thorough washing of hands with soap and water, and if unavailable, regular disinfection of hands by using a sanitizer with at least 60% alcohol component; Covering the nose and mouth with a tissue when coughing or sneezing. Properly disposing of used tissue, and washing of handsthereafter; Cleaning with soap and water or a bleach-and-water or disinfectant solution of surfaces and objects that are touched frequently; Limited transport and movement of patients (e.g. use of portable diagnostic equipment andtools to limit the movementofpatients from one place to another within the health facility); and Wearing of masks, or other personal protective equipment (PPE) as may be prescribed by the DOHorits local counterparts.

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Annex “E” 10. Middle East Respiratory Syndrome (MERS) a. Middle East respiratory syndrome coronavirus (MERS-CoV) 11. Pertussis ooping cough a. Bordetella pertussis Airborne e Carried by dust or droplet nuclei suspendedin air

1. Anthrax a. Bacillus anthracis
2. Coronavirus Disease 2019 (COVID-2019) a. Severe acute respiratory syndrome (SARS)-associated coronavirus 2 (SARS-CoV 2)
3. Human Avian Influenza
4. Influenza-like IlIness (ILI)
5. Measles a. Measles morbillivirus Regular and thorough washing hands with soap and water, and if unavailable, regular disinfection of hands by using a sanitizer with at least 60% alcohol component; Covering the nose and mouth with a tissue when coughing or sneezing. Properly disposing of used tissue, and washing of handsthereafter; Cleaning with soap and water or a bleach-and-water solution or disinfectant of surfaces and objects that are touched frequently; Increasing ventilation in all settings to reduce airborne transmission; Limited transport and movement of patients (e.g. use of portable diagnostic equipment andtoolsto limit the movementof patients from one place to another within the health facility); To do home quarantine or home isolation as advised by a medical professional or by the DOH’s advisories; Avoidance of close contact with people who have symptoms of the disease; and Wearing of masks, or other personal protective equipment (PPE) as may be prescribed by the DOHorits local counterparts. Vehicle-borne e Food e Water e Biologic products @ Fomites
6. Acute Bloody Diarrhea - food/water a. Campylobacter bacteria b. Salmonella bacteria c. Shigella species (bacillary dysentery) d. Entamoeba histolytica (amoebic dysentery) e. Enterohaemorrhagic E. coli (EHEC) Regular and thorough washing hands with soap and water, and if unavailable, regular disinfection of hands by using a sanitizer with at least 60% alcohol component; Cleaning with soap and water or a bleach-and-water solution or disinfectant of surfaces and objects that are touched frequently; Practicing good personal and food hygiene Access to safe drinking water. Drink bottled water when travelling as muchas possible. {vet bf wee

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Annex “E” . Acute Viral Hepatitis a. Hepatitis A virus (HAV) - food/water b. Hepatitis B virus (HBV)- biologic products c. Hepatitis C virus (HCV)- biologic products d. Hepatitis D virus (HDV) - biologic products e. Hepatitis E virus (HEV) - water . Anthrax a. Bacillus anthracis . Bacterial meningitis a. E. coli b. Listeria monocytogenes . Cholera a. Vibrio cholerae . Neonatal tetanus a. Clostridium tetani - biologic products . Paralytic Shellfish Poisoning - food . Typhoid and Paratyphoid Fever- food/water a. Salmonella enterica serotype Typhi b. Salmonella enterica serotypes Paratyphi A, B [tartrate negative], and C [S. Paratyphi] . Poliomyelitis (Acute Flaccid Paralysis) a. Poliovirus - food/water For Viral Hepatitis: e Using barrier contraception when engaging in sexual intercourse if currently infectious due to sexually transmitted infection; e Non-sharing of needles when administering drugs; e Avoiding use of an infected person’s personal items; and e Taking precautions when undergoing tattooing or body-piercing procedures. Vector-borne @ Mechanical @ Biologic . Dengue a. Dengue viruses (DENV-1, -2,-3, and -4) ® Removing stagnant waterin receptacles at least once a week; e Using screens on windowsand doors to keep mosquitoes outside homes; and A AME

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Annex “E” 2. Acute Encephalitis Syndrome/Japanese Encephalitis a. Japanese Encephalitis virus 3. Malaria a. Plasmodium parasites (P. falciparum, P. malariae, P. ovale and P. vivax) @ Using mosquito bed nets, if screened roomsare not available when sleeping outside of an enclosed space. *Zoonotic **The route oftransmission ofAcute Hemorrhagic Fever varies by specific virus. Some viral hemorrhagic fevers are spread by mosquito ortick bites. Others are transmitted by contact with infected blood or semen. A few varieties can be inhaled from infected ratfeces or urine. ~~