Influenza Surveillance Form for Schools

Influenza Surveillance Form for Schools

October 2024 - May 2025
Influenza reporting is voluntary unless it is linked to an outbreak or pediatric death.
* Flu surveillance occurs between from October 2024 - May 2025. Please submit weekly reports by the following Wednesday.

* Please note: The COVID-19 pandemic is affecting healthcare seeking behavior which impacts data used for ILI surveillance.

Flu activity is defined as:
Influenza-like illness (ILI): An illness characterized with a fever greater than or equal to 100˚F plus a cough and/or a sore throat in the absence of a known cause other than influenza.

A single case of influenza is not reportable unless linked to a pediatric death, but Collin County has a process for schools and health care organizations wanting to report influenza like illness (ILI) and positive lab results for surveillance.
- An outbreak of influenza is reportable.
- An outbreak is a localized increase in a disease, symptom or syndrome that clearly exceeds the expected level.
An outbreak is defined as:
- A sudden increase of cases over the normal background rate
- Five or more cases of flu or ILI in one day among students or staff in an epidemiologically linked group (e.g., single class, sports team or after school group).
School Name:*
School District:*
Week Ending In:*

MonthDayYear
Date
Total Enrolled:*
Total Number of Students Absent for the week (M-F):*
*Each absence will be counted as a separate occurrence example: 1 student out for 5 days will be 5 absences.
Total Number of Students Absent Due to ILI for the week (M-F):*
*Each ILI occurrence will be counted as a separate occurrence even if it is the same student out for multiple days. Example: If student is out Mon, Tues, Weds with FLU = 3 counts, not 1. *If no ILI absences are reported please put 0.
Was the school closed due to excessive ILI absences?*

NoYes
Level of ILI Activity:*

IncreasingDecreasingStayed the sameUnknown
Comments:
Should be Empty: