Foodborne Illness Outbreak Notification

General Information

Notification Date:
Reporting Organization:
Contact Person:
Contact Information:

Outbreak Details

Suspected Food(s)
Date(s) of Consumption
Location(s) Involved
Number of People Exposed

Clinical Information

Number of Cases
Number Hospitalized
Number of Deaths
Symptoms Observed
Date & Time of Onset

Actions Taken

Brief Description:

Additional Notes