DENGUE PATIENTS FILE ------------------------------------------------------------------------------ {PAT}IENT {ID} STUDY # CONSENTIMIENTO # ת This is also the SERUM 1 ID ת {ETNIA} {ETNIA} {N}AME NAME {AD}DRE{S}S < > {STATE} CODE ## {STATE} {N}AME < > {MUNI}CIPALITY CODE ### {MUNI}CIPALITY {N}AME < > AGE ## AGE TYPE # BABY AGE ## SEX {PREG}NANCY WEEKS ## {PHYS}ICIAN {HOSP}ITAL ## {HOSP}ITAL {N}AME < > {D}ATE OF {ONSET} {EPI}DEMIOLOGIC {WEEK} ## mm/dd/yyyy תתת OF THE DATE OF ONSET תתת ------------------------------------------------------------------------------ DATES BLOOD OR SERUM SAMPLES ARE OBTAINED OR RECEIVED IN THE LABORATORY {D}ATE {S}AMPLE {1} {F}IRST {S}AMPLE # {D}ATE {S}AMPLE {2} {S}ECOND {S}AMPLE # mm/dd/yyyy CSF # {D}ATE {S}AMPLE {CSF} ------------------------------------------------------------------------------ CLINICAL DATA YES = 1 NO = 2 MISSING VALUE = 9 FEVER # {MYAL}GIA # {ARTH}RAGIA # {HEAD}ACHE # RET-ORB. PAIN # {CONJ}UNCTIVITIS # {PHOT}OPHOBIA # RASH # CHILLS # {AB}DOMINAL {PA}IN #{S}ORE {THR}OAT #{NAUS}EA # {VOMI}TING # {EP}ISTA{XI}S #{BL}EEDING {GU}MS #{ECCH}IMOSES # {P}ETE{CHI}AE #{PRUR}ITUS # {JAUN}DICE # COUGH # {RHIN}ITIS # {DIAR}RHEA # {EDEM}A # {HEPA}TOMEGALY # {PA}LP.{SPLE}EN #{LYMPH}ADENOPATHY # {HEMATE}MESIS # {HEMATU}RIA # {MELE}NA # {SOMNO}LENCIA # ALT. CONC. # {CONVUL}SIONES # {TOURNI}QUETE # {NUM} {PETE}QUIAE ## T.A. < > {CON}CURRENT {D}ISEASE {A}CUTE, {C}HRONIC OR {B}OTH < > {AC}UTE {D}ISEASE < > {CH}RONIC {D}ISEASE < > NOTES {HOSP}ITALIZED # LABORATORY DATA {NA}ME {DA}TE OF {O}NSET SERUM 1 SERUM 2 SERUM 3 DATE 1 DATE 2 DATE 3 mm/dd/yyyy mm/dd/yyyy mm/dd/yyyy {D}AYS 1 ### {D}AYS {2} ### HI 1 ##### HI 2 ##### HI 3 ##### ELISA 1 #.### ELISA 2 #.### ELISA 3 #.### PLATE 1 ### PLATE 2 ### PLATE 3 ### (x1000) (x1000) (x1000) HT 1 ## HT 2 ## HT 3 ## {VIRUS} ISOLATED VIRUS ID OTHER ID {YEAR} THE VIRUS {TRA}NSSMITED #### {DIAG}NOSIS (DENGUE) < > {SEROL}OGIC RESPONSE < > {RTPCR} RESULT {C}ODE # RTPCR < > {FIN}AL {RES}ULT {C}ODE ## FINRES < >