Annex 3.

Template for Preparing an AVD Alert Phase Response Report

Aedes-Borne Viral Diseases Alert Phase Response Report (for Dengue and Chikungunya)
Name of the Reporting Unit/Facility: _________________________
Name of AVD Coordinator: _____ ___________________________
Date Prepared: __________________________________________

Response Strategy Steps Done If Done: If Not: Other Remarks:

YES NO
Case surveillance Verify reported AVD How many of the Why was
cases using standard verified cases were: verification not
case definitions. done?
Probable: ______
Suspect: ______
Confirmed: ____

Conduct active case How many people were Why was fever
detection through fever detected to have fever? surveillance not
surveillance within 300 _____ done?
meters radius from a
confirmed dengue case.

Of the people detected Why was referral

Refer people with fever to have fever, how many not done?
to the RHU/MHO for were referred to the
initial screening (e.g. RHU /MHO for initial
RDT). screening?

Laboratory-based Collect blood samples How many blood Why were blood
surveillance from 5-10% of the samples were taken? samples not taken?
suspected AVD cases for ______________
laboratory testing and
confirmation by the When will the samples
national reference be sent for lab
laboratory. confirmation________

Vector Control Conduct ‘search and What type of artificial Why was ‘search
 destroy’ measures. containers were and destroy’ not
searched and done?
destroyed?

What type of natural

containers were
searched and
destroyed?

Health Activate the AVD Fast Were AVD fast lane Why was activation
facilities/service Lane’ system in systems activated in all not done at all?
management hospitals. referral hospitals?

If not all, why?

Communications Intensify communication What information outlets Why was

for 4S: (1) ‘Search and were used? communication not
Destroy’, (2) Self- done?
protection measures, (3)
Seek early consultation, What IEC
(4) Say ‘Yes’ to fogging materials/methods were
only during outbreaks. used?

Note: (Kindly include the detailed actions taken by the CHDs, PHOs, CHOs , LGUs and other stakeholders
that needs to be involves in addressing dengue.)