Active Bacterial Core Surveillance (ABCs) Case Report Form
Use this form to report invasive bacterial disease, among Minnesota residents, caused by group A streptococcus, group B streptococcus, Haemophilus influenzae, Neisseria meningitidis or Streptococcus pneumoniae to the Minnesota Department of Health..
Download a print version of the form:
- ABCs Case Report Form (PDF: 741KB/2 pages)
ABCs case report form updated 1/2014.
- ABCs Case Report Form Instructions (PDF: 496KB/37 pages)
Step-by-step instructions for filling out the ABCs Case Report Form. Updated 1/2014
Answers to frequently asked questions
- Invasive infections include one of these organisms isolated from a normally
sterile site. The ABCs form is only used for invasive infections, except as noted in the exceptions.
- Case reporting is generated through microbiology labs, infection control practitioners, and physicians.
- Use this form to report invasive bacterial disease cases, not the Yellow Card.
- If you have questions regarding the ABCs Case Report Form, please call 651-201-5414.
- Pleural fluid (includes chest fluid, thoracentesis fluid)
- Peritoneal fluid (includes abdominal fluid, ascites)
- Pericardial fluid
- Bone (includes bone marrow)
- Joint (includes synovial fluid; fluid, needle aspirate or culture of any specific joint: knee, ankle, elbow, hip, wrist)
- Internal body sites (specimen obtained from surgery or aspirate from one of the following: lymph node, brain, heart, liver, spleen, vitreous fluid, kidney, pancreas, or ovary)
- Group A Streptococcus:
- Muscle (tissue or biopsy that is surgically obtained)
- Any site (even non-sterile) in a case of toxic shock syndrome (TSS) or necrotizing fasciitis (NF)
- Severe GAS Infection: Supplemental Form
Please also complete this supplimental form when reporting all invasive GAS cases.
- Group B Streptococcus:
- If a fetal death occurs, also placenta or amniotic fluid
Invasive bacterial pathogens (cultured from normally sterile sites) are reported on this form. Please note the exceptions:
- Reporting Meningococcal Disease (Neisseria meningitidis)
There are no exceptions for reporting Meningococcal Disease (Neisseria meningitidis).
Call 651-201-5414 or 877-676-5414 immediately to report meningococcal disease.
- Reporting Haemophilus influenzae Disease
There are no exceptions for reporting Haemophilus influenzae.
- Reporting Streptococcal Disease
- Group B Streptococcus
Exceptions: Group B Streptococcus is reportable if fetal death occurs and the site is placenta or amniotic fluid.
- Group A Streptococcus
Exceptions: Group A Streptococcus is reportable from surgically obtained muscle. This is also reportable from any site (even non-sterile sites) in a case of toxic shock syndrome or necrotizing fasciitis.
- Streptococcus pneumoniae
There are no exceptions for reporting Streptococcus pneumoniae.
- Group B Streptococcus
Please return the completed form to MDH:
- By mail (please mark the envelope "confidential")
Acute Disease Investigation and Control
625 North Robert Street
Post Office Box 64975
St. Paul, MN 55164-0975
- By fax to: