Neonatal Sepsis Surveillance Form - Minnesota Dept. of Health

Severe Group A Streptococcus (GAS) Infection: Supplemental Form

This form is used to report all invasive cases of Group A Strep to the Minnesota Department of Health. This form is supplemental to the ABCs Case Report Form. Please return both forms to MDH.

On this page:
GAS form & instructions
Frequently asked questions
Returning the completed form
Diseases to report on this form

GAS form & instructions

Frequently asked questions

  • If you have questions regarding these forms, please call 651-201-5414.

  • When reporting on a Severe Group A Streptococcus (GAS) Infection Supplemental Form, a Yellow Card is not necessary
    no yellow card

Returning the completed forms

  • After filling out the Severe GAS Infection Supplemental Form, please fax it to 651-201-5743.

Diseases to report these forms

  • Reporting Streptococcal Disease
    • 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.

More about this disease

Updated Wednesday, 06-Sep-2017 09:33:34 CDT