OUTBREAK – DETAILS OF STAFF AFFECTED KEY: D – Diarrhoea
N – Nausea
Home/Area: No
Staff Name
V – Vomiting
U – Unknown
X – Asymptomatic
Manager Job Role
Symptoms
NHSK/NHSW Date of sick
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Date of Return
Specimen/ Result
No
Staff Name
Job Role
Symptoms
Date of sick
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Date of Return
Specimen/ Result