LEGIONELLA - World Health Organization

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Usual place(s) for shopping Place:
Leisure centre: ❑ Yes ❑ No Place:
Hotels: ❑ Yes ❑ No Place:
Place of worship: ❑ Yes ❑ No Place:
Pubs/clubs;: ❑ Yes ❑ No Place:
Theatre/cinema/library: ❑ Yes ❑ No Place:
Petrol stations: ❑ Yes ❑ No Place:
Car wash: ❑ Yes ❑ No Place:
Travel diary of patient: activities 2 weeks prior to onset
Start from day before illness and work backwards from day 1 to day 14 before illness.
List places visited and travel by bus, car, train, cycle, foot.
Day 1: / /
Day 2: / /
Day 3: / /
Day 4: / /
Day 5: / /
Day 6: / /
Day 7: / /
Day 8: / /
Day 9: / /
Day 10: / /
Day 11: / /
Day 12: / /
Day13: / /
Day 14: / /
0 LEGIONELLA AND THE PREVENTION OF LEGIONELLOSIS