International Health Filter

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To identify suspected cases of respiratory diseases and other conditions subject to epidemiological surveillence.

Email *

Full Name

1 point

Age:

1 point

Gender:

1 point

Male

Female

Clear selection

Place of residence (State):

1 point

Place of destination:

1 point

Cities or countries visited in the last 21 days:

1 point

Fever (greater than 38.5°C):

5 points

Yes

Clear selection

Cough:

2 points

Yes

Clear selection

Headache:

1 point

Yes

Clear selection

Myalgia (muscular pain):

1 point

Yes

Clear selection

Lumbalgia (lower back pain):

1 point

Yes

Clear selection

Asthenia (weakness):

2 points

Yes

Clear selection

Lymphodenopaty (inflamation of nodes):

3 points

Yes

Clear selection

Skin rash (hives, vesicules, ulcers, scabs):

3 points

Yes

Clear selection

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