Atlanta Hotel Pneumonia Illness Outbreak

INTRODUCTION


The Fulton County Board of Health and Georgia Department of Public Health are working to investigate a cluster of respiratory illnesses reported among people who stayed at the Sheraton in downtown Atlanta during late June and early July.



Please answer all questions that apply and know that all of your answers will be kept completely confidential. Please complete one survey per person. Responses from those who were not ill are also valuable to our investigation - it enables us to compare activities for those who got ill to those who did not. We estimate that it should take you 10 minutes per survey to complete. If you have any questions while you are taking the survey, please call the Fulton County Board of Health Epidemiology at 404-613-1391. Thank you so much for your cooperation.

DEMOGRAPHIC INFORMATION

ILLNESS AND SYMPTOMS


1 . Please indicate if you experienced the following:


	No	Yes	Not Sure

Ill with symptoms of fever, cough, or shortness of breath DURING your stay or in the 14 days AFTER your visit to the Sheraton in downtown Atlanta


If you did not experience symptoms of illness during or following your visit to the Sheraton, please skip the following questions and proceed to the next section about hotel activities.

2 . On what date did your symptoms start?	//

3 . At what time did your symptoms start?	:AMPM

4 . Please check ALL of the following symptoms you experienced since checking into the Sheraton in downtown Atlanta.

5 . Other symptoms.


6 . IF you reported pneumonia, how were you diagnosed with pneumonia? (Please check all that apply)

Clinician

Chest x-ray

Self-diagnosed

Other

7 . Other method of diagnosis

8 . Have your symptoms resolved or gotten better?

Yes No

9 . IF your symptoms have resolved, on what date did you feel better?


10 . Did you visit a healthcare provider for this illness?

Yes

No


11 . IF YES, what type of healthcare provider? (please check any and all types of providers you saw)

Primary Care Physician

Health Clinic

Urgent Care Center

Hospital Emergency Department (did not stay overnight)

Hospital (stayed at least one night)

12 . IF you were seen at a hospital, please provide the name and location (City, State)

13 . Did you submit any samples (urine, sputum, or other) for testing?

Yes No Not Sure

14 . Do you know the results of that testing? Or, did a healthcare practitioner give you a diagnosis and, if so, what was it?

15 . IF you are aware of others that have had similar illness, please provide their information here (this information will remain confidential).

Hotel Activities


1 . Did you spend any nights at the Sheraton in downtown Atlanta? (i.e. Did you "check in" as a hotel guest?)	Yes No

2 . IF you stayed overnight at the hotel, on what date did you check in?	//

3 . IF you stayed overnight at the hotel, on what date did you check out?	//

4 . IF you did stay overnight at the Sheraton, in what room did you stay?

5 . IF you did not stay overnight at the hotel, please indicate on what dates you visited the hotel.

6 . Please indicate if you did any of the following at the Sheraton in downtown Atlanta.


	Yes	No	Not Sure

Showered

Took a bath

Swam in the pool

Used the fitness facility

Entered whirlpool spa

Near (not entered) whirlpool spa

Near decorative fountain(s)

Near other water feature

Consumed ice from an ice machine


7 . Please indicate if you were in or near the pool on any of the following days. ("Near" the pool would be within the gated courtyard pool area)

Off-site Activities


Now we have some questions about things you may have done in and around the Atlanta hotel during your time there.

1 . Please indicate if you recall being in or near any of the following during your stay in Atlanta.


	Yes	No	Not Sure

Healthcare Facilities

Senior or Assisted Living Facilities

Hot tub or whirlpool spa (entered)

Hot tub or whirlpool spa (near)

Jacuzzi tub

Pool (not at Sheraton)

Recreational misters

Steam room or wet sauna

Decorative fountain (not at Sheraton)

Humidifier

Gym facility (not at Sheraton)

Other areas with water


2 . IF you said "Yes" to any of the above, please provide more information here.

THANK YOU


Again, thank you very much for your participation in this survey. All of the information provided will be used to describe the outbreak that occurred and hopefully determine the source of illness. When you are finished, please select "Save" and then "Finish" for your responses to be transmitted through our secure website.

1 . Please use this space for any additional comments.