Tick the name of the disease from the list, or if it is not included tick “Gastroenteritis/foodborne intoxication (specify cause)” and write the name of the organism or toxin in the space provided. If the organism or toxin has not been identified, tick “Gastroenteritis - unknown cause”.

Note: There are separate case report forms for listeriosis, hepatitis A, toxic shellfish poisoning and VTEC/STEC infection.