Human and Animal Illness Associated with HABS

Harmful Algal Bloom Suspected Illness Reporting Form

Use the form below or call 3-1-1 to report suspected human or animal illness associated with harmful algal blooms.

If this is a human health emergency, contact 9-1-1.

If you think you or your pet have been exposed to a harmful algal bloom (HAB):

Rinse people and pets with tap water; do not let pets lick their fur until they have been rinsed.
Watch for symptoms.

If you have symptoms:

Call the Texas Poison Center Network at 1-800-222-1222.
Consult with your physician or your pet's veterinarian.

Check out the City of Austin Harmful Algal Bloom (HAB) page [https://www.austintexas.gov/page/algae] for more information including health effects of HAB exposure.

Full name of person making the report*

First Name

Last Name

Phone number*

Email address

Confirmation of your submission will be sent to this address.

Do you want someone to follow up with you?

Yes - be sure to include your contact info above Only if you need more information

Where did the exposure happen?*

Barton Creek Bull Creek Lady Bird Lake Lake Austin Lake Travis Lake Walter E. Long Onion Creek

Other:

Describe the exact location of the exposure.*

Please name any landmarks, trails, or notable features.

Did you notice any of the following in the area where the exposure took place?*

Discolored water Foam or scum Algal mats Paint-like streaks on the surface Dead fish or other animals in the water or on the shore The water looked clean

Other:

Check all that apply.

What are you reporting?*

Human illness only Animal illness only Human and animal illness

What is your relationship to the sick person?*

Self Parent Friend Healthcare provider

Other:

Name of the sick person. If you are reporting more than one sick person from the same household, enter information about the sickest person.

First Name

Last Name

Age of the sick person in years*

Describe the person's activities in and around the water. *

Did the sick person do any of the following in or around the water?*

Go wading Go swimming Put their face in the water Ingest water Eat in or near the water Dig in the mud or sand None of the above

Check all that apply.

What day and time of day did the exposure start?*

:

What day and time did the person start to have symptoms?*

:

Did the sick person get help from any of the following?*

Poison Control Center Physician / doctor's office Clinic / urgent care Emergency room or hospital None of the above Don't know

Other:

Check all that apply.

Please list the name and phone number of the doctor or medical facility.

How is the sick person now?*

Recovered or recovering Still sick

Other:

How many other people FROM YOUR HOUSEHOLD visited the exposure site at the same time?*

None 1 2 3 4 5 or more people

How many of those household members also got sick?*

None 1 2 3 4 5 or more people

List the names, ages, and symptoms of other household members who became sick. Did any require medical care?

Did the household members who did not get sick have exposure to the water?

Yes No Don't know

What is your relationship to the sick animal? *

Owner Veterinarian / Healthcare provider

Other:

What is the name of the sick animal? If you are reporting more than one sick animal from the same household, enter information about the sickest animal.*

What kind of animal?*

Dog

Other:

What breed is the dog?

How old is the animal?*

Less than 6 months old 6-12 months old 1-2 years old 3-5 years old 6-10 years old More than 10 years old Unknown

Describe the animal's activities in and around the water.*

Did the animal do any of the following?*

Get in the water (wading or swimming) Drink the water Lick its fur after being in the water Lick or eat mats of algae Eat or graze near the water None of the above

Check all that apply.

What day and time did the exposure start?*

:

What day and time did the animal start to show symptoms?*

:

Which symptoms did the animal have?*

Vomiting Diarrhea Fatigue, lethargy, or exhaustion Excessive salivation or drooling Difficulty breathing Convulsions or seizures Staggered walking or falling over Liver failure

Other:

Check all that apply.

Did the animal get care from a veterinarian?*

Yes No

What is the name and phone number of the veterinarian, clinic, or hospital?

Did you call a Poison Control Center for advice?*

Yes No

How is the animal now?*

Recovered or recovering Still sick Deceased

Other:

How many other animals from your household visited the exposure site at the same time?*

None 1 2 3 4 5 or more animals

How many of these household animals also got sick?*

None 1 2 3 4 5 or more animals

Did the animals that did not get sick have exposure to the water?*

Yes No

Other:

Please list the name, ages, and symptoms of other household animals who got sick. Did any require veterinary care?

Were there any other people or animals FROM OTHER HOUSEHOLDS present at the time and place of the exposure?

Yes No Don't know

Please share any information regarding other people or pets who were present. Did any become ill? Provide contact information, if possible.

Is there anything else you think we should know?

Thank you for reporting to Austin Public Health.

What happens when I click submit?

If you included an email address, you will receive an email confirmation that your submission has been received.
If you requested a response or if more information is required, someone from Austin Public Health will contact you within one week.
Some information on this form may be subject to public disclosure under the Texas Public Information Act.