Any person who has any of the clinical conditions as defined in the European AIDS case definition for:

• Adults and adolescents = 13 years3

• Children < 13 years of age4

• Adults, adolescents and children aged = 18 months

  At least one of the following three:

  • Positive result of a HIV screening antibody test or a combined screening test (HIV antibody and HIV p24 antigen) confirmed by a more specific antibody test (e.g. Western blot)

  • Positive result of 2 EIA antibody test confirmed by a positive result of a further EIA test

  • Positive results on two separate specimens from at least one of the following three:

    • Detection of HIV nucleic acid (HIV-RNA, HIV-DNA)

    • Demonstration of HIV by HIV p24 antigen test, including neutralisation assay

    • Isolation of HIV

• Children aged < 18 months

  Positive results on two separate specimens (excluding cord blood) from at least one of the following three:

  • Isolation of HIV

  • Detection of HIV nucleic acid (HIV-RNA, HIV-DNA)

  • Demonstration of HIV by HIV p24 antigen test, including neutralisation assay in a child =1 month of age

NA

• Isolation of Bacillus anthracis from a clinical specimen

• Detection of Bacillus anthracis nucleic acid in a clinical specimen

Positive nasal swab without clinical symptoms does not contribute to a confirmed diagnosis of a case.

At least one of the following three epidemiological links:

• Animal to human transmission

• Exposure to a common source

• Exposure to contaminated food/drinking water

Any person with one of the following two:

• Fever AND signs and symptoms of acute respiratory infection

• Death from an unexplained acute respiratory illness

At least one of the following three:

• Isolation of influenza A/H5N1 from a clinical specimen

• Detection of influenza A/H5 nucleic acid in a clinical specimen

• Influenza A/H5 specific antibody response (fourfold or greater rise or single high titre)

At least one of the following four:

• Human to human transmission by having been in close contact (within one metre) to a person reported as probable or confirmed case

• Laboratory exposure: where there is a potential exposure to influenza A/H5N1

• Close contact (within one metre) with an animal with confirmed A/H5N1 infection other than poultry or wild birds (e.g. cat or pig)

• Reside in or have visited an area where influenza A/H5N1 is currently suspected or confirmed5 AND at least one of the following two:

  • Having been in close contact (within one metre) with sick or dead domestic poultry or wild birds6 in the affected area

  • Having been in a home or a farm where sick or dead domestic poultry have been reported in the previous month in the affected area

At least one of the following two:

• Isolation of C. botulinum for infant botulism (stool) or wound botulism (wound) (isolation of C. botulinum in stool of adults not relevant for the diagnosis of food-borne botulism)

• Detection of botulinum toxin in a clinical specimen

At least one of the following two epidemiological links:

• Exposure to a common source (e.g. food, sharing of needles or other devices)

• Exposure to contaminated food/drinking water

Any person with fever

AND at least one of following seven:

• Sweating (profuse, malodorous, specially nocturnal)

• Chills

• Arthralgia

• Weakness

• Depression

• Headache

• Anorexia

At least one of the following two:

• Isolation of Brucella spp. from a clinical specimen

• Brucella specific antibody response (Standard Agglutination Test, Complement Fixation, ELISA)

At least one of the following four epidemiological links:

• Exposure to contaminated food/drinking water

• Exposure to products from a contaminated animal (milk or milk products)

• Animal to human transmission (contaminated secretions or organs e.g. vaginal discharge, placenta)

• Exposure to a common source

Any person with at least one of the following three:

• Diarrhoea

• Abdominal pain

• Fever

• Isolation of Campylobacter spp. from stool or blood

Differentiation of Campylobacter spp. should be performed if possible

At least one of the following five epidemiological links:

• Animal to human transmission

• Human to human transmission

• Exposure to a common source

• Exposure to contaminated food/drinking water

• Environmental exposure

An epidemiological link by Human to human transmission (sexual contact or vertical transmission)

Any person with at least one of the following two:

• Diarrhoea

• Vomiting

• Isolation of Vibrio cholerae from a clinical specimen

  AND

• Demonstration of O1 or O139 antigen in the isolate

  AND

• Demonstration of cholera-enterotoxin or the cholera-enterotoxin gene in the isolate

At least one of the following four epidemiological links:

• Exposure to a common source

• Human to human transmission

• Exposure to contaminated food/drinking water

• Environmental exposure

• Any person with a progressive neuropsychiatric disorder with a duration of illness of at least six months

• Routine investigations do not suggest an alternative diagnosis

• No history of exposure to human pituitary hormones or human dura mater graft

• No evidence of a genetic form of transmissible spongiform encephalopathy

Any person with at least four of the following five:

• Early psychiatric symptoms7

• Persistent painful sensory symptoms8

• Ataxia

• Myoclonus or chorea or dystonia

• Dementia

An epidemiological link by human to human transmission (e.g. blood transfusion)

Any person with at least one of the following two:

• Diarrhoea

• Abdominal pain

At least one of the following four:

• Demonstration of Cryptosporidium oocysts in stool

• Demonstration of Cryptosporidium in intestinal fluid or small-bowel biopsy specimens

• Detection of Cryptosporidium nucleic acid in stool

• Detection of Cryptosporidium antigen in stool

One of the following five epidemiological links:

• Human to human transmission

• Exposure to a common source

• Animal to human transmission

• Exposure to contaminated food/drinking water

• Environmental exposure

• Isolation of toxin-producing C. diphtheriae or C. ulcerans from a clinical specimen

An epidemiological link by human to human transmission

Not relevant for surveillance purposes

At least one of the following five:

• Histopathology or parasitology compatible with Echinococcus multilocularis or granulosus (e.g. direct isvisualisation of the protoscolex in cyst fluid)

• Detection of Echinoccocus granulosus pathognomonic macroscopic morphology of cyst(s) in surgical specimens

• Typical organ lesions detected by imaging techniques (e.g.: computerised tomography, sonography, MRI) AND confirmed by a serological test

• Echinococcus spp. specific serum antibodies by high-sensitivity serological test AND confirmed by a high specificity serological test

• Detection of Echinococcus multilocularis or granulosus nucleic acid in a clinical specimen

NA

At least one of the following three:

• Isolation of Shigatoxin/Verotoxin (STEC/VTEC) producing E. coli

• Detection of stx1 or stx2 gene(s) nucleic acid

• Detection of free shigatoxins.

Only for HUS the following can be used as laboratory criterion to confirm STEC/VTEC:

• E. coli serogroups specific antibody response

Isolation and additional ischaracterisation by serotype, phage type, eae genes, and subtypes of stx₁/stx₂ should be performed if possible

At least one of the following five epidemiological links:

• Human to human transmission

• Exposure to a common source

• Animal to human transmission

• Exposure to contaminated food/drinking water

• Environmental exposure

Any person with at least one of the following four:

• Diarrhoea

• Abdominal pain

• Bloating

• Signs of malabsorption (e.g. steatorrhoea, weight loss)

At least one of the following two:

• Demonstration of Giardia lamblia cysts or trophozoites in stool, duodenal fluid or small-bowel biopsy

• Demonstration of Giardia lamblia antigen in stool

At least one of the following four epidemiological links:

• Exposure to contaminated food/drinking water

• Human to human transmission

• Exposure to a common source

• Environmental exposure

Any person with at least one of the following eight:

• Urethritis

• Acute salpingitis

• Pelvic inflammatory disease

• Cervicitis

• Epididymitis

• Proctitis

• Pharyngitis

• Arthritis

OR

Any newborn child with conjunctivitis

At least one of the following four:

• Isolation of Neisseria gonorrhoeae from a clinical specimen

• Detection of Neisseria gonorrhoeae nucleic acid in a clinical specimen

• Demonstration of Neisseria gonorrhoeae by a non amplified nucleic acid probe test in a clinical specimen

• Microscopic detection of intracellular gram negative diploccocci in an urethral male specimen

An epidemiological link by human to human transmission (sexual contact or vertical transmission)

Not relevant for surveillance purposes

Laboratory criteria for case definition

At least one of the following two:

• Isolation of Haemophilus influenzae from a normally sterile site

• Detection of Haemophilus influenzae nucleic acid from a normally sterile site

Typing of the isolates should be performed, if possible

NA

Any person with a discrete onset of symptoms (e.g. fatigue, abdominal pain, loss of appetite, intermittent nausea and vomiting)

AND

At least one of the following three:

• Fever

• Jaundice

• Elevated serum aminotransferase levels

At least one of the following three:

• Detection of hepatitis A virus nucleic acid in serum or stool

• Hepatitis A virus specific antibody response

• Detection of hepatitis A virus antigen in stool

At least one of the following four:

• Human to human transmission

• Exposure to a common source

• Exposure to contaminated food/drinking water

• Environmental exposure

Any person with a discrete onset of symptoms (e.g. fatigue, abdominal pain, loss of appetite, intermittent nausea and vomiting)

AND

At least one of the following three:

• Fever

• Jaundice

• Elevated serum aminotransferase levels

Hepatitis B virus core IgM antigen specific antibody response

Laboratory results need to be interpreted according to the vaccination status

An epidemiological link by human to human transmission (e.g. sexual contact, vertical transmission or blood transmission)

Not relevant for surveillance purposes

At least one of the following two:

• Detection of hepatitis C virus nucleic acid in serum

• Hepatitis C virus specific antibody response confirmed by a different antibody test

NA

At least one the following four:

• Isolation of influenza virus from a clinical specimen

• Detection of influenza virus nucleic acid in a clinical specimen

• Identification of influenza virus antigen by DFA test in a clinical specimen

• Influenza specific antibody response

Sub typing of the influenza isolate should be performed, if possible

An epidemiological link by human to human transmission

Any person with pneumonia

• Laboratory criteria for case confirmation

  At least one of the following three:

  • Isolation of Legionella spp. from respiratory secretions or any normally sterile site

  • Detection of Legionella pneumophila antigen in urine

  • Legionella pneumophila serogroup 1 specific antibody response

• Laboratory criteria for a probable case

  At least one of the following four:

  • Detection of Legionella pneumophila antigen in respiratory secretions or lung tissue e.g. by DFA staining using monoclonal-antibody derived reagents

  • Detection of Legionella spp. nucleic acid in a clinical specimen

  • Legionella pneumophila non-serogroup 1 or other Legionella spp. specific antibody response

  • L. pneumophila serogroup 1, other serogroups or other Legionella species: single high titre in specific serum antibody

At least one of the following two epidemiological links:

• Environmental exposure

• Exposure to the same common source

Any person with

• Fever

OR

At least two of the following eleven:

• Chills

• Headache

• Myalgia

• Conjunctival suffusion

• Haemorrhages into skin and mucous membranes

• Rash

• Jaundice

• Myocarditis

• Meningitis

• Renal impairment

• Respiratory symptoms such as haemoptysis

At least one of the following four:

• Isolation of Leptospira interrogans from a clinical specimen

• Detection of Leptospira interrogans nucleic acid in a clinical specimen

• Demonstration of Leptospira interrogans by immunofluorescence in a clinical specimen

• Leptospira interrogans specific antibody response

At least one of the following three epidemiological links:

• Animal to human transmission

• Environmental exposure

• Exposure to a common source

Any person with at least one of the following three:

• Listeriosis of newborns defined as

  Stillbirth

  OR

  At least one of the following five in the first month of life:

  • Granulomatosis infantiseptica

  • Meningitis or meningoencephalitis

  • Septicaemia

  • Dyspnoea

  • Lesions on skin, mucosal membranes or conjunctivae

• Listeriosis in pregnancy defined as at least one of the following three:

  • Abortion, miscarriage, stillbirth or premature birth

  • Fever

  • Influenza-like symptoms

• Other form of listeriosis defined as at least one of the following four:

  • Fever

  • Meningitis or meningoencephalitis

  • Septicaemia

  • isLocalised infections such as arthritis, endocarditis, and abscesses

At least one of the following two:

• Isolation of Listeria monocytogenes from a normally sterile site

• Isolation of Listeria monocytogenes from a normally non-sterile site in a foetus, stillborn, newborn or the mother at or within 24 hours of birth

At least one of the following three epidemiological links:

• Exposure to a common source

• Human to human transmission (vertical transmission)

• Exposure to contaminated food/drinking water

Incubation period 3-70 days, most often 21 days

Any person with fever OR a history of fever

At least one of the following three:

• Demonstration of malaria parasites by light microscopy in blood films

• Detection of Plasmodium nucleic acid in blood

• Detection of Plasmodium antigen

Differentiation of Plasmodium spp. should be performed if possible

NA

Any person with fever

AND

• Maculo-papular rash

AND at least one of the following three:

• Cough

• Coryza

• Conjunctivitis

At least one of the following four:

• Isolation of measles virus from a clinical specimen

• Detection of measles virus nucleic acid in a clinical specimen

• Measles virus specific antibody response characteristic for acute infection in serum or saliva

• Detection of measles virus antigen by DFA in a clinical specimen using measles specific monoclonal antibodies

Laboratory results need to be interpreted according to the vaccination status. If recently vaccinated, investigate for wild virus

An epidemiological link by human to human transmission

Any person with at least one of the following five:

• Fever

• Meningeal signs

• Petechial rash

• Septic shock

• Septic arthritis

At least one of the following four:

• Isolation of Neisseria meningitidis from a normally sterile site, including purpuric skin lesions

• Detection of Neisseria meningitidis nucleic acid from a normally sterile site, including purpuric skin lesions

• Detection of Neisseria meningitidis antigen in CSF

• Detection of gram negative stained diplococcus in CSF

An epidemiological link by human to human transmission

Any person with

• Fever

AND

At least two of the following three:

• Sudden onset of tender swelling of the parotid or other salivary glands

• Orchitis

• Meningitis

At least one of the following three:

• Isolation of mumps virus from a clinical specimen

• Detection of mumps virus nucleic acid

• Mumps virus specific antibody response characteristic for acute infection in serum or saliva

Laboratory results need to be interpreted according to the vaccination status

An epidemiological link by human to human transmission

Any person with a cough lasting at least two weeks

AND

at least one of the following three:

• Paroxysms of coughing

• Inspiratory ‘whooping’

• Post-tussive vomiting

OR

Any person diagnosed as pertussis by a physician

OR

Apnoeic episodes in infants

At least one of the following three:

• Isolation of Bordetella pertussis from a clinical specimen

• Detection of Bordetella pertussis nucleic acid in a clinical specimen

• Bordetella pertussis specific antibody response

An epidemiological link by human to human transmission

At least one of the following three:

• Isolation of Yersinia pestis from a clinical specimen

• Detection of Yersinia pestis nucleic acid from a clinical specimen (F1 antigen)

• Yersinia pestis anti-F1 antigen specific antibody response

At least one of the following four epidemiological links:

• Human to human transmission

• Animal to human transmission

• Laboratory exposure (where there is a potential exposure to plague)

• Exposure to a common source

Not relevant for surveillance purposes

At least one of the following three:

• Isolation of S. pneumoniae from a normally sterile site

• Detection of S. pneumoniae nucleic acid from a normally sterile site

• Detection of S. pneumoniae antigen from a normally sterile site

NA

Any person < 15 years of age with acute flaccid paralysis (AFP)

OR

Any person in whom polio is suspected by a physician

At least one of the following three:

• Isolation of a polio virus and intratypic differentiation — Wild polio virus (WPV)

• Vaccine derived poliovirus (VDPV) (for the VDPV at least 85 % similarity with vaccine virus in the nucleotide sequences in the VP1 section)

• Sabin-like poliovirus: intratypic differentiation performed by a WHO-accredited polio laboratory (for the VDPV a >1 % up to 15 % VP1 sequence difference compared with vaccine virus of the same serotype)

At least one of the following two epidemiological links:

• Human to human transmission

• An history of travel to a polio-endemic area or an area with suspected or confirmed circulation of poliovirus

Any person with at least one of the following three:

• Fever

• Pneumonia

• Hepatitis

At least one of the following three:

• Isolation of Coxiella burnetii from a clinical specimen

• Detection of Coxiella burnetii nucleic acid in a clinical specimen

• Coxiella burnetii specific antibody response (IgG or IgM phase II)

At least one of the following two epidemiological links:

• Exposure to a common source

• Animal to human transmission

Any person with an acute encephalomyelitis

AND

At least two of the following seven:

• Sensory changes referred to the site of a preceding animal bite

• Paresis or paralysis

• Spasms of swallowing muscles

• Hydrophobia

• Delirium

• Convulsions

• Anxiety

At least one of the following four:

• Isolation of Lyssa virus from a clinical specimen

• Detection of Lyssa virus nucleic acid in a clinical specimen (e.g. saliva or brain tissue)

• Detection of viral antigens by a DFA in a clinical specimen

• Lyssa virus specific antibody response by virus isneutralisation assay in serum or CSF

Laboratory results need to be interpreted according to the vaccination or immunisation status

At least one of the following three epidemiological links:

• Animal to human transmission (animal with suspected or confirmed infection)

• Exposure to a common source (same animal)

• Human to human transmission (e.g. transplantation of organs)

Any person with sudden onset of generalised maculo-papular rash

AND

At least one of the following five:

• Cervical adenopathy

• Sub-occipital adenopathy

• Post-auricular adenopathy

• Arthralgia

• Arthritis

• Laboratory criteria for case confirmation

  At least one of the following three:

• Isolation of rubella virus from a clinical specimen

• Detection of rubella virus nucleic acid in a clinical specimen

• Rubella virus specific antibody response (IgG) in serum or saliva

• Laboratory criteria for probable case

• Rubella virus specific antibody response (IgM)11

Laboratory results need to be interpreted according to the vaccination status

An epidemiological link by human to human transmission

At least one of the following four:

• Isolation of rubella virus from a clinical specimen

• Detection of Rubella virus nucleic acid

• Rubella virus specific antibody response (IgM)

• Persistence of rubella IgG between 6 and 12 months of age (at least two samples with similar concentration of rubella IgG)

Laboratory results need to be interpreted according to the vaccination status

Any infant or any stillborn born to a woman with a laboratory confirmed rubella infection during pregnancy by human to human transmission vertical transmission)

Any person with at least one of the following four:

• Diarrhoea

• Fever

• Abdominal pain

• Vomiting

• Isolation of Salmonella (other than S. Typhi and S. Paratyphi) from stool or blood

At least one of the following five epidemiological links:

• Human to human transmission

• Exposure to a common source

• Animal to human transmission

• Exposure to contaminated food/drinking water

• Environmental exposure

Any person with fever or a history of fever

AND

At least one of the following three:

• Cough

• Difficulty in breathing

• Shortness of breath

AND

At least one of the following four:

• Radiographic evidence of pneumonia

• Radiographic evidence of acute respiratory distress syndrome

• Autopsy findings of pneumonia

• Autopsy findings of acute respiratory distress syndrome

AND

No alternative diagnosis which can fully explain the illness

• Laboratory criteria for case confirmation

  At least one of the following three:

  • Isolation of virus in cell culture from any clinical specimen and identification of SARS-CoV using method such as RT-PCR

  • Detection SARS-CoV nucleic acid in at least one of the following three:

    • At least two different clinical specimens (e.g. nasopharyngeal swab and stool)

    • The same clinical specimen collected on two or more occasions during the course of the illness (e.g. sequential nasopharyngeal aspirates)

    • Two different assays or repeat RT-PCR using a new RNA extract from the original clinical sample on each occasion of testing

• SARS-CoV specific antibody response by one of the following two:

  • Seroconversion by ELISA or IFA in acute and convalescent phase serum tested in parallel

  • Fourfold or greater rise in antibody titre between acute and convalescent phase sera tested in parallel

• Laboratory criteria for a probable case

  At least one of the following two:

  • A single positive antibody test for SARS-CoV

  • A positive PCR result for SARS-CoV on a single clinical specimen and assay

At least one of the following three:

• Any person with at least one of the following three:

  • Employed in an occupation associated with an increased risk of SARS-CoV exposure (e.g. staff in a laboratory working with live SARS-CoV/SARS-CoV-like viruses or storing clinical specimens infected with SARS-CoV; persons with exposure to wildlife or other animals considered a reservoir of SARS-CoV, their excretions or secretions, etc.)

  • Close contact12 of one or more persons with confirmed SARS or under investigation for SARS

  • History of travel to, or residence in, an area experiencing an outbreak of SARS

• Two or more health-care workers13 with clinical evidence of SARS in the same health-care unit and with onset of illness in the same 10-day period

• Three or more persons (health-care workers and/or patients and/or visitors) with clinical evidence of SARS with onset of illness in the same 10-day period and epidemiologically linked to a healthcare facility

Any person with at least one of the following four:

• Diarrhoea

• Fever

• Vomiting

• Abdominal pain

• Isolation of Shigella spp. from a clinical specimen

At least one of the following five epidemiological links:

• Human to human transmission

• Exposure to a common source

• Animal to human transmission

• Exposure to contaminated food/drinking water

• Environmental exposure

Any person with at least one of the following two:

• Fever

AND

Vesicles or firm pustules rash at the same stage of development with a centrifugal distribution

• Atypical presentations defined as at least one of the following four:

  • Haemorrhagic lesions

  • Flat velvety lesions not progressing to vesicles

  • Variola sine eruptione

  • Milder type

• Laboratory criteria for case confirmation

  At least one of the following two laboratory tests:

  • Isolation of smallpox (variola virus) from a clinical specimen followed by sequencing (designated P4 laboratories only)

  • Detection of Variola virus nucleic acid in a clinical specimen followed by sequencing

Laboratory results need to be interpreted according to the vaccination status

• Laboratory criteria for a probable case

• Identification of orthopox virus particles by EM

At least one of the following two epidemiological links:

• Human to human transmission

• Laboratory exposure (where there is a potential exposure to Variola virus)

• Primary syphilis

  Any person with one or several (usually painless) chancres in the genital, perineal, anal area or mouth or pharyngeal mucosa or elsewhere extragenitally

• Secondary syphilis

  Any person with at least one of the following three:

  • Diffuse maculo-papular rash often involving palms and soles

  • Generalised lymphadenopathy

  • Condyloma lata

  • Enanthema

  • Allopetia diffusa

• Early latent syphilis (< 1 year)

  A history of symptoms compatible with those of the earlier stages of syphilis within the previous 12 months

• Late latent syphilis (> 1 year)

  Any person meeting laboratory criteria (specific serological tests)

At least one of the following four laboratory tests:

• Demonstration of Treponema pallidum in lesion exudates or tissues by dark-field microscopic examination

• Demonstration of Treponema pallidum in lesion exudates or tissues by DFA test

• Demonstration of Treponema in lesion exudates or tissues by PCR

• Detection of Treponema pallidum antibodies by screening test (TPHA, TPPA or EIA) AND additionally detection of Tp-IgM antibodies (by IgM-ELISA, IgM immunoblot or 19S-IgM-FTA-abs) — confirmed by a second IgM assay

• Primary/secondary syphilis

  An epidemiological link by human to human (sexual contact)

• Early latent syphilis (< 1 year)

  An epidemiological link by human to human (sexual contact) within the 12 previous months

Any infant < 2 years of age with at least one of the following 10:

• Hepatospenomegaly

• Mucocutaneous lesions

• Condyloma lata

• Persistent rhinitis

• Jaundice

• Pseudoparalysis (due to periostitis and osteochondritis)

• Central nervous involvement

• Anaemia

• Nephrotic syndrome

• Malnutrition

• Laboratory criteria for case confirmation

  At least one of the following three:

  • Demonstration of Treponema pallidum by dark field microscopy in the umbilical cord, the placenta, a nasal discharge or skin lesion material

  • Demonstration of Treponema pallidum by DFA-TP in the umbilical cord, the placenta, a nasal discharge or skin lesion material

  • Detection of Treponema pallidum — specific IgM (FTA-abs, EIA)

  AND a reactive non treponemal test (VDRL, RPR) in the child's serum

• Laboratory criteria for a probable case

  At least one of the following three:

  • Reactive VDRL-CSF test result

  • Reactive non treponemal and treponemal serologic tests in the mother's serum

  • Infant's non treponemal antibody titre is fourfold or greater than the antibody titre in the mother's serum

Any infant with an epidemiological link by human to human transmission (vertical transmission)

Any person with at least two of the following three:

• Painful muscular contractions primarily of the masseter and neck muscles leading to facial spasms known as trismus and ‘risus sardonicus’

• Painful muscular contractions of trunk muscles

• Generalised spasms, frequently position of opisthotonus

At least one of the following two:

• Isolation of Clostridium tetani from an infection site

• Detection of tetanus toxin in a serum sample

NA

Not relevant for surveillance purposes

At least one of the following four:

• Demonstration of T. gondii in body tissues or fluids

• Detection of T. gondii nucleic acid in a clinical specimen

• T. gondii specific antibody response (IgM, IgG, IgA) in a newborn

• Persistently stable IgG T. gondii titres in an infant (<12 months of age)

NA

Any person with at least three of the following six:

• Fever

• Muscle soreness and pain

• Diarrhoea

• Facial oedema

• Eosinophilia

• Subconjunctival, subungual and retinal haemorrhages

At least one of the following two:

• Demonstration of Trichinella larvae in tissue obtained by muscle biopsy

• Trichinella specific antibody response (IFA test, ELISA or Western Blot)

At least one of the following two epidemiological links:

• Exposure to contaminated food (meat)

• Exposure to a common source

Any person with the following two:

• Signs, symptoms and/or radiological findings consistent with active tuberculosis in any site

  AND

• A clinician's decision to treat the person with a full course of anti-tuberculosis therapy

OR

A case discovered post-mortem with pathological findings consistent with active tuberculosis that would have indicated anti-tuberculosis antibiotic treatment had the patient been diagnosed before dying

• Laboratory criteria for case confirmation

  At least one of the following two:

  • Isolation of Mycobacterium tuberculosis complex (excluding Mycobacterium bovis-BCG) from a clinical specimen

  • Detection of Mycobacterium tuberculosis complex nucleic acid in a clinical specimen AND positive microscopy for acid-fast bacilli or equivalent fluorescent staining bacilli on light microscopy

• Laboratory criteria for a probable case

  At least one of the following three:

  • Microscopy for acid-fast bacilli or equivalent fluorescent staining bacilli on light microscopy

  • Detection of Mycobacterium tuberculosis complex nucleic acid in a clinical specimen

  • Histological appearance of granulomata

NA

Any person with at least one of the following clinical forms:

• Ulceroglandular tularaemia

  • Cutaneous ulcer

    AND

  • Regional lymphadenopathy

• Glandular tularaemia

  • Enlarged and painful lymph nodes without apparent ulcer

• Oculoglandular tularaemia

  • Conjunctivitis

    AND

  • Regional lymphadenopathy

• Oropharyngeal tularaemia

  • Cervical lymphadenopathy

    AND

  at least one of the following three:

  • Stomatitis

  • Pharyngitis

  • Tonsillitis

• Intestinal tularaemia

  At least one of the following three:

  • Abdominal pain

  • Vomiting

  • Diarrhoea

• Pneumonic tularaemia

  • Pneumonia

• Typhoidal tularaemia

  At least one of the following two:

  • Fever without early localising signs and symptoms

  • Septicaemia

At least one of the following three:

• Isolation of Francisella tularensis from a clinical specimen

• Detection of Francisella tularensis nucleic acid in a clinical specimen

• Francisella tularensis specific antibody response

At least one of the following three epidemiological links:

• Exposure to a common source

• Animal to human transmission

• Exposure to contaminated food/drinking water

Any person with at least one of the following two:

• Onset of sustained fever

• At least two of the following four:

  • Headache

  • Relative bradycardia

  • Non productive cough

  • Diarrhoea, constipation, malaise or abdominal pain

Paratyphoid fever has the same symptoms as typhoid fever, however usually a milder course.

• Isolation of Salmonella Typhi or Paratyphi from a clinical specimen

At least one of the following three epidemiological links:

• Exposure to a common source

• Human to human transmission

• Exposure to contaminated food/drinking water

Any person with at least one of the following two:

• Fever

• Haemorrhagic manifestations in various forms that may lead to multi-organ failure

At least one of the following two:

• Isolation of specific virus from a clinical specimen

• Detection of specific virus nucleic acid in a clinical specimen and genotyping

At least one of the following:

• Travel in the last 21 days to a region where VHF cases are known or believed to have occurred

• Exposure within the last 21 days to a probable or confirmed case of a Viral Hemorrhagic Fever whose onset of illness was within the last six months

Any person with fever

OR

At least one of the following two:

• Encephalitis

• Meningitis

• Laboratory test for case confirmation

  At least one of the following four:

  • Isolation of WNV from blood or CSF

  • Detection of WNV nucleic acid in blood or CSF

  • WNV specific antibody response (IgM) in CSF

  • WNV IgM high titre AND detection of WNV IgG, AND confirmation by neutralisation

• Laboratory test for a probable case

  WNV specific antibody response in serum

  Laboratory results need to be interpreted according to flavivirus vaccination status

At least one of the following two epidemiological links:

• Animal to human transmission (residing, having visited or having been exposed to mosquito bites in an area where WNV is endemic in horses or birds)

• Human to human transmission (vertical transmission, blood transfusion, transplants)

Any person with fever

AND

At least one of the following two:

• Jaundice

• Generalised haemorrhage

At least one of the following five:

• Isolation of yellow fever virus from a clinical specimen

• Detection of yellow fever virus nucleic acid

• Detection of yellow fever antigen

• Yellow fever specific antibody response

• Demonstration of typical lesions in post mortem liver histopathology

Laboratory results need to be interpreted according to flavivirus vaccination status

Travel in the last one week to a region where yellow fever cases are known or believed to have occurred

Any person with at least one of the following five:

• Fever

• Diarrhoea

• Vomiting

• Abdominal pain (pseudoappendicitis)

• Tenesmus