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Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (notified under document C(2012) 5538) (Text with EEA relevance) (2012/506/EU),
Epidemiological criteria and epidemiological link
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Epidemiological criteria are deemed to have been met when an epidemiological link can be established.
Epidemiological link, during the incubation period, means one of the following six:
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the fact that a person has had contact with a laboratory confirmed human case in such a way as to have had the opportunity to acquire the infection
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the fact that a person has had contact with an animal with a laboratory confirmed infection/colonisation in such a way as to have had the opportunity to acquire the infection
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the fact that a person has been exposed to the same common source or vehicle of infection, as a confirmed human case
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the fact that a person has consumed food or drinking water with a laboratory confirmed contamination or has consumed potentially contaminated products from an animal with a laboratory confirmed infection/colonisation
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the fact that a person has bathed in water or has had contact with a contaminated environmental source that has been laboratory confirmed
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the fact that a person has worked in a laboratory where there is a potential for exposure
A person may be considered epidemiologically linked to a confirmed case if at least one case in the chain of transmission is laboratory confirmed. In case of an outbreak of faeco-oral or airborne transmitted infections, the chain of transmission does not necessarily need to be established to consider a case epidemiologically linked.
Transmission may occur by one or more of the following routes:
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by projection of aerosol from an infected person onto the mucous membranes while coughing, spitting, singing or talking, or when microbial aerosols dispersed into the atmosphere are inhaled by others
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direct contact with an infected person (faecal-oral, respiratory droplets, skin or sexual exposure) or animal (e.g. biting, touching) or indirect contact to infected materials or objects (infected fomites, body fluids, blood)
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from mother to child, often in utero, or as a result of the incidental exchange of body fluids usually during the perinatal period
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indirect transmission by infected mosquitoes, mites, flies and other insects which transmit disease to humans through their bites
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consumption of potentially contaminated food or drinking water.
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