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)

2.2. ANTHRAX (Bacillus anthracis)

Clinical Criteria

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

Cutaneous anthrax

At least one the following two:

• Papular or vesicular lesion

• Depressed black eschar with surrounding oedema

Gastrointestinal anthrax

• Fever or feverishness

AND at least one of the following two:

• Severe abdominal pain

• Diarrhoea

Inhalational anthrax

• Fever or feverishness

AND at least one of the following two:

• Acute respiratory distress

• Radiological evidence of mediastinal widening

Meningeal/meningoencephalitic anthrax

• Fever

AND at least one of the following three:

• Convulsions

• Loss of consciousness

• Meningeal signs

Anthrax septicaemia

Laboratory Criteria

• 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

Epidemiological Criteria

At least one of the following three epidemiological links:

• Animal to human transmission

• Exposure to a common source

• Exposure to contaminated food/drinking water

Case Classification

A. Possible case NA

B. Probable case

Any person meeting the clinical criteria and with an epidemiological link

C. Confirmed case

Any person meeting the clinical and the laboratory criteria