1.EXPLANATION OF THE SECTIONS USED IN THE DEFINITION AND CLASSIFICATION...Clinical criteria Laboratory criteria Epidemiological criteria and epidemiological link Case classification Possible case Probable case Confirmed case Laboratory-confirmed case with clinical criteria Laboratory-confirmed case with unknown clinical criteria Laboratory-confirmed case without clinical criteria 2.CASE DEFINITIONS OF COMMUNICABLE DISEASES 2.1.ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) AND HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION...Clinical Criteria (AIDS) Laboratory Criteria (HIV) Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.2.ANTHRAX (Bacillus anthracis) Clinical Criteria Cutaneous anthrax Gastrointestinal anthrax Inhalational anthrax Meningeal/meningoencephalitic anthrax Anthrax septicaemia Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.3.AVIAN INFLUENZA A/H5 OR A/H5N1 IN HUMANS Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Nationally confirmed case D.WHO confirmed case 2.4.BOTULISM (Clostridium botulinum) Clinical Criteria Food-borne and wound botulism Infant botulism Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.5.BRUCELLOSIS (Brucella spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.6.CAMPYLOBACTERIOSIS (Campylobacter spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.7.CHLAMYDIAL INFECTION (Chlamydia trachomatis), INCLUDING LYMPHOGRANULOMA VENEREUM (LGV) Clinical Criteria Chlamydial infection non-LGV LGV Laboratory Criteria Chlamydial infection non-LGV LGV Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.8.CHOLERA (Vibrio cholerae) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.9.CREUTZFELDT-JAKOB DISEASE, VARIANT (vCJD) Preconditions Clinical Criteria Diagnostic Criteria Diagnostic criteria for case confirmation: Diagnostic criteria for a probable or a possible case: Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.10.CRYPTOSPORIDIOSIS (Cryptosporidium spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.11.DIPHTHERIA (Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis) Clinical Criteria Classic Respiratory Diphtheria: Mild Respiratory Diphtheria: Cutaneous Diphtheria: Diphtheria of other sites: Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.12.ECHINOCOCCOSIS (Echinococcus spp.) Clinical Criteria Diagnostic Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.13.GIARDIASIS (Giardia lamblia) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.14.GONORRHOEA (Neisseria gonorrhoeae) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.15.HAEMOPHILUS INFLUENZAE, INVASIVE DISEASE (Haemophilus influenzae) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.16.HEPATITIS A (Hepatitis A virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.17.HEPATITIS B (Hepatitis B virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.18.HEPATITIS C (Hepatitis C virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.19.INFLUENZA (Influenza virus) Clinical Criteria Influenza-like illness (ILI) Acute respiratory infection (ARI) Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.20.INFLUENZA A(H1N1) Clinical criteria Laboratory criteria Epidemiological criteria Case classification A.Case under investigation B.Probable case C.Confirmed case 2.21.LEGIONNAIRES’ DISEASE (Legionella spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.22.LEPTOSPIROSIS (Leptospira spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.23.LISTERIOSIS (Listeria monocytogenes) Clinical Criteria Laboratory Criteria Epidemiological Criteria Additional information Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.24.MALARIA (Plasmodium spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.25.MEASLES (Measles virus) Clinical Criteria Laboratory Criteria Epidemiological criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.26.MENINGOCCOCAL DISEASE, INVASIVE (Neisseria meningitidis) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.27.MUMPS (Mumps virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.28.PERTUSSIS (Bordetella pertussis) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.29.PLAGUE (Yersinia pestis) Clinical Criteria Bubonic plague: Septicaemic plague: Pneumonic plague: Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.30.PNEUMOCOCCAL INVASIVE DISEASE(S) (Streptococcus pneumoniae) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.31.POLIOMYELITIS (Polio virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.32.Q FEVER (Coxiella burnetii) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.33.RABIES (Lyssa virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.34.RUBELLA (Rubella virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.35.RUBELLA, CONGENITAL (Including Congenital Rubella Syndrome) Clinical Criteria Congenital rubella infection (CRI) Congenital rubella syndrome (CRS) (A) (B) Laboratory Criteria Epidemiological Criteria Case Classification Congenital Rubella A.Possible case NA B.Probable case C.Confirmed case 2.36.SALMONELLOSIS (Salmonella spp. other than Salmonella typhi and Salmonella paratyphi)...Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.37.SEVERE ACUTE RESPIRATORY SYNDROME — SARS (SARS-coronavirus, SARS-CoV) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification for the inter-epidemic period A.Possible case B.Probable case C.Nationally confirmed case D.Confirmed case Case Classification during an outbreak A.Possible case B.Probable case C.Nationally confirmed case D.Confirmed case 2.38.SHIGA TOXIN/VEROCYTO-TOXIN PRODUCING ESCHERICHIA COLI INFECTION (STEC/VTEC) Clinical Criteria STEC/VTEC diarrhoea HUS Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case of STEC-associated HUS B.Probable case of STEC/VTEC C.Confirmed case of STEC/VTEC 2.39.SHIGELLOSIS (Shigella spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.40.SMALLPOX (Variola virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case B.Probable case C.Confirmed case 2.41.SYPHILIS (Treponema pallidum) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.42.SYPHILIS, CONGENITAL AND NEONATAL (Treponema pallidum) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.43.TETANUS (Clostridium tetani) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.44.TICK-BORNE ENCEPHALITIS (TBE virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.45.TOXOPLASMOSIS, CONGENITAL (Toxoplasma gondii) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case NA B.Probable case NA C.Confirmed case 2.46.TRICHINELLOSIS (Trichinella spp.) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.47.TUBERCULOSIS (Mycobacterium tuberculosis complex) Clinical Criteria Laboratory Criteria Epidemiological Criteria NA Case Classification A.Possible case B.Probable case C.Confirmed case 2.48.TULARAEMIA (Francisella tularensis) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.49.TYPHOID/PARATYPHOID FEVER (Salmonella typhi/paratyphi) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.50.VIRAL HAEMORRHAGIC FEVERS (VHF) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.51.WEST NILE FEVER (West Nile virus infection, WNV) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.52.YELLOW FEVER (Yellow fever virus) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 2.53.YERSINIOSIS (Yersinia enterocolitica, Yersinia pseudotuberculosis) Clinical Criteria Laboratory Criteria Epidemiological Criteria Case Classification A.Possible case NA B.Probable case C.Confirmed case 3.CASE DEFINITIONS OF SPECIAL HEALTH ISSUES 3.1.GENERAL CASE DEFINITION OF NOSOCOMIAL INFECTION (OR ‘HEALTHCARE-ASSOCIATED INFECTION’) 3.1.1.BJ: BONE AND JOINT INFECTION BJ-BONE: Osteomyelitis Note reporting instruction: BJ-JNT: Joint or bursa BJ-DISC: Disc space infection 3.1.2.BSI: BLOODSTREAM INFECTION BSI: Laboratory-confirmed bloodstream infection 3.1.3.CNS: CENTRAL NERVOUS SYSTEM INFECTION CNS-IC: Intracranial infection (brain abscess, subdural or epidural infection, encephalitis)...Note reporting instruction: CNS-MEN: Meningitis or ventriculitis Note reporting instructions: CNS-SA: Spinal abscess without meningitis Note reporting instruction: 3.1.4.CRI: CATHETER-RELATED INFECTION CRI1-CVC: Local CVC-related infection (no positive blood culture) CRI1-PVC: Local PVC-related infection (no positive blood culture) CRI2-CVC: General CVC-related infection (no positive blood culture) CRI2-PVC: General PVC-related infection (no positive blood culture) CRI3-CVC: microbiologically confirmed CVC-related bloodstream infection CRI3-PVC: microbiologically confirmed PVC-related bloodstream infection 3.1.5.CVS: CARDIOVASCULAR SYSTEM INFECTION CVS-VASC: Arterial or venous infection Note reporting instructions: CVS-ENDO: Endocarditis CVS-CARD: Myocarditis or pericarditis CVS-MED: Mediastinitis Note reporting instruction: 3.1.6.EENT: EYE, EAR, NOSE, THROAT, OR MOUTH INFECTION EENT-CONJ: Conjunctivitis Note reporting instructions: EENT-EYE: Eye, other than conjunctivitis EENT-EAR: Ear mastoid EENT-ORAL: Oral cavity (mouth, tongue, or gums) Note reporting instruction: EENT-SINU: Sinusitis EENT-UR: Upper respiratory tract, pharyngitis, laryngitis, epiglottitis 3.1.7.GI: GASTROINTESTINAL SYSTEM INFECTION GI-CDI: Clostridium difficile infection GI-GE: Gastroenteritis (excl. CDI) GI-GIT: Gastrointestinal tract (oesophagus, stomach, small and large bowel, and...GI-HEP: Hepatitis Note reporting instructions: GI-IAB: Intraabdominal, not specified elsewhere including gallbladder, bile ducts, liver...Note reporting instruction: 3.1.8.LRI: LOWER RESPIRATORY TRACT INFECTION, OTHER THAN PNEUMONIA LRI-BRON: Bronchitis, tracheobronchitis, bronchiolitis, tracheitis, without evidence of pneumonia Note reporting instruction: LRI-LUNG: Other infections of the lower respiratory tract Note reporting instruction: 3.1.9.NEO: SPECIFIC NEONATAL CASE DEFINITIONS NEO-CSEP: Clinical Sepsis NEO-LCBI: Laboratory-confirmed BSI Note reporting instructions: NEO-CNSB: Laboratory-confirmed BSI with coagulase-negative staphylococci (CNS) Note reporting instructions: NEO-PNEU: Pneumonia NEO-NEC: Necrotising enterocolitis 3.1.10.PN: PNEUMONIA (a)Bacteriologic diagnostic performed by: (b)Alternative microbiology methods (PN 3) (c)Others Note:PN 1 and PN 2 criteria were validated without previous...Intubation-associated pneumonia (IAP) Note:Pneumonia for which intubation was started on the day of...3.1.11.REPR: REPRODUCTIVE TRACT INFECTION REPR-EMET: Endometritis Note reporting instruction: REPR-EPIS: Episiotomy REPR-VCUF: Vaginal cuff Note reporting instruction: REPR-OREP: Other infections of the male or female reproductive tract...Note reporting instructions: 3.1.12.SSI: SURGICAL SITE INFECTION Note:All definitions are to be assumed to be confirmed for...Superficial incisional (SSI-S) Deep incisional (SSI-D) Organ/Space (SSI-O) 3.1.13.SST: SKIN AND SOFT TISSUE INFECTION SST-SKIN: Skin infection Note reporting instructions: SST-ST: Soft tissue (necrotising fascitis, infectious gangrene, necrotising cellulitis, infectious...Note reporting instructions: SST-DECU: Decubitus ulcer, including both superficial and deep infections SST-BURN: Burn SST-BRST: Breast abscess or mastitis 3.1.14.SYS: SYSTEMIC INFECTION SYS-DI: Disseminated infection Note reporting instructions: SYS-CSEP: Clinical sepsis in adults and children Note reporting instructions: 3.1.15.UTI: URINARY TRACT INFECTION UTI-A: microbiologically confirmed symptomatic UTI UTI-B: not microbiologically confirmed symptomatic UTI 3.2.GENERIC CASE DEFINITION OF ANTIMICROBIAL RESISTANCE Definition Clinically Susceptible (S) Clinically Intermediate (I) Clinically Resistant (R) Clinical breakpoints are presented as S≤x mg/L; I>x, ≤y mg/L;...
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)
THE EUROPEAN COMMISSION,
Having regard to the Treaty on the Functioning of the European Union,
Having regard to Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community1, and in particular Article 3(c) thereof,
Whereas:
(1)
According to Article 2 of Commission Decision 2002/253/EC2, the case definitions laid down in the Annex to that Decision should be updated to the extent necessary on the basis of the latest scientific data.
(2)
In accordance with Article 9 of Regulation (EC) No 851/2004 of the European Parliament and of the Council of 21 April 2004 establishing a European Centre for disease prevention and control3 (ECDC), the ECDC provided, at the request of the Commission, a scientific opinion on case definitions aiding the Commission and the Member States in the development of intervention strategies in the field of surveillance of and response to communicable diseases.
(3)
The case definitions already listed in the Annex to Decision 2002/253/EC for HIV/AIDS, diphtheria, Haemophilus influenzae (invasive disease), hepatitis B and C, meningococcal disease, mumps, legionellosis, congenital rubella, shiga toxin/verocytotoxin producing Escherichia coli infection (STEC/VTEC), salmonellosis and leptospirosis should be updated on the basis of that scientific opinion provided by ECDC.
(4)
A generic case definition of antimicrobial resistance, a generic definition of nosocomial infections, a number of specific case definitions of nosocomial infections, and a case definition for tick-borne encephalitis should also be added to the Annex to Decision 2002/253/EC on the basis of that scientific opinion provided by ECDC.
(5)
For the purpose of clarity, it is appropriate to restructure the Annex to Decision 2002/253/EC in order to ensure that case definitions for communicable diseases are in a separate list from those for special health issues, and that, within each list, the case definitions appear in numerical order.
(6)
The measures provided for in this Decision are in accordance with the opinion of the Committee set up by Decision No 2119/98/EC,
HAS ADOPTED THIS DECISION: