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Commission Implementing Decision (EU) 2018/945Show full title

Commission Implementing Decision (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions (Text with EEA relevance)

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  1. Introductory Text

  2. Article 1.The communicable diseases and related special health issues to be...

  3. Article 2.For the purposes of submitting data for the epidemiological surveillance...

  4. Article 3.Decisions 2000/96/EC and 2002/253/EC are hereby repealed. References to those...

  5. Article 4.This Decision shall enter into force on the 20th day...

  6. Signature

    1. ANNEX I

      Communicable diseases and related special health issues to be covered by the epidemiological surveillance network

      1. 1. DISEASES

      2. 2. SPECIAL HEALTH ISSUES

    2. ANNEX II

      1. 1. EXPLANATION OF THE SECTIONS USED IN THE DEFINITION AND CLASSIFICATION...

        1. CLINICAL CRITERIA

        2. LABORATORY CRITERIA

        3. EPIDEMIOLOGICAL CRITERIA AND EPIDEMIOLOGICAL LINK

        4. CASE CLASSIFICATION

        5. POSSIBLE CASE

        6. PROBABLE CASE

        7. CONFIRMED CASE

        8. LABORATORY-CONFIRMED CASE WITH CLINICAL CRITERIA

        9. LABORATORY-CONFIRMED CASE WITH UNKNOWN CLINICAL CRITERIA

        10. LABORATORY-CONFIRMED CASE WITHOUT CLINICAL CRITERIA

      2. 2. ABBREVIATION LIST

      3. 3. CASE DEFINITIONS OF COMMUNICABLE DISEASES

        1. 3.1. ANTHRAX

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        2. 3.2. BOTULISM

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        3. 3.3. BRUCELLOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        4. 3.4. CAMPYLOBACTER ENTERITIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

          5. Antimicrobial resistance

        5. 3.5. CHIKUNGUNYA VIRUS DISEASE

          1. Clinical Criteria

          2. Laboratory Criteria

            1. A. Probable case

            2. B. Confirmed case

          3. Epidemiological Criteria

          4. Case Classification

        6. 3.6. CHLAMYDIAL INFECTION, INCLUDING CHLAMYDIAL LYMPHOGRANULOMA (VENEREUM) (LGV)

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Chlamydial infection non-LGV

            2. LGV

          3. Epidemiological Criteria

          4. Case Classification

        7. 3.7. CHOLERA

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        8. 3.8. CREUTZFELDT-JAKOB DISEASE (CJD)

          1. Preconditions

          2. Clinical Criteria

          3. Diagnostic Criteria

            1. Diagnostic criteria for case confirmation:

            2. Diagnostic criteria for a probable or a possible case:

          4. Epidemiological Criteria

          5. Case Classification

        9. 3.9. CRYPTOSPORIDIOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        10. 3.10. DENGUE

          1. Clinical Criteria

          2. Laboratory Criteria

            1. A. Probable case

            2. B. Confirmed case

          3. Epidemiological Criteria

          4. Case Classification

        11. 3.11. DIPHTHERIA

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        12. 3.12. ECHINOCOCCOSIS

          1. Clinical Criteria

          2. Diagnostic Criteria

          3. Case Classification

        13. 3.13. GIARDIASIS (LAMBLIASIS)

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        14. 3.14. GONOCOCCAL INFECTION

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

          5. Antimicrobial resistance

        15. 3.15. HAEMOPHILUS INFLUENZAE INFECTION, INVASIVE DISEASE

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Case Classification

        16. 3.16. ACUTE HEPATITIS A

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        17. 3.17. HEPATITIS B

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        18. 3.18. HEPATITIS C

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Case Classification

        19. 3.19. HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION AND ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)...

          1. Clinical Criteria (AIDS)

          2. Laboratory Criteria (HIV)

          3. Case Classification

        20. 3.20. INFLUENZA

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        21. 3.21. INFLUENZA A/H5N1

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        22. 3.22. LEGIONNAIRES' DISEASE

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Laboratory criteria for case confirmation

            2. Laboratory criteria for a probable case

          3. Case Classification

        23. 3.23. LEPTOSPIROSIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        24. 3.24. LISTERIOSIS

          1. Clinical Criteria

            1. Listeriosis in pregnancy:

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        25. 3.25. LYME NEUROBORRELIOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

            1. A. Confirmed case

            2. B. Probable case

          3. Epidemiological Criteria

          4. Case Classification

        26. 3.26. MALARIA

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Case Classification

        27. 3.27. MEASLES

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological criteria

          4. Case Classification

        28. 3.28. MENINGOCOCCAL INFECTION, INVASIVE DISEASE

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        29. 3.29. MUMPS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        30. 3.30. PERTUSSIS

          1. Clinical Criteria

            1. Notes:

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        31. 3.31. PLAGUE

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        32. 3.32. STREPTOCOCCUS PNEUMONIAE INFECTION, INVASIVE DISEASE

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Case Classification

            1. Antimicrobial resistance:

        33. 3.33. ACUTE POLIOMYELITIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        34. 3.34. Q FEVER

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        35. 3.35. RABIES

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        36. 3.36. RUBELLA

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        37. 3.37. CONGENITAL RUBELLA SYNDROME

          1. Clinical Criteria

            1. Congenital rubella infection (CRI)

            2. Congenital rubella syndrome (CRS)

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification Congenital Rubella

        38. 3.38. SALMONELLA ENTERITIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

          5. Antimicrobial resistance

        39. 3.39. SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Laboratory criteria for case confirmation

            2. Laboratory criteria for a probable case

          3. Epidemiological Criteria

          4. Case Classification for the inter-epidemic period

          5. Case Classification during an outbreak

        40. 3.40. SHIGA TOXIN/VEROCYTOTOXIN-PRODUCING E. COLI INFECTION (STEC/VTEC), INCLUDING HAEMOLYTIC-URAEMIC SYNDROME (HUS)...

          1. Clinical Criteria

            1. STEC/VTEC diarrhoea

            2. HUS

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        41. 3.41. SHIGELLOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

          5. Antimicrobial resistance

        42. 3.42. SMALLPOX

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Laboratory criteria for case confirmation

            2. Laboratory criteria for a probable case

          3. Epidemiological Criteria

          4. Case Classification

        43. 3.43. SYPHILIS

          1. Clinical Criteria

            1. Primary syphilis

            2. Secondary syphilis

            3. Early latent syphilis (< 1 year)

          2. Laboratory Criteria

          3. Epidemiological Criteria

            1. Primary/secondary syphilis

            2. Early latent syphilis

          4. Case Classification

        44. 3.44. CONGENITAL SYPHILIS

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Laboratory criteria for case confirmation

            2. Laboratory criteria for a probable case

          3. Epidemiological Criteria

          4. Case Classification

        45. 3.45. TETANUS

          1. Clinical Criteria

          2. Case Classification

        46. 3.46. TICK-BORNE VIRAL ENCEPHALITIS

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Laboratory criteria for case confirmation:

            2. Laboratory criteria for a probable case:

          3. Epidemiological Criteria

          4. Case Classification

        47. 3.47. CONGENITAL TOXOPLASMOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Case Classification

        48. 3.48. TRICHINELLOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        49. 3.49. TUBERCULOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Laboratory criteria for case confirmation

            2. Laboratory criteria for a probable case

          3. Case Classification

          4. Antimicrobial resistance

        50. 3.50. TULARAEMIA

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        51. 3.51. TYPHOID AND PARATYPHOID FEVERS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        52. 3.52. VIRAL HAEMORRHAGIC FEVERS (VHF)

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        53. 3.53. WEST NILE VIRUS INFECTION (WNV)

          1. Clinical Criteria

          2. Laboratory Criteria

            1. Laboratory test for case confirmation

            2. Laboratory test for a probable case

          3. Epidemiological Criteria

          4. Case Classification

        54. 3.54. YELLOW FEVER

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        55. 3.55. ENTERITIS DUE TO YERSINIA ENTEROCOLITICA OR YERSINIA PSEUDOTUBERCULOSIS

          1. Clinical Criteria

          2. Laboratory Criteria

          3. Epidemiological Criteria

          4. Case Classification

        56. 3.56. ZIKA VIRUS DISEASE

          1. Clinical Criteria

          2. Laboratory Criteria

            1. A. Confirmed case

            2. B. Probable case

          3. Epidemiological Criteria

          4. Case Classification

        57. 3.57. CONGENITAL ZIKA VIRUS DISEASE

          1. Clinical Criteria

          2. Laboratory Criteria

            1. A. Confirmed case

          3. Epidemiological Criteria

          4. Case Classification

      4. 4. CASE DEFINITIONS OF SPECIAL HEALTH ISSUES

        1. 4.1. GENERAL CASE DEFINITION OF NOSOCOMIAL INFECTION (OR ‘HEALTHCARE-ASSOCIATED INFECTION (HAI)’)...

          2. 4.1.1. BJ: Bone and joint infection

            1. BJ-BONE: Osteomyelitis

              1. Note reporting instruction

            2. BJ-JNT: Joint or bursa

            3. BJ-DISC: Disc space infection

          3. 4.1.2. BSI: Bloodstream infection

            1. BSI: Laboratory-confirmed bloodstream infection

          4. 4.1.3. CNS: Central nervous system infection

            1. CNS-IC: Intracranial infection (brain abscess, subdural or epidural infection, encephalitis)...

              1. Note reporting instruction

            2. CNS-MEN: Meningitis or ventriculitis

              1. Note reporting instructions

            3. CNS-SA: Spinal abscess without meningitis

              1. Note reporting instruction

          5. 4.1.4. CRI: Catheter-related infection

            1. CRI1-CVC: Local CVC-related infection (no positive blood culture)

            2. CRI1-PVC: Local PVC-related infection (no positive blood culture)

            3. CRI2-CVC: General CVC-related infection (no positive blood culture)

            4. CRI2-PVC: General PVC-related infection (no positive blood culture)

            5. CRI3-CVC: microbiologically confirmed CVC-related bloodstream infection

            6. CRI3-PVC: microbiologically confirmed PVC-related bloodstream infection

          6. 4.1.5. CVS: Cardiovascular system infection

            1. CVS-VASC: Arterial or venous infection

              1. Note reporting instructions

            2. CVS-ENDO: Endocarditis

            3. CVS-CARD: Myocarditis or pericarditis

            4. CVS-MED: Mediastinitis

              1. Note reporting instruction

          7. 4.1.6. EENT: Eye, ear, nose, throat, or mouth infection

            1. EENT-CONJ: Conjunctivitis

              1. Note reporting instructions

            2. EENT-EYE: Eye, other than conjunctivitis

            3. EENT-EAR: Ear mastoid

            4. EENT-ORAL: Oral cavity (mouth, tongue, or gums)

              1. Note reporting instruction

            5. EENT-SINU: Sinusitis

            6. EENT-UR: Upper respiratory tract, pharyngitis, laryngitis, epiglottitis

          8. 4.1.7. GI: Gastrointestinal system infection

            1. GI-CDI: Clostridium difficile infection

            2. GI-GE: Gastroenteritis (excl. CDI)

            3. GI-GIT: Gastrointestinal tract (esophagus, stomach, small and large bowel, and...

            4. GI-HEP: Hepatitis

              1. Note reporting instructions

            5. GI-IAB: Intraabdominal, not specified elsewhere including gallbladder, bile ducts, liver...

              1. Note reporting instruction

          9. 4.1.8. LRI: Lower respiratory tract infection, other than pneumonia

            1. LRI-BRON: Bronchitis, tracheobronchitis, bronchiolitis, tracheitis, without evidence of pneumonia

              1. Note reporting instruction

            2. LRI-LUNG: Other infections of the lower respiratory tract

              1. Note reporting instruction

          10. 4.1.9. NEO: Specific neonatal case definitions

            1. NEO-CSEP: Clinical Sepsis

            2. NEO-LCBI: Laboratory-confirmed BSI

              1. Note reporting instructions

            3. NEO-CNSB: Laboratory-confirmed BSI with coagulase-negative staphylococci

              1. Note reporting instructions

            4. NEO-PNEU: Pneumonia

            5. NEO-NEC: Necrotising enterocolitis

          11. 4.1.10. PN: Pneumonia

            1. Notes:

            2. Intubation-associated pneumonia (IAP)

          12. 4.1.11. REPR: Reproductive tract infection

            1. REPR-EMET: Endometritis

              1. Note reporting instruction

            2. REPR-EPIS: Episiotomy

            3. REPR-VCUF: Vaginal cuff

              1. Note reporting instruction

            4. REPR-OREP: Other infections of the male or female reproductive tract...

              1. Note reporting instructions

          13. 4.1.12. SSI: Surgical site infection

            2. Superficial incisional (SSI-S)

            3. Deep incisional (SSI-D)

            4. Organ/Space (SSI-O)

          14. 4.1.13. SST: Skin and soft tissue infection

            1. SST-SKIN: Skin infection

              1. Note reporting instructions

            2. SST-ST: Soft tissue (necrotizing fascitis, infectious gangrene, necrotizing cellulitis, infectious...

              1. Note reporting instructions

            3. SST-DECU: Decubitus ulcer, including both superficial and deep infections

            4. SST-BURN: Burn

            5. SST-BRST: Breast abscess or mastitis

          15. 4.1.14. SYS: Systemic infection

            1. SYS-DI: Disseminated infection

              1. Note reporting instructions

            2. SYS-CSEP: treated unidentified severe infection

              1. Note reporting instructions

          16. 4.1.15. UTI: Urinary tract infection

            1. UTI-A: microbiologically confirmed symptomatic UTI

            2. UTI-B: not microbiologically confirmed symptomatic UTI

        2. 4.2. GENERAL CASE DEFINITION OF BLOOD STREAM INFECTION DUE TO SPECIFIC...

          1. Clinical criteria

          2. Laboratory criteria

          3. Epidemiological criteria

          4. Case classification

          5. Antimicrobial resistance

        3. 4.3. GENERIC CASE DEFINITION AND CLASSIFICATION OF ANTIMICROBIAL REISTANCE TO ANTIMICROBIAL...

          1. Clinical resistance to antimicrobial agents

            1. Definition

            2. Classification

              1. Clinically Susceptible (S)

              2. Clinically Intermediate (I)

              3. Clinically Resistant (R)

              4. Pandrug-resistant (PDR)

          2. Microbiological resistance to antimicrobial agents

            1. Phenotypic definition

            2. Phenotypic classification

              1. Wild-type (WT) phenotype

              2. Non-wild-type (NWT) phenotype

            3. Identification of an acquired antimicrobial resistance mechanism (for example, drug...

            4. Genotypic definition

            5. Genotypic classification

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