Article 1
The communicable diseases and related special health issues to be...
Article 2
For the purposes of submitting data for the epidemiological surveillance...
Article 3
Decisions 2000/96/EC and 2002/253/EC are hereby repealed. References to those...
Article 4
This Decision shall enter into force on the 20th day...
ANNEX I
Communicable diseases and related special health issues to be covered by the epidemiological surveillance network
1.
DISEASES
2.
SPECIAL HEALTH ISSUES
ANNEX II
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.
ABBREVIATION LIST
3.
CASE DEFINITIONS OF COMMUNICABLE DISEASES
3.1.
ANTHRAX
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.2.
BOTULISM
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.3.
BRUCELLOSIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.4.
CAMPYLOBACTER ENTERITIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
Antimicrobial resistance
3.5.
CHIKUNGUNYA VIRUS DISEASE
Clinical Criteria
Laboratory Criteria
A.
Probable case
B.
Confirmed case
Epidemiological Criteria
Case Classification
3.6.
CHLAMYDIAL INFECTION, INCLUDING CHLAMYDIAL LYMPHOGRANULOMA (VENEREUM) (LGV)
Clinical Criteria
Laboratory Criteria
Chlamydial infection non-LGV
LGV
Epidemiological Criteria
Case Classification
3.7.
CHOLERA
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.8.
CREUTZFELDT-JAKOB DISEASE (CJD)
Preconditions
Clinical Criteria
Diagnostic Criteria
Diagnostic criteria for case confirmation:
Diagnostic criteria for a probable or a possible case:
Epidemiological Criteria
Case Classification
3.9.
CRYPTOSPORIDIOSIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.10.
DENGUE
Clinical Criteria
Laboratory Criteria
A.
Probable case
B.
Confirmed case
Epidemiological Criteria
Case Classification
3.11.
DIPHTHERIA
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.12.
ECHINOCOCCOSIS
Clinical Criteria
Diagnostic Criteria
Case Classification
3.13.
GIARDIASIS (LAMBLIASIS)
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.14.
GONOCOCCAL INFECTION
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
Antimicrobial resistance
3.15.
HAEMOPHILUS INFLUENZAE INFECTION, INVASIVE DISEASE
Clinical Criteria
Laboratory Criteria
Case Classification
3.16.
ACUTE HEPATITIS A
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.17.
HEPATITIS B
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.18.
HEPATITIS C
Clinical Criteria
Laboratory Criteria
Case Classification
3.19.
HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION AND ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)...
Clinical Criteria (AIDS)
Laboratory Criteria (HIV)
Case Classification
3.20.
INFLUENZA
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.21.
INFLUENZA A/H5N1
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.22.
LEGIONNAIRES' DISEASE
Clinical Criteria
Laboratory Criteria
Laboratory criteria for case confirmation
Laboratory criteria for a probable case
Case Classification
3.23.
LEPTOSPIROSIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.24.
LISTERIOSIS
Clinical Criteria
Listeriosis in pregnancy:
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.25.
LYME NEUROBORRELIOSIS
Clinical Criteria
Laboratory Criteria
A.
Confirmed case
B.
Probable case
Epidemiological Criteria
Case Classification
3.26.
MALARIA
Clinical Criteria
Laboratory Criteria
Case Classification
3.27.
MEASLES
Clinical Criteria
Laboratory Criteria
Epidemiological criteria
Case Classification
3.28.
MENINGOCOCCAL INFECTION, INVASIVE DISEASE
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.29.
MUMPS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.30.
PERTUSSIS
Clinical Criteria
Notes:
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.31.
PLAGUE
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.32.
STREPTOCOCCUS PNEUMONIAE INFECTION, INVASIVE DISEASE
Clinical Criteria
Laboratory Criteria
Case Classification
Antimicrobial resistance:
3.33.
ACUTE POLIOMYELITIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.34.
Q FEVER
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.35.
RABIES
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.36.
RUBELLA
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.37.
CONGENITAL RUBELLA SYNDROME
Clinical Criteria
Congenital rubella infection (CRI)
Congenital rubella syndrome (CRS)
Laboratory Criteria
Epidemiological Criteria
Case Classification Congenital Rubella
3.38.
SALMONELLA ENTERITIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
Antimicrobial resistance
3.39.
SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
Clinical Criteria
Laboratory Criteria
Laboratory criteria for case confirmation
Laboratory criteria for a probable case
Epidemiological Criteria
Case Classification for the inter-epidemic period
Case Classification during an outbreak
3.40.
SHIGA TOXIN/VEROCYTOTOXIN-PRODUCING E. COLI INFECTION (STEC/VTEC), INCLUDING HAEMOLYTIC-URAEMIC SYNDROME (HUS)...
Clinical Criteria
STEC/VTEC diarrhoea
HUS
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.41.
SHIGELLOSIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
Antimicrobial resistance
3.42.
SMALLPOX
Clinical Criteria
Laboratory Criteria
Laboratory criteria for case confirmation
Laboratory criteria for a probable case
Epidemiological Criteria
Case Classification
3.43.
SYPHILIS
Clinical Criteria
Primary syphilis
Secondary syphilis
Early latent syphilis (< 1 year)
Laboratory Criteria
Epidemiological Criteria
Primary/secondary syphilis
Early latent syphilis
Case Classification
3.44.
CONGENITAL SYPHILIS
Clinical Criteria
Laboratory Criteria
Laboratory criteria for case confirmation
Laboratory criteria for a probable case
Epidemiological Criteria
Case Classification
3.45.
TETANUS
Clinical Criteria
Case Classification
3.46.
TICK-BORNE VIRAL ENCEPHALITIS
Clinical Criteria
Laboratory Criteria
Laboratory criteria for case confirmation:
Laboratory criteria for a probable case:
Epidemiological Criteria
Case Classification
3.47.
CONGENITAL TOXOPLASMOSIS
Clinical Criteria
Laboratory Criteria
Case Classification
3.48.
TRICHINELLOSIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.49.
TUBERCULOSIS
Clinical Criteria
Laboratory Criteria
Laboratory criteria for case confirmation
Laboratory criteria for a probable case
Case Classification
Antimicrobial resistance
3.50.
TULARAEMIA
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.51.
TYPHOID AND PARATYPHOID FEVERS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.52.
VIRAL HAEMORRHAGIC FEVERS (VHF)
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.53.
WEST NILE VIRUS INFECTION (WNV)
Clinical Criteria
Laboratory Criteria
Laboratory test for case confirmation
Laboratory test for a probable case
Epidemiological Criteria
Case Classification
3.54.
YELLOW FEVER
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.55.
ENTERITIS DUE TO YERSINIA ENTEROCOLITICA OR YERSINIA PSEUDOTUBERCULOSIS
Clinical Criteria
Laboratory Criteria
Epidemiological Criteria
Case Classification
3.56.
ZIKA VIRUS DISEASE
Clinical Criteria
Laboratory Criteria
A.
Confirmed case
B.
Probable case
Epidemiological Criteria
Case Classification
3.57.
CONGENITAL ZIKA VIRUS DISEASE
Clinical Criteria
Laboratory Criteria
A.
Confirmed case
Epidemiological Criteria
Case Classification
4.
CASE DEFINITIONS OF SPECIAL HEALTH ISSUES
4.1.
GENERAL CASE DEFINITION OF NOSOCOMIAL INFECTION (OR ‘HEALTHCARE-ASSOCIATED INFECTION (HAI)’)...
4.1.1.
BJ: Bone and joint infection
BJ-BONE: Osteomyelitis
Note reporting instruction
BJ-JNT: Joint or bursa
BJ-DISC: Disc space infection
4.1.2.
BSI: Bloodstream infection
BSI: Laboratory-confirmed bloodstream infection
4.1.3.
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
4.1.4.
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
4.1.5.
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
4.1.6.
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
4.1.7.
GI: Gastrointestinal system infection
GI-CDI: Clostridium difficile infection
GI-GE: Gastroenteritis (excl. CDI)
GI-GIT: Gastrointestinal tract (esophagus, 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
4.1.8.
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
4.1.9.
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
Note reporting instructions
NEO-PNEU: Pneumonia
NEO-NEC: Necrotising enterocolitis
4.1.10.
PN: Pneumonia
Notes:
Intubation-associated pneumonia (IAP)
4.1.11.
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
4.1.12.
SSI: Surgical site infection
Superficial incisional (SSI-S)
Deep incisional (SSI-D)
Organ/Space (SSI-O)
4.1.13.
SST: Skin and soft tissue infection
SST-SKIN: Skin infection
Note reporting instructions
SST-ST: Soft tissue (necrotizing fascitis, infectious gangrene, necrotizing cellulitis, infectious...
Note reporting instructions
SST-DECU: Decubitus ulcer, including both superficial and deep infections
SST-BURN: Burn
SST-BRST: Breast abscess or mastitis
4.1.14.
SYS: Systemic infection
SYS-DI: Disseminated infection
Note reporting instructions
SYS-CSEP: treated unidentified severe infection
Note reporting instructions
4.1.15.
UTI: Urinary tract infection
UTI-A: microbiologically confirmed symptomatic UTI
UTI-B: not microbiologically confirmed symptomatic UTI
4.2.
GENERAL CASE DEFINITION OF BLOOD STREAM INFECTION DUE TO SPECIFIC...
Clinical criteria
Laboratory criteria
Epidemiological criteria
Case classification
Antimicrobial resistance
4.3.
GENERIC CASE DEFINITION AND CLASSIFICATION OF ANTIMICROBIAL REISTANCE TO ANTIMICROBIAL...
Clinical resistance to antimicrobial agents
Definition
Classification
Clinically Susceptible (S)
Clinically Intermediate (I)
Clinically Resistant (R)
Pandrug-resistant (PDR)
Microbiological resistance to antimicrobial agents
Phenotypic definition
Phenotypic classification
Wild-type (WT) phenotype
Non-wild-type (NWT) phenotype
Identification of an acquired antimicrobial resistance mechanism (for example, drug...
Genotypic definition
Genotypic classification
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)
THE EUROPEAN COMMISSION,
Having regard to the Treaty on the Functioning of the European Union,
Having regard to Decision No 1082/2013/EU of the European Parliament and of the Council of 22 October 2013 on serious cross-border threats to health and repealing Decision No 2119/98/EC , and in particular Article 6(5)(a) and (b) thereof,
Whereas:
(1)
Pursuant to Decision No 2119/98/EC of the European Parliament and of the Council , Commission Decision 2000/96/EC established a list of communicable diseases and special health issues to be covered by epidemiological surveillance in the Community network.
(2)
Commission Decision 2002/253/EC laid down case definitions for reporting communicable diseases listed in Decision 2000/96/EC to the Community network.
(3)
The Annex to Decision No 1082/2013/EU sets out the criteria for selecting the communicable diseases and related special health issues to be covered by epidemiological surveillance within the network.
(4)
The list of diseases and related special health issues established by Decision 2000/96/EC should be updated to reflect changes in disease incidence and prevalence, the needs of the European Union and its Member States, as well as to ensure compliance with the criteria provided in the Annex to Decision No 1082/2013/EU.
(5)
The list of case definitions should be updated in the light of new scientific information and evolving laboratory diagnostic criteria and practices.
(6)
Both the list of diseases and the list of case definitions are brought into line with the World Health Organisation nomenclature according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10).
(7)

The updated list of diseases should cover the following communicable diseases threatening public health that have emerged or re-emerged more recently in accordance with the criteria provided in the Annex to Decision No 1082/2013/EU for selection of communicable diseases and related special health issues to be covered by epidemiological surveillance:
- Chikungunya: In view of autochthonous outbreaks of chikungunya virus infections in Italy (2007) and France (2010 and 2014), the widespread presence of competent vectors (Aedes albopictus) in the Mediterranean basin, and the return of travellers from endemic areas, systematic surveillance is necessary to prevent the spread of chikungunya virus in the Union,
- Dengue: The large dengue outbreak in Madeira in 2012 and the presence of competent vectors (Aedes mosquitos), in particular in Mediterranean Member States, highlight the need for additional surveillance to help prevent the spread of the dengue virus in the Union,
- Zika: The infection of pregnant women with the Zika virus can lead to the birth of children with severe neurological defects. Early detection and surveillance of people returning from affected areas are crucial. Surveillance data is needed to inform public health measures to prevent the introduction and spread of the Zika virus to the Union,
- Lyme neuroborreliosis: The transmission of Lyme neuroborreliosis, a complication of Lyme disease which is caused by the bacterium Borrelia burgdorferi and transmitted to humans through the bite of infected ticks, is a concern for the Union. Systematic surveillance is needed to monitor its epidemiology in order to support measures to prevent and control the disease and its complications.
(8)
Pursuant to Article 9 of Regulation (EC) No 851/2004 of the European Parliament and of the Council , the European Centre for Disease Prevention and Control (‘ECDC’) has, at the Commission's request, provided scientific assistance on the establishment of case definitions for Chikungunya, Dengue, Lyme neuroborreliosis and Zika infections on the revision of case definitions for a number of other diseases , as well as on the revision of case definitions related to certain healthcare associated infections and to antimicrobial resistance . The case definitions should therefore be amended accordingly.
(9)
The measures provided for in this Decision are in accordance with the opinion of the Committee on serious cross-border threats to health established under Article 18 of Decision No 1082/2013/EU.
(10)
Accordingly, Decisions 2000/96/EC and 2002/253/EC should be replaced by this Decision,
HAS ADOPTED THIS DECISION:
OJ L 293, 5.11.2013, p. 1.
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 Community (OJ L 268, 3.10.1998, p. 1).
Commission Decision 2000/96/EC of 22 December 1999 on the communicable diseases to be progressively covered by the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (OJ L 28, 3.2.2000, p. 50).
Commission Decision 2002/253/EC of 19 March 2002 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 (OJ L 86, 3.4.2002, p. 44).
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 control (OJ L 142, 30.4.2004, p. 1).
Botulism, brucellosis, campylobacter enteritis, giardiasis, gonococcal infection, listeriosis, rubella, salmonella enteritis, shiga toxin/verocytotoxin-producing E. coli infection, shigellosis, syphilis and congenital syphilis, tetanus, tuberculosis, typhoid and paratyphoid fevers, pertussis, enteritis due to Yersinia enterocolitica or Yersinia pseudotuberculosis and healthcare-associated infections.
In general and, more specifically, campylobacter enteritis, gonococcal infection, salmonella enteritis, shigellosis, tuberculosis and bloodstream infections due to specific pathogens, in particular Staphylococcus aureus (susceptibility to meticillin and other anti-staphylococcal beta-lactams), Enterococcus faecium and Enterococcus faecalis (susceptibility to glycopeptides), Klebsiella pneumoniae and Escherichia coli (susceptibility to carbapenems and to colistin in carbapenem-resistant isolates), and Pseudomonas aeruginosa and Acinetobacter species (susceptibility to carbapenems).