2012 Nationally Notifiable Diseases and Conditions and Current Case Definitions Prepared by: The Division of Notifiable Diseases and Healthcare Information (proposed) Public Health Surveillance and Informatics Program Office (proposed) Office of Surveillance Epidemiology and Laboratory Services Centers for Disease Control and Prevention Case Definitions based upon CSTE Position Statements available at www.CSTE.org Suggested Citation 2012 Case Definitions: Nationally Notifiable Conditions Infectious and Non-Infectious Case. (2012). Atlanta, GA: Centers for Disease Control and Prevention Index Click on the condition below to link to the case definition. Nationally Notifiable Infectious Conditions Anthrax Arboviral neuroinvasive and non-neuroinvasive diseases California serogroup virus disease Eastern equine encephalitis virus disease Powassan virus disease St. Louis encephalitis virus disease West Nile virus disease Western equine encephalitis virus disease Babesiosis Botulism Botulism, foodborne Botulism, infant Botulism, other (wound & unspecified) Brucellosis Chancroid Chlamydia trachomatis infection Cholera Coccidioidomycosis Cryptosporidiosis Cyclosporiasis Dengue Dengue Fever Dengue Hemorrhagic Fever Dengue Shock Syndrome Diphtheria Ehrlichiosis/Anaplasmosis Ehrlichia chaffeensis Ehrlichia ewingii Anaplasma phagocytophilum Undetermined Giardiasis Gonorrhea Haemophilus influenzae, invasive disease Hansen disease (leprosy) Hantavirus pulmonary syndrome Hemolytic uremic syndrome, post-diarrheal Hepatitis Hepatitis A, acute Hepatitis B, acute Hepatitis B, chronic Hepatitis B virus, perinatal infection Hepatitis C, acute Hepatitis C, past or present HIV infection (AIDS has been reclassified as HIV stage III) HIV infection, adult/ adolescent (age > = 13 years) HIV infection, child (age >= 18 months and < 13 years) HIV infection, pediatric (age < 18 months) Influenza-associated pediatric mortality Legionellosis Listeriosis Lyme disease Malaria Measles Meningococcal disease Mumps Novel influenza A virus infections Pertussis Plague Poliomyelitis, paralytic Poliovirus infection, nonparalytic Psittacosis Q Fever Acute Chronic Rabies Rabies, animal Rabies, human Rubella (German Measles) Rubella, congenital syndrome Salmonellosis Severe Acute Respiratory Syndrome-associated Coronavirus (SARS-CoV) disease Shiga toxin-producing Escherichia coli (STEC) Shigellosis Smallpox Spotted Fever Rickettsiosis Streptococcal toxic-shock syndrome Streptococcus pneumoniae, invasive disease Syphilis Primary Secondary Latent Early latent Late latent Latent, unknown duration Neurosyphilis Late, non-neurological Stillbirth Congenital Tetanus Toxic-shock syndrome (other than Streptococcal) Trichinellosis (Trichinosis) Tuberculosis Tularemia Typhoid fever Vancomycin - intermediate Staphylococcus aureus (VISA) Vancomycin - resistant Staphylococcus aureus (VRSA) Varicella (morbidity) Varicella (deaths only) Vibriosis Viral Hemorrhagic Fevers, due to: Ebola virus Marburg virus Crimean-Congo Hemorrhagic Fever virus Lassa virus Lujo virus New world arenaviruses (Gunarito, Machupo, Junin, and Sabia viruses) Yellow fever Nationally Notifiable Non-Infectious Conditions Cancer Elevated blood lead levels Child (<16 years) Adult (≥16 Years) Foodborne disease outbreak Pesticide-related illness, acute Silicosis Waterborne disease outbreak Conditions Under National Surveillance CSTE has established standard reporting and case classification methods for “Conditions Under National Surveillance,” but these conditions are not considered “Nationally Notifiable.” Campylobacteriosis Influenza-associated hospitalizations Free-living Amebae, Infections caused by Melioidosis Nationally Notifiable Infectious Conditions Anthrax (Bacillus anthracis) 2010 Case Definition CSTE Position Statement Number: 09-ID-10 Clinical Description Cutaneous Anthrax: An acute illness, or post-mortem examination revealing a painless skin lesion developing over 2 to 6 days from a papular through a vesicular stage into a depressed black eschar with surrounding edema. Fever, malaise and lymphadenopathy may accompany the lesion. Inhalation Anthrax: An acute illness, or post-mortem examination revealing a prodrome resembling a viral respiratory illness, followed by hypoxia, dyspnea or acute respiratory distress with resulting cyanosis and shock. Radiological evidence of mediastinal widening or pleural effusion is common. Gastrointestinal Anthrax: An acute illness, or post-mortem examination revealing severe abdominal pain and tenderness, nausea, vomiting, hematemesis, bloody diarrhea, anorexia, fever, abdominal swelling and septicemia. Oropharyngeal Anthrax: An acute illness, or post-mortem examination revealing a painless mucosal lesion in the oral cavity or oropharynx, with cervical adenopathy, edema, pharyngitis, fever, and possibly septicemia. Meningeal Anthrax: An acute illness, or post-mortem examination revealing fever, convulsions, coma, or meningeal signs. Signs of another form will likely be evident as this syndrome is usually secondary to the above syndromes. Case Classification Suspected An illness suggestive of one of the known anthrax clinical forms. No definitive, presumptive, or suggestive laboratory evidence of B. anthracis, or epidemiologic evidence relating it to anthrax. Probable A clinically compatible illness that does not meet the confirmed case definition, but with one of the following: Epidemiological link to a documented anthrax environmental exposure; Evidence of B. anthracis DNA (for example, by LRN-validated polymerase chain reaction) in clinical specimens collected from a normally sterile site (such as blood or cerebrospinal fluid [CSF]) or lesion of other affected tissue (skin, pulmonary, reticuloendothelial, or gastrointestinal); Positive result on testing of clinical serum specimens using the Quick ELISA Anthrax-PA kit; Detection of Lethal Factor (LF) in clinical serum specimens by LF mass spectrometry Positive result on testing of culture from clinical specimens with the RedLine Alert test. Confirmed A clinically compatible illness with one of the following: Culture and identification of B. anthracis from clinical specimens by the Laboratory Response Network (LRN); Demonstration of B. anthracis antigens in tissues by immunohistochemical staining using both B. anthracis cell wall and capsule monoclonal antibodies; Evidence of a four-fold rise in antibodies to protective antigen between acute and convalescent sera or a fourfold change in antibodies to protective antigen in paired convalescent sera using Centers for Disease Control and Prevention (CDC) quantitative anti- PA IgG ELISA testing; Documented anthrax environmental exposure AND evidence of B. anthracis DNA (for example, by LRN-validated polymerase chain reaction) in clinical specimens collected from a normally sterile site (such as blood or CSF) or lesion of other affected tissue (skin, pulmonary, reticuloendothelial, or gastrointestinal). Arboviral neuroinvasive and non- neuroinvasive diseases 2011 Case Definition CSTE Position Statement Numbers: 10-ID-18, 10-ID-20, 10-ID-21, 10-ID-22, 10-ID-23, 10-ID-24 Subtypes California Serogroup Viruses, (i.e., California encephalitis, Jamestown Canyon, Keystone, La Crosse, Snowshoe hare, and Trivittatus viruses) Eastern Equine Encephalitis Virus Powassan Virus St. Louis Encephalitis Virus West Nile Virus Western Equine Encephalitis Virus Background Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes, ticks, sand flies, or midges. Other modes of transmission for some arboviruses include blood transfusion, organ transplantation, perinatal transmission, consumption of unpasteurized dairy products, breast feeding, and laboratory exposures. More than 130 arboviruses are known to cause human disease. Most arboviruses of public health importance belong to one of three virus genera: Flavivirus, Alphavirus, and Bunyavirus. Clinical Description Most arboviral infections are asymptomatic. Clinical disease ranges from mild febrile illness to severe encephalitis. For the purposes of surveillance and reporting, based on their clinical presentation, arboviral disease cases are often categorized into two primary groups: neuroinvasive disease and non-neuroinvasive disease. Neuroinvasive disease Many arboviruses cause neuroinvasive disease such as aseptic meningitis, encephalitis, or acute flaccid paralysis (AFP). These illnesses are usually characterized by the acute onset of fever with stiff neck, altered mental status, seizures, limb weakness, cerebrospinal fluid (CSF) pleocytosis, or abnormal neuroimaging. AFP may result from anterior ("polio") myelitis, peripheral neuritis, or post- infectious peripheral demyelinating neuropathy (i.e., Guillain-Barré syndrome). Less common neurological manifestations, such as cranial nerve palsies, also occur. Non-neuroinvasive disease Most arboviruses are capable of causing an acute systemic febrile illness (e.g., West Nile fever) that may include headache, myalgias, arthralgias, rash, or gastrointestinal symptoms. Rarely, myocarditis, pancreatitis, hepatitis, or ocular manifestations such as chorioretinitis and iridocyclitis can occur. Clinical criteria for diagnosis Arboviral Diseases, Neuroinvasive and Non-Neuroinvasive A clinically compatible case of arboviral disease is defined as follows: Neuroinvasive disease Fever (≥100.4°F or 38°C) as reported by the patient or a health-care provider, AND Meningitis, encephalitis, acute flaccid paralysis, or other acute signs of central or peripheral