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					                                                                                                                                                                                                                                                         PAPER NSG 15
Health Protection Scotland                                                                                                                                                                                          Date - 13 November 2008
Sheet 1 - Notifiable Diseases and Case Definitions
Diseases                    Case Definition                                                                                                                Definition source                                        Organism (disease corresponds        Notes
                                                                                                                                                                                                                    to)
Anthrax                     Clinical description                                                                                                           As per EU Case Definition (Anthrax)                      Bacillus anthracis
                            Inhalational anthrax
                            After inhalation of Bacillus anthracis and a brief prodrome acute febrile respiratory failure develops with hypoxia, dyspnoa
Botulism                    Clinical description                                                                                                           As per EU Case Definition (Botulism, Foodborne)          Clostridium botulinum
                            Clinical picture compatible with botulism, e.g. symptoms such as diplopia, blurred vision and bulbar weakness. Symmetric
                            paralysis may progress rapidly.
Brucellosis                 Clinical description                                                                                                           As per EU Case Definition (Brucellosis)                  Brucella genus
                            Clinical picture compatible with brucellosis, e.g. acute or insidious onset of fever, night sweats, undue fatigue, anorexia,
                            weight loss, headache and arthralgia.
Cholera                     Clinical description                                                                                                           As per EU Case Definition (Cholera)                      Vibrio cholerae
                            Clinical picture compatible with cholera, e.g. watery diarrhoea and/or vomiting. Severity is variable.
                                                                                                                                                                                                                                                         There is no clinical description that could
Clinical syndrome due Awaited
                                                                                                                                                                                                                                                         not also descibe symptoms caused by other
to E.coli O157 infection
                                                                                                                                                                                                                                                         organisms - Leave Case Definition blank
Diphtheria              Clinical description                                                                                                               As per EU Case Definition (Diphtheria)                   Corynebacterium diphtheriae
                        Clinical picture compatible with diphtheria, e.g. an upper-respiratory tract illness characterised by sore throat, low-grade                                                                (toxigenic strains)
                        fever, and an adherent membrane of the tonsil(s), pharynx, and/or nose.
Haemolytic Uraemic      Clinical description                                                                                                               HPS clinical description                                 Escherichia coli O 157
Syndrome (HUS)          Clinical picture compatible with HUS i.e. any person with
                        Microangiopathic haemolytic anaemia (low or falling haemoglobin/fragmented red cells)
                                                                                                                                                                                                                                                         Kevin Pollock reviewed 9/1/09
                        AND
Haemophilus             Clinical description                                                                                                               As per EU Case Definition (Haemophilus Influenzae Type   Haemophilus influenzae type b
influenzae type b (Hib) Clinical picture compatible with invasive disease, e.g. bacteremia, meningitis, arthritis, epiglottitis, osteomyelitis or          B, Invasive)                                             (from blood, CSF or other normally
                        cellulitis.
                                                                                                                                                                                                                    sterile site)
Measles               Clinical description                                                                                                                 As per EU Case Definition (Measles)                      Measles virus
                      Clinical picture compatible with measles, i.e. a generalised rash lasting >3 days and a temperature >38,0° C and one or
                      more of the following: cough, coryza, Koplik's spots, conjunctivitis.
Meningococcal disease Clinical description                                                                                                                 As per EU Case Definition (Meningococcal Disease)        Neisseria meningitidis
                      Clinical picture compatible with meningococcal disease, e.g. meningitis and/or meningococcemia that may progress
                      rapidly to purpura fulminans, shock and death. Other manifestations are possible.
Mumps                 Clinical description                                                                                                                 As per EU Case Definition (Mumps)                        Mumps virus
                      Clinical picture compatible with mumps, e.g. acute onset of uni- or bilateral tender, self-limited swelling of the parotid or
                      other salivary gland, lasting >2 days, and without other apparent cause.
Necrotizing fasciitis Clinical description                                                                                                                 HPS clinical description                                 Streptococcus pyogenes
                      Clinical picture compatible with Necrotizing fasciitis i.e. any person with
                      fever, extreme pain, inflammation of subcutaneous (superficial or deep) tissue, and often
                      associated diarrhoea and vomiting and probably with a history of trauma.                                                                                                                                                           Anne Eastaway supplied 25/3/09
Paratyphoid           Clinical description                                                                                                                 As per EU Case Definition (Typhoid/Paratyphoid Fever)    Salmonella Paratyphi
                      An illness caused by Salmonella paratyphii that is often characterised by insidious onset of sustained fever,
                      headache, malaise, anorexia, relative bradycardia, constipation or diarrhoea and nonproductive cough. However, many
Pertussis             Clinical description                                                                                                                 As per EU Case Definition (Pertussis, Whooping cough)    Bordetella pertussis
                      Clinical picture compatible with pertussis, e.g. a cough illness lasting at least 2 weeks with one of the following:
                      paroxysms of coughing, inspiratory ‘whoop’ or post-tussive vomiting without other apparent cause.
Plague                Clinical description                                                                                                                 As per EU Case Definition (Plague)                       Yersinia pestis
                      The disease is characterized by fever, chills, headache, malaise, prostration and leukocytosis that manifests in one or more
                      of the following principal clinical forms:
Poliomyelitis         Clinical description                                                                                                                 As per EU Case Definition (Poliomyelitis)                See also Polio virus
                      Clinical picture compatible with poliomyelitis, e.g. acute onset of a flaccid paralysis of one or more limbs with decreased
                      or absent tendon reflexes in the affected limbs, without other apparent cause and without sensory or cognitive loss.
Rabies                Clinical description                                                                                                                 As per EU Case Definition (Rabies, Human)                Rabies virus
                      Rabies is an acute encephalomyelitis that almost always progresses to coma or death within 10 days after the first
                      symptom.
Rubella               Clinical description                                                                                                                 As per EU Case Definition (Rubella)                      Rubella virus
                      Clinical picture compatible with rubella, e.g. acute onset of generalized maculopapular rash and arthralgia/arthritis,
                      lymphadenopathy, or conjunctivitis.
Severe Acute          Clinical description                                                                                                                 As per EU Case Definition (SARS)                         SARS-associated coronavirus
Respiratory Syndrome Clinical picture compatible with SARS, i.e. fever
                      AND
(SARS)
                      at least one of the following three:                                                                                                                                                                                               Jim McMenamin reviewed 9/1/09
Smallpox              cough, difficulty with breathing, shortness of breath
                      Clinical description                                                                                                                 As per EU Case Definition (Smallpox)                     Variola virus
                      Clinical picture compatible with Smallpox i.e. fever
                      AND                                                                                                                                                                                                                                Jim McMenamin reviewed 9/1/09
Tetanus               Vesicles or firm pustules rash at the same stage of development with a centrifugal distribution
                      Clinical description                                                                                                                 As per EU Case Definition (Tetanus)                      Clostridium tetani
                            Clinical picture compatible with tetanus, e.g. acute onset of hypertonia and/or painful muscular contractions (usually of
                            the muscles of the jaw and neck)and generalised muscle spasms without other apparent medical cause.
Tuberculosis                Clinical description                                                                                                           As per EU Case Definition (Tuberculosis)                 Mycobacterium tuberculosis
(respiratory or non-        A clinician's judgement that clinical and/or radiological signs and/or symptoms are compatible with tuberculosis                                                                        complex
respiratory)                and a clinician's decision to treat the patient with a full course of anti-tuberculosis therapy.
Tularaemia                  Clinical description                                                                                                           As per EU Case Definition (Tularaemia)                   Francisella tularensis               Linda Browning reviewed 20/01/09
                            Clinical picture compatible with Tularaemia -
                            Any person with at least one of the following forms
Typhoid                     Clinical description                                                                                                           As per EU Case Definition (Typhoid/Paratyphoid Fever)    Salmonella Typhi
                            An illness caused by Salmonella typhi that is often characterised by insidious onset of sustained fever,
                            headache, malaise, anorexia, relative bradycardia, constipation or diarrhoea and nonproductive cough. However, many
Viral haemorrhagic          Ebola/Marburg fever                                                                                                            As per EU Case Definition (Viral Haemorrhagic fevers)    Crimean-Congo haemorrhagic fever
fevers                      Clinical description                                                                                                                                                                    virus, Ebola virus, Lassa virus,
                            Begins with acute fever, diarrhoea that can be bloody and vomiting. Headache, nausea, and abdominal pain are common.
                                                                                                                                                                                                                    Marburg virus
                            Haemorrhagic manifestations may follow. Some patients may also show a maculopapular rash on the trunk.
West Nile fever             Clinical description                                                                                                           As per EU Case Definition (West Nile Fever)              West Nile virus                  Linda Browning reviewed 20/01/09
                            A clinician's judgement that clinical symptoms are compatible with West Nile Fever

Yellow Fever                Any person with Fever over 38C
                            Clinical description                                                                                                           As per EU Case Definition (Yellow Fever)                 Yellow fever virus
                            An illness characterised by acute onset and constitutional symptoms followed by a brief remission, a recurrence of fever,
                            hepatitis, albuminuria, and in some instances, renal failure, shock and generalised hæmorrhages.
                            yellow highlight = updated from previous version
                            red text = notes added
Health Protection Scotland                                                                                                                                           Date - 13 November 2008

Sheet 2 - Notifiable Organisms and Case Definitions
Organism                                         Case Definition                                                    Definition source                                Disease (organism corresponds to)      Notes

                                                 Clinical description                                               EU Case Definition (Anthrax)                     Anthrax
                                                 Inhalational anthrax
Bacillus anthracis                               After inhalation of Bacillus
                                                 Clinical description anthracis and a brief prodrome                                                                                                                                             Key
                                                 Clinical picture compatible with B. cereus food    FDA/CFSAN Bad Bug Book                         Fried Rice Syndrome????
Bacillus cereus                                  poisoning. The onset of watery diarrhea, abdominal                                                                                                         Needs reviewed by John Cowden        Red text - To be confirmed
                                                 Clinical description                               EU Case Definition (Pertussis, Whooping cough) Pertussis
Bordetella pertussis                             Clinical picture compatible with pertussis, e.g. a cough illness                                                                                                                                Blue text - HPS definition
                                                 Clinical description                                Defra Zoonoses Report                                           Lyme Disease
Borrelia burgdorferi                             Clinical picture compatible with Lyme Disease, e.g.                                                                                                        Needs reviewed by John Cowden
                                                 flu like description
                                                 Clinical symptoms with tiredness,                   EU Case Definition (Brucellosis)                                Brucellosis
                                                 Clinical picture compatible with brucellosis, e.g. acute or
Brucella genus                                   insidious onset of fever, night sweats, undue fatigue,
                                                 Clinical description                                  EU Case Definition (Campylobacter Infection)                  Gastroenteritis
Campylobacter genus                              Clinical picture compatible with campylobacteriosis,
                                                 Clinical description                                  EU Case Definition                                            Chlamydia                              Needs reviewed Jim McM
Chlamydia psittaci                               Clinical picture compatible with chlamydial infection
                                                 Clinical description least one of the following six:
                                                 Any person with at                                    EU Case Definition                                            Botulism
Clostridium botulinum                            Clinical picture compatible with botulism, e.g. symptoms such
                                                 as diplopia, blurred vision and bulbar weakness. Symmetric
                                                 Clinical description                                               HPS Definition - CDAD case definition from the CDAD
                                                 A case of CDAD is someone in whose stool C.                        Scottish surveillance protocol. Its content is in
Clostridium difficile                            difficile toxin has been identified at the same time               line with European and other international
                                                 Clinical description                                               FDA/CFSAN Bad Bug Book                            Perfringens food poisoning
Clostridium perfringens                          Clinical picture compatible with Clostridium                                                                                                               Needs reviewed by John Cowden
                                                 perfringerens food poisoning. The onset of watery
                                                 Clinical description                                               EU Case Definition (Tetanus)                     Tetanus
                                                 Clinical picture compatible with tetanus, e.g. acute onset of
Closridium tetani                                hypertonia and/or painful muscular contractions (usually of
                                               Clinical description                                  EU Case Definition (Diphtheria)                Diphtheria
Corynebacterium diphtheriae (toxigenic strains)Clinical picture compatible with diphtheria, e.g. an
                                               upper-respiratory tract illness characterised by sore EU Case Definition (Diphtheria)
                                               Clinical description                                                                                                                                         Katy Sinka - EU case definition is
Corynebacterium ulcerans                       Clinical picture compatible with diphtheria, e.g. an                                                                                                         shared with diphtheriae above
                                               Clinical description illness characterised by sore
                                               upper-respiratory tract
                                               Clinical picture compatible with Q Fever i.e.         EU Case Definition (Q Fever)                   Q Fever
Coxiella burnetii                              At least one of the following three:                                                                                                                         Needs reviewed by John Cowden
                                               Clinical description                                  EU Case Definition (Viral Haemorrhagic Fevers) Crimean-Congo Haemorrhagic Fever
                                                 An illness of gradual onset with acute high fever, chills,
Crimean-Congo haemorrhagic fever virus           myaliga, nausea, anorexia, vomitting, headache and
                                                 Clinical description                                     EU Case Definition (Cryptosporidiosis)      Cryptosporidiosis
Cryptosporidium                                  Clinical picture compatible with cryptosporidiosis,
                                                 characterised by diarrhoea, abdominal cramps, loss WHO Case Definition
                                                 Clinical description                                                                                 Dengue Fever
Dengue virus                                     Given the variability in the clinical illness associated                                                                                                   Needs reviewed by Chris Redman
                                                 with dengue infection, it is not appropriate to adopt EU Case Definition (Viral Haemorrhagic Fevers) Ebola Fever
                                                 Clinical description
                                                 Begins with acute fever, diarrhoea that can be bloody and
Ebola virus                                      vomiting. Headache, nausea, and abdominal pain are
                                                 Clinical description                                               EU Case Definition (Echinococcus)                Echinococcosis
Echinococcus genus                               Clinical picture compatible with echinococcosis,
                                                 Clinical description any of several clinical
                                                 which may produce                                                                                                   VTEC diarrhorea                                                             EU Case Definition for entero-
                                                 Clinical picture compatible with VTEC
                                                 Any person with at least one of the following two:
                                                                                                                    EU Case Definition (VERO toxin producing E                                                                                   haemorrhagic Escherichia coli, this
Verocytotoxin-producing E.coli (VTEC)            - Diarrhoea                                                        coli (VTEC)                                                                             Needs reviewed by Mary Locking       may not apply to this disease.
                                             Clinical description                                                   EU Case Definition (Tularaemia)                  Tularaemia
                                             Clinical picture compatible with Tularaemia i.e.
Francisella tularensis                                                                                                                                                                                      Needs reviewed by John Cowden
                                             At least one of the following clinical forms:
                                             Clinical description                                                   EU Case Definition (Giardiasis)                  Giardiasis
Giardia lamblia                              Clinical picture compatible with infection with
                                             Giardia lamblia, characterised by diarrhoea,
                                             Clinical description                                                   EU Case Definition (Viral Haemorrhagic Fevers) Venezuelan Haemorrhagic Fever
Guanarito virus                              Any person with at least one of the following two:                                                                                                             Needs Reviewed by Chris Redman
                                             - Fever description
                                             Clinical                                                               EU Case Definition (Haemophilus influenzae     Haemophilus influenzae type b (Hib)
Haemophilus influenzae type b (from blood, CSF or other normally sterile site) invasive disease,
                                             Clinical picture compatible with                                       Type B, Invasive)
                                             e.g. bacteremia, meningitis, arthritis, epiglottitis,
                                             Clinical description                                                   EU Case Definition (Viral Haemorrhagic Fevers) Haemorrhagic Fever with Renal Syndrome
Hantavirus                                   Any person with at least one of the following two:                                                                    (HFRS)                                   Needs Reviewed by Chris Redman
                                             - Fever description
                                             Clinical                                                               EU Case Definition (Hepatitis, Viral)          Hepatitis
Hepatitis A virus                            In symptomatic cases clinical picture compatible
                                             Clinical description                                                   EU Case Definition (Hepatitis, Viral)            Hepatitis
Hepatitis B virus                            In symptomatic cases clinical picture compatible
                                             with hepatitis, e.g. discrete onset of symptoms and
                                             Clinical description                                                   EU Case Definition (Hepatitis, Viral)            Hepatitis
Hepatitis C virus                            In symptomatic cases clinical picture compatible
                                             with hepatitis, e.g. discrete onset of symptoms and
                                             Clinical description                                                   EU Case Definition (Hepatitis, Viral)            Hepatitis
Hepatitis E virus                            In symptomatic cases clinical picture compatible                                                                                                               Needs Reviewed by Lesley Wallace
                                             with hepatitis, e.g. discrete onset of symptoms and
                                             Clinical description                                                   EU Case Definition (Influenza)                   Influenza
                                                   Clinical picture compatible with influenza, e.g.
Influenza virus (all types, including all sub-types)
Junín virus                                        sudden onset of disease, cough, fever > 38° C,
                                                   Clinical description                                             EU Case Definition (Viral Haemorrhagic Fevers) Argentine Haemorrhagic Fever (AHF)
                                                   Any person with at least one of the following two:                                                                                                       Needs Reviewed by Chris Redman
Kyasanur Forest disease virus                      - Fever description
                                                   Clinical                                                         EU Case Definition (Viral Haemorrhagic Fevers) Kyasanur Forest Disease
                                                 Any person with at least one of the following two:                                                                                                         Needs Reviewed by Chris Redman
Lassa virus                                      - Fever
                                                 Clinical description                                               EU Case Definition (Viral Haemorrhagic Fevers) Lassa Fever
                                                 An illness of gradual onset with malaise, fever, headache,
                                                 sore throat, cough, nausea, vomiting, diarrhoea, myalgia and
Legionella genus                                 Clinical description                                               EU Case Definition (Legionellosis)               Legionnaires disease
                                                 Pneumonia
                                                 Pontiac fever
Leptospira genus                                Clinical description                                              EU Case Definition (Leptospirosis)              Leptospirosis
                                                Clinical picture compatible with leptospirosis,
Listeria monocytogenes                          characterised by fever, headache, chills, myalgia,
                                                Clinical description                                              EU Case Definition              Listeriosis
                                                Infection caused by Listeria monocytogenes, which
Machupo virus                                   may produce any of
                                                Clinical descriptionseveral clinical syndromes,    EU Case Definition (Viral Haemorrhagic Fevers) Bolivian Haemorrhagic Fever (BHF)
                                                Any person with at least one of the following two:                                                                                                                Needs Reviewed by Chris Redman
Marburg virus                                   - Fever
                                                Clinical description                               EU Case Definition (Viral Haemorrhagic Fevers) Marburg Fever
                                                Begins with acute fever, diarrhoea that can be bloody and
                                                vomiting. Headache, nausea, and abdominal pain are
Measles virus                                   Clinical description                                     EU Case Definition (Measles)                             Measles
                                                Clinical picture compatible with measles, i.e. a
Mumps virus                                     generalised rash lasting >3 days and a temperature EU Case Definition (Mumps)
                                                Clinical description                                                                                              Mumps
                                                Clinical picture compatible with mumps, e.g. acute
Mycobacterium bovis                             onset of uni- or
                                                Clinical criteriabilateral tender, self-limited swelling EU Case Definition (Tuberculosis) and                    Tuberculosis
                                                — A clinician's judgement that clinical and/or                    Zoonoses Report                                                                                 Needs reviewed by John Cowden
Mycobacterium tuberculosis complex              radiological signs
                                                Clinical criteria and/or symptoms are compatible                  EU Case Definition (Tuberculosis)               Tuberculosis (respiratory or non-respiratory)
                                                — A clinician's judgement that clinical and/or
                                                radiological signs and/or symptoms are compatible
Neisseria meningitidis                          Clinical description                                              EU Case Definition (Meningococcal Disease)      Meningococcal disease
                                                Clinical picture compatible with meningococcal
Norovirus                                       disease, e.g. meningitis and/or meningococcemia
                                                Clinical description                                              Health Protection Agency                        Norovirus enteritis
                                                Clinical picture compatible with Norovirus                                                                                                                        Needs reviewed by John Cowden
Omsk haemorrhagic fever virus                   gastroenteritis i.e
                                                Clinical description                                              EU Case Definition (Viral Haemorrhagic Fevers) Omsk Haemorrhagic Fever
                                                Any person with at least one of the following two:                                                                                                                Needs Reviewed by Chris Redman
Plasmodium falciparum, vivax, ovale and         - Fever description
                                                Clinical                                             EU Case Definition (Malaria)                                 Malaria
malariae                                        Clinical picture compatible with malaria, e.g. fever
Polio virus                                     and common associated symptoms, which includes EU Case Definition (Poliomyelitis, Paralytic)
                                                Clinical description                                                                                              Poliomyelitis
                                                Clinical picture compatible with poliomyelitis, e.g.
Rabies virus                                    acute onset of a flaccid paralysis of one or more
                                                Clinical description                                 EU Case Definition (Rabies, Human)                           Rabies
                                                Rabies is an acute encephalomyelitis that almost always
                                                progresses to coma or death within 10 days after the first
Rickettsia prowazekii                           Clinical description                                                                                Epidemic Typhus                                               Source is WIKI - must be reviewed
                                                Clinical picture compatible with epidemic typhus i.e                                                                                                              and more acceptable source found
Rift Valley fever virus                         Severe headache, a sustained high fever, cough,
                                                Clinical description                                 EU Case Definition (Viral Haemorrhagic Fevers) Rift Valley Fever
                                                Any person with at least one of the following two:                                                                                                                Needs Reviewed by Chris Redman
Rubella virus                                   - Fever description
                                                Clinical                                             EU Case Definition (Rubella)                   Rubella
                                                Clinical picture compatible with rubella, e.g. acute onset of
                                                generalized maculopapular rash and arthralgia/arthritis,
Sabia virus                                     Clinical description                                              EU Case Definition (Viral Haemorrhagic Fevers) Brazilian Haemorrhagic Fever
                                                Any person with at least one of the following two:                                                                                                                Needs Reviewed by Chris Redman
Salmonella (all human types)                    - Fever
                                                Clinical description                                              EU Case Definition (Salmonellosis, Non-Typhi,
                                                Clinical picture compatible with salmonellosis, e.g.              Non-Paratyphi)
SARS-associated coronavirus                     diarrhoea, abdominal
                                                Clinical description pain, nausea and sometimes                   EU Case Definition (SARS)                       Severe Acute Respiratory Syndrome
                                                Clinical picture compatible with SARS, i.e. fever                                                                 (SARS)                                          Needs reviewed by JmcM
Shigella genus                                  AND
                                                Clinical description                                              EU Case Definition (Shigellosis)                Shigellosis
                                                An illness of variable severity characterised by
Enterotoxigenic Staphylococcus aureus           diarrhoea, fever, nausea, cramps, and tenesmus.
                                                Clinical description                                              FDA/CFSAN Bad Bug Book                          Staphylococcal food poisoning
                                                Clinical picture compatible with Staphylococcus                                                                                                                   Being reviewed by Oliver Blatchford
Staphylococcus aureus (all blood isolates)      food poisoning. i.e
                                                                                                                                                                                                                  Being reviewed by Oliver Blatchford
Methicillin-resistant Staphylococcus aureus
(MRSA)                                                                                                                                                                                                            Being reviewed by Oliver Blatchford
Streptococcus pyogenes (from blood,             Clinical description                                                                                              Necrotizing fasciitis
cerebrospinal fluid or other normally sterile   Clinical picture compatible with Necrotizing fasciitis i.e. any
                                                person with,
                                                                                                                                                                                                                  Needs reviewed by Anne Eastaway
site)
Streptococcus pneumoniae (from blood,           Clinical description                                              EU Case Definition (Streptococcus
cerebrospinal fluid or other normally sterile   Steptococcus pneumoniae causes many clinical                      pneumoniae, Invasive Disease)
site)
Toxoplasma gondii                               syndromes, depending on the site of infection (e.g.
                                                Clinical description                                              EU Case Definition (Toxoplasmosis)              Toxoplasmosis
                                                A protozoan disease, which presents with an acute
Trichinella genus                               illness with one or more of the following:
                                                Clinical description                                              EU Case Definition (Trichinosis)                Trichinosis
                                                A disease caused by ingestion of Trichinella larvae.
Varicella-zoster virus                          The disease has variable clinical manifestations.
                                                Clinical description                                 Health Protection Agency                                     Chickenpox
                                                Clinical picture compatible with Chickenpox i.e                                                                                                                   Needs reviewed by JmcM
Variola virus                                               beginning with
                                                - Initially description cold like symptoms followed EU Case Definition (Smallpox)
                                                Clinical                                                                                                          Smallpox
                                                Clinical picture compatible with Smallpox i.e. fever                                                                                                              Needs reviewed by JmcM
Vibrio cholerae                                 AND
                                                Clinical description                                  EU Case Definition (Cholera)                                Cholera
                                                Clinical picture compatible with cholera, e.g. watery
West Nile fever virus                           diarrhoea and/or vomiting. Severity is variable.
                                                Clinical description                                  EU Case Definition (West Nile Fever)                        West Nile Fever
                                                Clinical picture compatible with West Nile Fever i.e.                                                                                                             Needs reviewed by John Cowden
Yellow Fever virus                              Any person with fever
                                                Clinical description                                  EU Case Definition (Yellow Fever)                           Yellow Fever
                                                An illness characterised by acute onset and
Yersinia enterocolitica                         constitutional symptoms followed by a brief
                                                Clinical description                                  EU Case Definition (Yersinia)                               Yersiniosis
                                                Clinical picture compatible with Yersiniosis i.e.                                                                                                                 Needs reviewed by John Cowden
Yersinia pestis                                 Any person with at least one of the following five:
                                                Clinical description                                              EU Case Definition (Plague)                     Bubonic Plague
                                                The disease is characterized by fever, chills, headache,
                                                malaise, prostration and leukocytosis that manifests in one or
Yersinia pseudotuberculosis                     Clinical description                                              EU Case Definition (Yersinia)                   Yersiniosis
                                                Clinical picture compatible with Yersiniosis i.e.                                                                                                                 Needs reviewed by John Cowden
                                                Any person with at least one of the following five:

				
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