Question

1. Write two case definitions for each of the following diseases. Be VERY specific. Cite your sources. Which definition do you think will identify more cases and why?

Influenza

i.Case definition #1:

ii.Source for #1

iii.Case definition #2:

iv.Source for #2:

v.Which definition do you think will identify more cases and why?

Measles

i.Case definition #1:

ii.Source for #1

iii.Case definition #2:

iv.Source for #2:

v.Which definition do you think will identify more cases and why?

Chikungunya

i.Case definition #1:

ii.Source for #1

iii.Case definition #2:

iv.Source for #2:

v.Which definition do you think will identify more cases and why?

MERS

i.Case definition #1:

ii.Source for #1

iii.Case definition #2:

iv.Source for #2:

v.Which definition do you think will identify more cases and why?

Your chosen infectious disease for BIOL 436W students (536 students do Rocky Mountain Spotted Fever)

i.Case definition #1:

ii.Source for #1

iii.Case definition #2:

iv.Source for #2:

v.Which definition do you think will identify more cases and why?

Answer 1

1.

Influenza:

i)An acute respiratory infection with:

• measured fever of 38C^o  
• and cough
• with onset within the last 10 days

ii .World Health Organization,WHO survellance case definitions for ILI and SARI,January 2014

III.An acute respiratory infection:

• Atleast one among the following:fever,feverishness,headache,malaise,myalgia
• with sudden onset

iv.Jean-SebastianCasalengo,Daniel Eibach,"Performance of influenza case definitions for influenza community surveillance "(ECDC)2009-2014

v.I think the WHO case definition for influenza will identify more cases beacause they are specifying the onset with degree of fever and the symptom of influenza.

Measles

i.Any person with fever and maculopapular rash (ie.non-vesicular) and cough,coryza(ie,runny nose) or conjunctivitis

ii.World Health Organization,WHO-recommended surveillance standards of measles,2018

iii.An acute illness characterized by:

• Gneralized,maculopapular rash lasting3days
• Temperature 101⁰F or 38.3⁰C;and
• Cough,coryza,or conjunctivitis

iv.Centers for Disease Control and Prevention,"National Notifiable Diseases Surveillance System(NNDSS),Measles/Rubeola case definition,2013

v.in my view the case definition of CDC will identify more cases because,here they are specifying all the signs and symptoms of the diseasease for the duration of the main symptom that is maculopapular rash

Chickungunya

i.

Criteria for diagnosis:

1.Clinical criteria:

• acute onset of fever 38.5⁰C and severe
• Arthralgia/arthritis not explained by other medical conditions

2.Epidemological criteria:

• residing or having visited epidemic areas,having reported transmission within 15 days prior to the onset of symptoms

3.Laboratory criteria:

at least oneof the following tests in the acute phase;

• virus isolation
• Presence of viral RNA by RT-PCR
• Presence of virus specific IgM antibodies in the single serum sample collected in acute or convalescent stage
• Four-fold rising of IgG titres in samples collected atleast 3 weeks apart

Case definition for Surveillance:

Possible case:a patient meeting clinical criteria

Probable Case:a patient meeting both the clinical and epidemiological criteria

Confirmed case:a patient meeting the laboratory criteria,irrespective of the clinical presentation

ii.WHO,SEARO,"Proposed case definition of Chickungunya Fever"

iii)

• Acute onseet of fever 38.5⁰C and severe /incapacitating
• Arthalgia not explainedbyother medical conditions

vi.ECDC,"Informationfor health practitioners CHICKUNGUNYA VIRUS

vi. in my View the WHO and SEARO definition will easy understood and identify more cases in simple way,why because they are specifying each and every criteria for the disease

MERS

i.

• A person with a febrile acute respiratory illness with clinical radiological,histopathological evidence of parenchymal disease(eg.Pneumonia/ARDS
• Testing for MERS-CoV(Middlle East respiratory syndrome coronavirus) is unavailable or negative on a single inadequate specimen
• The patient has a direct epidemiologic-linkwith a confirmed MERS-CoV Case

ii.WHO,"Revised interim case definition for reporting to WHO-MERS-CoV,july 2013

iii.A confirmed case is a person with laboratory confirmation of MERS-CoV infection.Cofirmatory laboratory testing requires a positive PCR on atleast two specific genomic targets or a single positive target with sequencing on a second.

iv.CDC,"Interim Patient Under Investigation Giudance and case Definitions",Sep 2017

v.I think the most absolute case definition for MERS is fromWHO,They are specifying the syndromes of the disease and its lab investigation for its confirmation.

Rocky Mountain Spotted Fever

i.Any reported fever and one or more of the following:

rash,headache,myalgia,anemia,thrombocytopenia, or any hepatic transaminase evaluation

ii.CDC,"National Mountain Spotted Fever Case definition",2008

iii.Rocky Mountain Spotted Fever(RMSF) is the most lethal and most frrequently reported rickettsial illness in the United States.Initial signs and symptoms of the disease include sudden onset of fever,headache, and muscle pain,followed by development of rash

iv.Wikepedia,"Rocky Mountain Spotted Fever",2018

v.In my view the more absolute definition for this disease is given by Wikipedia,in their definition they are describing regarding the typeof illness