# Table: Text-based Syndrome Case Definitions and Associated Category A Conditions

+-------------+--------------------------------------------+----------+
| *           | **Definition**                             | **       |
| *Syndrome** |                                            | Category |
|             |                                            | A        |
|             |                                            | Con      |
|             |                                            | dition** |
+=============+============================================+==========+
| Bo          | ACUTE condition that may represent         | Botulism |
| tulism-like | exposure to botulinum toxin                |          |
|             |                                            |          |
|             | ACUTE paralytic conditions consistent with |          |
|             | botulism: cranial nerve VI (lateral        |          |
|             | rectus) palsy, ptosis, dilated pupils,     |          |
|             | decreased gag reflex, media rectus palsy.  |          |
|             |                                            |          |
|             | ACUTE descending motor paralysis           |          |
|             | (including muscles of respiration)         |          |
|             |                                            |          |
|             | ACUTE symptoms consistent with botulism:   |          |
|             | diplopia, dry mouth, dysphagia, difficulty |          |
|             | focusing to a near point.                  |          |
+-------------+--------------------------------------------+----------+
| Hemorrhagic | SPECIFIC diagnosis of any virus that       | VHF      |
| Illness     | causes viral hemorrhagic fever (VHF):      |          |
|             | yellow fever, dengue, Rift Valley fever,   |          |
|             | Crimean-Congo HF, Kyasanur Forest disease, |          |
|             | Omsk HF, Hantaan, Junin, Machupo, Lassa,   |          |
|             | Marburg, Ebola                             |          |
|             |                                            |          |
|             | ACUTE condition with multiple organ        |          |
|             | involvement that may be consistent with    |          |
|             | exposure to any virus that causes VHF      |          |
|             |                                            |          |
|             | ACUTE blood abnormalities consistent with  |          |
|             | VHF: leukopenia, neutropenia,              |          |
|             | thrombocytopenia, decreased clotting       |          |
|             | factors, albuminuria                       |          |
+-------------+--------------------------------------------+----------+
| Ly          | ACUTE regional lymph node swelling and/ or | Plague   |
| mphadenitis | infection (painful bubo- particularly in   | (        |
|             | groin, axilla or neck)                     | Bubonic) |
+-------------+--------------------------------------------+----------+
| Localized   | SPECIFIC diagnosis of localized cutaneous  | Anthrax  |
| Cutaneous   | lesion/ ulcer consistent with cutaneous    | (cu      |
| Lesion      | anthrax or tularemia                       | taneous) |
|             |                                            |          |
|             | ACUTE localized edema and/ or cutaneous    | T        |
|             | lesion/ vesicle, ulcer, eschar that may be | ularemia |
|             | consistent with cutaneous anthrax or       |          |
|             | tularemia                                  |          |
|             |                                            |          |
|             | INCLUDES insect bites                      |          |
|             |                                            |          |
|             | EXCLUDES any lesion disseminated over the  |          |
|             | body or generalized rash                   |          |
|             |                                            |          |
|             | EXCLUDES diabetic ulcer and ulcer          |          |
|             | associated with peripheral vascular        |          |
|             | disease                                    |          |
+-------------+--------------------------------------------+----------+
| Gastr       | ACUTE infection of the upper and/ or lower | Anthrax  |
| ointestinal | gastrointestinal (GI) tract                | (g       |
|             |                                            | astroint |
|             | SPECIFIC diagnosis of acute GI distress    | estinal) |
|             | such as Salmonella gastroenteritis         |          |
|             |                                            |          |
|             | ACUTE non-specific symptoms of GI distress |          |
|             | such as nausea, vomiting, or diarrhea      |          |
|             |                                            |          |
|             | EXCLUDES any chronic conditions such as    |          |
|             | inflammatory bowel syndrome                |          |
+-------------+--------------------------------------------+----------+
| Respiratory | ACUTE infection of the upper and/ or lower | Anthrax  |
|             | respiratory tract (from the oropharynx to  | (inhal   |
|             | the lungs, includes otitis media)          | ational) |
|             |                                            |          |
|             | SPECIFIC diagnosis of acute respiratory    | T        |
|             | tract infection (RTI) such as pneumonia    | ularemia |
|             | due to parainfluenza virus                 |          |
|             |                                            | Plague   |
|             | ACUTE non-specific diagnosis of RTI such   | (pn      |
|             | as sinusitis, pharyngitis, laryngitis      | eumonic) |
|             |                                            |          |
|             | ACUTE non-specific symptoms of RTI such as |          |
|             | cough, stridor, shortness of breath,       |          |
|             | throat pain                                |          |
|             |                                            |          |
|             | EXCLUDES chronic conditions such as        |          |
|             | chronic bronchitis, asthma without acute   |          |
|             | exacerbation, chronic sinusitis, allergic  |          |
|             | conditions (Note: INCLUDE *acute           |          |
|             | exacerbation* of chronic illnesses.)       |          |
+-------------+--------------------------------------------+----------+
| N           | ACUTE neurological infection of the        | Not      |
| eurological | central nervous system (CNS)               | ap       |
|             |                                            | plicable |
|             | SPECIFIC diagnosis of acute CNS infection  |          |
|             | such as pneumoccocal meningitis, viral     |          |
|             | encephailitis                              |          |
|             |                                            |          |
|             | ACUTE non-specific diagnosis of CNS        |          |
|             | infection such as meningitis not otherwise |          |
|             | specified (NOS), encephailitis NOS,        |          |
|             | encephalopathy NOS                         |          |
|             |                                            |          |
|             | ACUTE non-specific symptoms of CNS         |          |
|             | infection such as meningismus, delerium    |          |
|             |                                            |          |
|             | EXCLUDES any chronic, hereditary or        |          |
|             | degenerative conditions of the CNS such as |          |
|             | obstructive hydrocephalus, Parkinson's,    |          |
|             | Alzheimer's                                |          |
+-------------+--------------------------------------------+----------+
| Rash        | ACUTE condition that may present as        | Smallpox |
|             | consistent with smallpox (macules,         |          |
|             | papules, vesicles predominantly of         |          |
|             | face/arms/legs)                            |          |
|             |                                            |          |
|             | SPECIFIC diagnosis of acute rash such as   |          |
|             | chicken pox in person \> XX years of age   |          |
|             | (base age cut-off on data interpretation)  |          |
|             | or smallpox                                |          |
|             |                                            |          |
|             | ACUTE non-specific diagnosis of rash       |          |
|             | compatible with infectious disease, such   |          |
|             | as viral exanthem                          |          |
|             |                                            |          |
|             | EXCLUDES allergic or inflammatory skin     |          |
|             | conditions such as contact or seborrheaic  |          |
|             | dermatitis, rosacea                        |          |
|             |                                            |          |
|             | EXCLUDES rash NOS, rash due to poison ivy, |          |
|             | sunburn, and eczema                        |          |
+-------------+--------------------------------------------+----------+
| Specific    | ACUTE infection of known cause not covered | Not      |
| Infection   | in other syndrome groups, usually has more | ap       |
|             | generalized symptoms (i.e., not just       | plicable |
|             | respiratory or gastrointestinal)           |          |
|             |                                            |          |
|             | INCLUDES septicemia from known bacteria    |          |
|             |                                            |          |
|             | INCLUDES other febrile illnesses such as   |          |
|             | scarlet fever                              |          |
+-------------+--------------------------------------------+----------+
| Fever       | ACUTE potentially febrile illness of       | Not      |
|             | origin not specified                       | ap       |
|             |                                            | plicable |
|             | INCLUDES fever and septicemia not          |          |
|             | otherwise specified                        |          |
|             |                                            |          |
|             | INCLUDES unspecified viral illness even    |          |
|             | though unknown if fever is present         |          |
|             |                                            |          |
|             | EXCLUDE entry in this syndrome category if |          |
|             | more specific diagnostic code is present   |          |
|             | allowing same patient visit to be          |          |
|             | categorized as respiratory, neurological   |          |
|             | or gastrointestinal illness syndrome       |          |
+-------------+--------------------------------------------+----------+
| Severe      | ACUTE onset of shock or coma from          | Not      |
| Illness or  | potentially infectious causes              | ap       |
| Death       |                                            | plicable |
| potentially | EXCLUDES shock from trauma                 |          |
| due to      |                                            |          |
| infectious  | INCLUDES SUDDEN death, death in emergency  |          |
| disease     | room, intrauterine deaths, fetal death,    |          |
|             | spontaneous abortion, and still births     |          |
|             |                                            |          |
|             | EXCLUDES induced fetal abortions, deaths   |          |
|             | of unknown cause, and unattended deaths    |          |
+-------------+--------------------------------------------+----------+